keyword
https://read.qxmd.com/read/38479169/impact-of-pharmacogenomic-profiles-on-post-surgical-pain-following-laparotomy-for-gynecologic-pathology
#1
JOURNAL ARTICLE
Gretchen E Glaser, Brandon Maddy, Amanika Kumar, Karen Ishitani, Maureen A Lemens, Kristine Hanson, Ann M Moyer, Elizabeth Habermann, Sean C Dowdy
OBJECTIVES: The aim of this prospective study was to compare perioperative opioid use in women by status of CYP2D6, a highly polymorphic pharmacogene relevant to opioid metabolism. METHODS: Patients undergoing laparotomy were prospectively recruited and provided a preoperative saliva swab for a pharmacogenomic (PGx) gene panel. Postoperative opioid usage and pain scores were evaluated via chart review and a phone survey. Pharmacogenes known to be relevant to opioid metabolism were genotyped, and opioid metabolizing activity predicted by CYP2D6 genotyping...
March 12, 2024: Gynecologic Oncology
https://read.qxmd.com/read/38313794/the-impact-of-opioid-receptor-gene-polymorphism-on-fentanyl-and-alfentanil-s-analgesic-effects-in-the-pediatric-perioperative-period
#2
JOURNAL ARTICLE
Jelena Lilic, Vesna G Marjanovic, Ivana Budic, Nikola Stefanovic, Dragana Stokanovic, Goran T Marjanovic, Tatjana Jevtovic-Stoimenov, Mladjan Golubovic, Maja Zecevic, Radmila Velickovic-Radovanovic
INTRODUCTION: The polymorphism of the gene coding mu-opioid receptor ( OPRM1 ) is one of the factors contributing to the variability in the response to opioid analgesics in children. The goal of this study is to investigate its role in association with postoperative acute pain in children of various ages. METHODS: This prospective study analyzed 110 pediatric patients, after plastic or orthopedic surgery, who were genotyped and randomly assigned to receive fentanyl or alfentanil...
2024: Pharmacogenomics and Personalized Medicine
https://read.qxmd.com/read/38254077/a-consideration-of-cyp2d6-genetic-variations-in-the-ghanaian-population-as-a-potential-culprit-for-the-tramadol-abuse-crisis
#3
JOURNAL ARTICLE
Nicholas Ekow Thomford, Susanna Aba Abraham, Samuel Badu Nyarko, Robert Peter Biney
BACKGROUND: Cytochrome P450 2D6 is involved in the metabolism of several important medicines including opioids. Variations in CYP2D6 have been implicated in drug response and according to the Clinical Pharmacogenetics Implementation Consortium Guideline (CPIC) for CYP2D6, dosing for CYP2D6 substrates should be based on variants carried by individuals. Although CYP2D6 variations in Ghana had been previously recorded, not all variants have been reported in the Ghanaian population. In this exploratory study we set to investigate certain unreported variations in the Ghanaian population in addition to the previously reported ones and use that to understand the tramadol 'abuse' crisis that is currently being experienced in Ghana...
January 22, 2024: BMC Medical Genomics
https://read.qxmd.com/read/38126330/effect-of-gene-variants-on-opioid-dose-pain-and-adverse-effect-outcomes-in-advanced-cancer-an-explorative-study
#4
JOURNAL ARTICLE
Aaron K Wong, Pal Klepstad, Andrew A Somogyi, Sara Vogrin, Brian Le, Jennifer Philip, Justin P Rubio
Aim: Associations between gene variants and opioid net effect are unclear. We conducted an exploratory pharmacogenetic analysis of 35 gene variants and opioid response in advanced cancer. Patients & methods: This multi-center prospective cohort study included clinical data, questionnaires (pain and adverse effects) and DNA (blood). Negative binomial regression and logistic regression were used. Results: Within 54 participants, eight statistically significant associations (p = 0.002-0.038) were observed between gene variants and opioid dose, pain scores or adverse effects, the majority being within the neuroimmune TLR4 pathway (IL1B [rs1143634], IL2 [rs2069762], IL6 [rs1800795], BDNF [rs6265]) and ARRB2 pathway (ARRB2 [rs3786047], DRD2 [rs6275])...
