rs4680型
曲马多
羟考酮
氢可酮
可待因
医学
类阿片
药物遗传学
CYP2D6型
药物基因组学
指南
邻苯二酚-O-甲基转移酶
美沙酮
不利影响
药理学
慢性疼痛
麻醉
单核苷酸多态性
阿片类药物使用障碍
精神科
内科学
基因型
吗啡
止痛药
生物
受体
细胞色素P450
病理
基因
新陈代谢
生物化学
作者
Kristine R. Crews,Andrew A. Monte,Rachel Huddart,Kelly E. Caudle,Evan D. Kharasch,Andrea Gaedigk,Henry M. Dunnenberger,J. Steven Leeder,John T. Callaghan,Caroline Flora Samer,Teri E. Klein,Cyrine E. Haidar,Sara L. Van Driest,Gualberto Ruaño,Katrin Sangkuhl,Larisa H. Cavallari,Daniel J. Müller,Cynthia A. Prows,Mohamed Nagy,Andrew A. Somogyi,Todd C. Skaar
摘要
Opioids are mainly used to treat both acute and chronic pain. Several opioids are metabolized to some extent by CYP2D6 (codeine, tramadol, hydrocodone, oxycodone, and methadone). Polymorphisms in CYP2D6 have been studied for an association with the clinical effect and safety of these drugs. Other genes that have been studied for their association with opioid clinical effect or adverse events include OPRM1 (mu receptor) and COMT (catechol-O-methyltransferase). This guideline updates and expands the 2014 Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2D6 genotype and codeine therapy and includes a summation of the evidence describing the impact of CYP2D6, OPRM1, and COMT on opioid analgesia and adverse events. We provide therapeutic recommendations for the use of CYP2D6 genotype results for prescribing codeine and tramadol and describe the limited and/or weak data for CYP2D6 and hydrocodone, oxycodone, and methadone, and for OPRM1 and COMT for clinical use.
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