December 21, 2023: Pharmacogenomics
https://read.qxmd.com/read/38081553/pain-and-opioid-use-following-total-knee-arthroplasty-psycho-social-factors-are-more-predictive-than-pharmacogenomics
#5
JOURNAL ARTICLE
Richard L Wixson, Henry M Dunnenberger, David M Dickerson, Alexander J Tauchen, Claire Heshmat, Jason L Koh
BACKGROUND: This prospective, observational study was designed to assess the phenotype variation of the genes associated with pain and opioid use following total knee arthroplasty in comparison to psycho-social elements. METHODS: Preoperative demographic data and Patient-Reported Outcomes Measurement Information System (PROMIS)-43 scores were obtained on 305 elective total knee arthroplasty patients. Patient visual analog scale (VAS) pain scores and opioid use were extracted from the hospital record...
December 9, 2023: Journal of Arthroplasty
https://read.qxmd.com/read/38028431/precision-integrative-medicine-for-pain-management-in-sickle-cell-disease
#6
REVIEW
Wally R Smith, Cecelia R Valrie, Cheedy Jaja, Martha O Kenney
Sickle cell disease (SCD) is a prevalent and complex inherited pain disorder that can manifest as acute vaso-occlusive crises (VOC) and/or chronic pain. Despite their known risks, opioids are often prescribed routinely and indiscriminately in managing SCD pain, because it is so often severe and debilitating. Integrative medicine strategies, particularly non-opioid therapies, hold promise in safe and effective management of SCD pain. However, the lack of evidence-based methods for managing SCD pain hinders the widespread implementation of non-opioid therapies...
2023: Front Pain Res (Lausanne)
https://read.qxmd.com/read/38027465/effects-of-pharmacogenetic-profiles-on-pediatric-pain-relief-and-adverse-events-with-ibuprofen-and-oxycodone
#7
JOURNAL ARTICLE
Samina Ali, Aran Yukseloglu, Colin J Ross, Rhonda J Rosychuk, Amy L Drendel, Robin Manaloor, David W Johnson, Sylvie Le May, Bruce Carleton
INTRODUCTION: Individual genetic variation may influence clinical effects for pain medications. Effects of CYP2C9, CYP3A4, and CYP2D6 polymorphisms on clinical effectiveness and safety for ibuprofen and oxycodone were studied. OBJECTIVE: Primary objectives were to AU2 evaluate if allelic variations would affect clinical effectiveness and adverse events (AEs) occurrence. METHODS: This pragmatic prospective, observational cohort included children aged 4 to 16 years who were seen in a pediatric emergency department with an acute fracture and prescribed ibuprofen or oxycodone for at-home pain management...
December 2023: Pain Reports
https://read.qxmd.com/read/37940651/cytochrome-p450-2d6-activity-in-people-with-codeine-use-disorder
#8
JOURNAL ARTICLE
Mark R C Daglish, Sarah R Reilly, Sam Mostafa, Cameron Edwards, Thomas M O'Gorman, Jeremy S Hayllar
Compound-analgesics containing codeine (CACC) have been a common source of codeine for people seeking opioid replacement therapy (ORT) for codeine use disorder (CUD). Our previous work demonstrated no relationship between pre-treatment CACC and ORT buprenorphine doses; we hypothesised that CYP2D6 activity would partially account for this disconnection. One hundred six participants with CUD were compared to a published population sample of 5408 Australian patients. Mean age of participants with CUD at treatment entry was 35 years, with mean 6...
November 9, 2023: Pharmacogenomics Journal
https://read.qxmd.com/read/37802488/serum-lidocaine-lignocaine-concentrations-during-prolonged-perioperative-infusion-in-patients-undergoing-breast-cancer-surgery-a-secondary-analysis-of-a-randomised-controlled-trial
#9
RANDOMIZED CONTROLLED TRIAL
Andrew J Toner, Martin A Bailey, Stephan A Schug, Michael Phillips, Jacobus Pj Ungerer, Andrew A Somogyi, Tomas B Corcoran
Perioperative lidocaine (lignocaine) infusions are being employed with increasing frequency. The determinants of systemic lidocaine concentrations during prolonged administration are unclear. In the Long-term Outcomes after Lidocaine Infusions for PostOperative Pain (LOLIPOP) pilot trial, the impact of infusion duration and body size metrics on serum lidocaine concentrations was examined with regression models in 48 women undergoing breast cancer surgery. Lidocaine was delivered as an intravenous bolus (1.5 mg/kg) and infusion (2 mg/kg per h) intraoperatively, followed by a 12-h subcutaneous infusion (1...
November 2023: Anaesthesia and Intensive Care
https://read.qxmd.com/read/37797454/historical-perspectives-and-recent-advances-in-small-molecule-ligands-of-selective-biased-multi-targeted-%C3%AE-%C3%AE-%C3%AE%C2%BA-opioid-receptor-2019-2022
#10
REVIEW
Ye He, Qian Su, Liyun Zhao, Lijuan Zhang, Lu Yu, Jianyou Shi
The opioids have been used for more than a thousand years and are not only the most widely prescribed drugs for moderate to severe pain and acute pain, but also the preferred drugs. However, their non-analgesic effects, especially respiratory depression and potential addiction, are important factors that plague the safety of clinical use and are an urgent problem for pharmacological researchers to address. Current research on analgesic drugs has evolved into different directions: de-opioidization; application of pharmacogenomics to individualize the use of opioids; development of new opioids with less adverse effects...
September 20, 2023: Bioorganic Chemistry
https://read.qxmd.com/read/37705211/a-pilot-study-to-identify-pharmacogenomic-and-clinical-risk-factors-associated-with-opioid-related-falls-and-adverse-effects-in-older-adults
#11
JOURNAL ARTICLE
Sophia Sheikh, Rosemarie Fernandez, Carmen Smotherman, Jennifer Brailsford, Taimour Langaee, Esteban Velasquez, Morgan Henson, Taylor Munson, Andrew Bertrand, Phyllis Hendry, Stephen Anton, Roger B Fillingim, Larisa H Cavallari
Given the high prevalence of pain in older adults and current trends in opioid prescribing, inclusion of genetic information in risk prediction tools may improve opioid risk assessment. Our objectives were to (1) determine the feasibility of recruiting socioeconomically disadvantaged and racially diverse middle aged and older adult populations for a study seeking to identify risk factors for opioid-related falls and other serious adverse effects and (2) explore potential associations between the Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (CIP-RIOSORD) risk class and other patient factors with falls and serious opioid adverse effects...
September 13, 2023: Clinical and Translational Science
https://read.qxmd.com/read/37698371/cyp2d6-guided-opioid-therapy-for-adults-with-cancer-pain-a%C3%A2-randomized-implementation-clinical-trial
#12
RANDOMIZED CONTROLLED TRIAL
Scott A Mosley, Emily Cicali, Alex Del Cueto, Diane G Portman, Kristine A Donovan, Yan Gong, Taimour Langaee, Priya Gopalan, Jessica Schmit, Jason S Starr, Natalie Silver, Young D Chang, Sahana Rajasekhara, Joshua E Smith, Heloisa P Soares, Michael Clare-Salzler, Petr Starostik, Thomas J George, Howard L McLeod, Roger B Fillingim, J Kevin Hicks, Larisa H Cavallari
INTRODUCTION: The CYP2D6 enzyme metabolizes opioids commonly prescribed for cancer-related pain, and CYP2D6 polymorphisms may contribute to variability in opioid response. We evaluated the feasibility of implementing CYP2D6-guided opioid prescribing for patients with cancer and reported pilot outcome data. METHODS: Adult patients from two cancer centers were prospectively enrolled into a hybrid implementation-effectiveness clinical trial and randomized to CYP2D6-genotype-guided opioid selection, with clinical recommendations, or usual care...
December 2023: Pharmacotherapy
https://read.qxmd.com/read/37679047/hydrocodone-oxycodone-and-morphine-metabolism-and-drug-drug-interactions
#13
JOURNAL ARTICLE
Shelby Coates, Philip Lazarus
Awareness of drug interactions involving opioids is critical for patient treatment as they are common therapeutics used in numerous care settings including both chronic and disease related pain. Not only do opioids have narrow therapeutic indexes and are extensively used, but they have the potential to cause severe toxicity. Opioids are the classical pain treatment for patients who suffer from moderate to severe pain. More importantly, opioids are often prescribed in combination with multiple other drugs, especially in patient populations who typically are prescribed a large drug regimen...
September 7, 2023: Journal of Pharmacology and Experimental Therapeutics
https://read.qxmd.com/read/37594401/does-preoperative-pharmacogenomic-testing-of-patients-undergoing-tka-improve-postoperative-pain-a-randomized-trial
#14
RANDOMIZED CONTROLLED TRIAL
Molly B Kraus, Joshua S Bingham, Adrijana Kekic, Colby Erickson, Christopher B Grilli, David P Seamans, David P Upjohn, Joseph G Hentz, Henry D Clarke, Mark J Spangehl
BACKGROUND: Pharmacogenomics is an emerging and affordable tool that may improve postoperative pain control. One challenge to successful pain control is the large interindividual variability among analgesics in their efficacy and adverse drug events. Whether preoperative pharmacogenomic testing is worthwhile for patients undergoing TKA is unclear. QUESTIONS/PURPOSES: (1) Are the results of preoperative pharmacogenetic testing associated with lower postoperative pain scores as measured by the Overall Benefit of Analgesic Score (OBAS)? (2) Do the results of preoperative pharmacogenomic testing lead to less total opioids given? (3) Do the results of preoperative pharmacogenomic testing lead to changes in opioid prescribing patterns? METHODS: Participants of this randomized trial were enrolled from September 2018 through December 2021 if they were aged 18 to 80 years and were undergoing primary TKA under general anesthesia...
February 1, 2024: Clinical Orthopaedics and related Research
https://read.qxmd.com/read/37587271/genome-wide-association-study-on-pharmacological-outcomes-of-musculoskeletal-pain-in-uk-biobank
#15
JOURNAL ARTICLE
Song Li, Geert Poelmans, Regina L M van Boekel, Marieke J H Coenen
The pharmacological management of musculoskeletal pain starts with NSAIDs, followed by weak or strong opioids until the pain is under control. However, the treatment outcome is usually unsatisfying due to inter-individual differences. To investigate the genetic component of treatment outcome differences, we performed a genome-wide association study (GWAS) in ~23,000 participants with musculoskeletal pain from the UK Biobank. NSAID vs. opioid users were compared as a reflection of the treatment outcome of NSAIDs...
August 16, 2023: Pharmacogenomics Journal
https://read.qxmd.com/read/37537419/neonatal-opioid-toxicity-opioid-withdrawal-abstinence-syndrome-with-emphasis-on-pharmacogenomics-and-respiratory-depression
#16
REVIEW
Brian A Baldo
The increasing use of opioids in pregnant women has led to an alarming rise in the number of cases of neonates with drug-induced withdrawal symptoms known as neonatal opioid withdrawal syndrome (NOWS). NOWS is a toxic heterogeneous condition with many neurologic, autonomic, and gastrointestinal symptoms including poor feeding, irritability, tachycardia, hypertension, respiratory defects, tremors, hyperthermia, and weight loss. Paradoxically, for the management of NOWS, low doses of morphine, methadone, or buprenorphine are administered...
October 2023: Archives of Toxicology
https://read.qxmd.com/read/37531096/short-acting-versus-long-acting-opioids-for-pediatric-postoperative-pain-management
#17
REVIEW
Yun Han Chen, Senthilkumar Sadhasivam, Spencer DeMedal, Mihaela Visoiu
INTRODUCTION: Opioids are potent analgesics commonly used to manage children's moderate to severe perioperative pain in children. A wide range of short and long-acting opioids are used to treat surgical pain and will be reviewed in this article. AREAS COVERED: Both short- and long-acting opioids contain unique therapeutic benefits and adverse effects; however, due to the side effect profile and safety concerns, lack of familiarity, and evidence with long-acting opioids to treat surgical pain, shorter-acting opioids have traditionally been used in children...
August 2, 2023: Expert Review of Clinical Pharmacology
https://read.qxmd.com/read/37251329/an-updated-examination-of-the-perception-of-barriers-for-pharmacogenomics-implementation-and-the-usefulness-of-drug-gene-pairs-in-latin-america-and-the-caribbean
#18
JOURNAL ARTICLE
Aimeé Salas-Hernández, Macarena Galleguillos, Matías Carrasco, Andrés López-Cortés, María Ana Redal, Dora Fonseca-Mendoza, Patricia Esperón, Farith González-Martínez, Ismael Lares-Asseff, Alberto Lazarowski, Verónica Loera-Castañeda, Diadelis Remírez, Matías F Martínez, Rodrigo Vargas, Fabricio Rios-Santos, Antonio Macho, Juan P Cayún, Germán R Perez, Carolina Gutierrez, Leslie C Cerpa, Tamara Leiva, Susan Calfunao, Lesly Xajil, Christopher Sandoval, Marcelo Suárez, Ariana Gonzalez, Gabriela Echeverría-Garcés, Luis Sullón-Dextre, Eugenia Cordero-García, Alexis R Morales, Andrea Avendaño, Enrique Sánchez, Laura C Bastone, Cesar Lara, Patricia Zuluaga-Arias, Ana María Soler, Julio Da Luz, Gabriela Burgueño-Rodríguez, Marcelo Vital, Elizabeth Reyes-Reyes, Alexander Huaccha, Yeimy V Ariza, Naomi Tzul, Ana L Rendón, Roberto Serrano, Larissa Acosta, Angelo Motta-Pardo, Leonardo Beltrán-Angarita, Erika Brand, Miguel A Jiménez, Gladys Maribel Hidalgo-Lozada, Marina M J Romero-Prado, Karla Escobar-Castro, Mariel Umaña-Rivas, Juan D Vivas, Paola Lagos, Yineth Ballén Martínez, Sharleth Quesada, Camila Calfio, Maria L Arias, María A Lavanderos, Dante D Cáceres, Alberto Salazar-Granara, Nelson M Varela, Luis A Quiñones
Pharmacogenomics (PGx) is considered an emergent field in developing countries. Research on PGx in the Latin American and the Caribbean (LAC) region remains scarce, with limited information in some populations. Thus, extrapolations are complicated, especially in mixed populations. In this paper, we reviewed and analyzed pharmacogenomic knowledge among the LAC scientific and clinical community and examined barriers to clinical application. We performed a search for publications and clinical trials in the field worldwide and evaluated the contribution of LAC...
2023: Frontiers in Pharmacology
https://read.qxmd.com/read/37248824/pharmacogenetics-of-pain-management-in-zimbabwean-patients-with-sickle-cell-disease
#19
JOURNAL ARTICLE
Nyasha Lorraine Mapira, Roslyn Stella Thelingwani, Zedias Chikwambi, Patience Kuona, Collen Masimirembwa
Background: Pain is a common cause of hospitalization in sickle cell disease (SCD) patients. Failure to effectively control pain remains a challenge in patient care. Materials & methods: The authors conducted a cross-sectional study to determine the effect of CYP2D6 and UGT2B7 polymorphisms on pain management in 106 Zimbabwean SCD patients. Participant information was collected on a questionnaire. Genotyping was conducted using the GenoPharm® pharmacogenomics open array panel containing CYP2D6 and UGT genetic variants implicated in opioid response...
May 30, 2023: Pharmacogenomics
https://read.qxmd.com/read/37239755/digital-therapeutics-dtx-expand-multimodal-treatment-options-for-chronic-low-back-pain-the-nexus-of-precision-medicine-patient-education-and-public-health
#20
JOURNAL ARTICLE
Aarushi Rohaj, Grzegorz Bulaj
Digital therapeutics (DTx, software as a medical device) provide personalized treatments for chronic diseases and expand precision medicine beyond pharmacogenomics-based pharmacotherapies. In this perspective article, we describe how DTx for chronic low back pain (CLBP) can be integrated with pharmaceutical drugs (e.g., NSAIDs, opioids), physical therapy (PT), cognitive behavioral therapy (CBT), and patient empowerment. An example of an FDA-authorized DTx for CLBP is RelieVRx, a prescription virtual reality (VR) app that reduces pain severity as an adjunct treatment for moderate to severe low back pain...
May 18, 2023: Healthcare (Basel, Switzerland)
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