Pharmacogenomics of Pain Management: The Impact of Specific Biological Polymorphisms on Drugs and Metabolism

AbstractPurpose of ReviewPain is multifactorial and complex, often with a genetic component. Pharmacogenomics is a relative new field, which allows for the development of a truly unique and personalized therapeutic approach in the treatment of pain.Recent FindingsUntil recently, drug mechanisms in humans were determined by testing that drug in a population and calculating response averages. However, some patients will inevitably fall outside of those averages, and it is nearly impossible to predict who those outliers might be. Pharmacogenetics considers a patient ’s unique genetic information and allows for anticipation of that individual’s response to medication.SummaryPharmacogenomic testing is steadily making progress in the management of pain by being able to identify individual differences in the perception of pain and susceptibility and sensitivity to drugs based on genetic markers. This has a huge potential to increase efficacy and reduce the incidence of iatrogenic drug dependence and addiction. The streamlining of relevant polymorphisms of genes encoding receptors, transporters, and drug-metabolizing enzymes influencing the pain phenotype can be an important guide to develop safe new strategies and approaches to personalized pain management. Additionally, some challenges still prevail and preclude adoption of pharmacogenomic testing universally. These include lack of knowledge about pharmacogenomic testing, inadequate standardization of the process of dat...
Source: Current Oncology Reports - Category: Cancer & Oncology Source Type: research

Related Links:

BACKGROUND: Chronic pain affects approximately 22% of the world's population. Opioids can be useful in chronic pain management. However, some patients have negative perception of opioids. The purpose of this research was to evaluate patients' perception ab...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
Conclusions: Perception of opioids among patients who take them was either neutral or positive. However, 39.0% patients who have not been prescribed opioids did not want an opioid prescription, citing fear of addiction and side effects as the primary reasons. PMID: 32606268 [PubMed]
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
Prescription opioids account for over 70% of opioid addiction and more than 50% of opioid related deaths. Interventions have focused on efforts to reduce outpatient prescribing, but limited focus on inpatient prescribing. A survey of general internal medicine residents found that 17% have a system for daily pain assessment and 25% rarely or never evaluated their patients ’ total oral morphine equivalents (OME). The lack of standardization was considered a factor that lead to inconsistent opioid prescribing practices.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
Pain and opioid management are core ambulatory palliative care skills. Existing literature on how to manage opioid misuse/use disorder excludes patients found in palliative care settings, such as individuals with serious illness (e.g., cancer) or those near the end of life.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
By LINDA T. HAND Every day, we make thousands of choices. Some of them – even those that seem trivial at the time – will change the course of our lives. This concept was memorably illustrated in the 1998 film Sliding Doors, which imagined two very different paths for Gywneth Paltrow’s character, Helen, based entirely on whether or not she makes or misses the London Tube on her commute home—the film’s eponymous sliding doors.  Helen doesn’t have the luxury of weighing her possible futures and altering her choices accordingly, perhaps quickening her pace or stopping for a la...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Health Tech Health Technology Linda Hand Prealize Health proactive healthcare Source Type: blogs
Abstract The diagnosis of opioid use disorder (OUD) is often overlooked or inadequately managed during the inpatient admission. When recognized, a common strategy is opioid detoxification, an approach that is often ineffective and can be potentially dangerous because of loss of tolerance and subsequent risk for overdose. Medication for addiction treatment (MAT), including methadone and buprenorphine, is effective and can be dispensed in the hospital for both opioid withdrawal and initiation of maintenance treatment. Hospitalists should be knowledgeable about diagnosing and managing patients with OUD, including how...
Source: The Medical Clinics of North America - Category: General Medicine Authors: Tags: Med Clin North Am Source Type: research
Improving management of postoperative pain following shoulder surgery is vital for optimizing patient outcomes, length of stay, and decreasing addiction to narcotic medications. Multimodal analgesia (i.e. controlling pain via multiple different analgesic methods with differing mechanisms) is an ever-evolving approach to enhancing pain control perioperatively after shoulder surgery. With a variety of options for the shoulder surgeon to turn to, this review will succinctly review the pros and cons of each approach and proposes a potential pain management algorithm.
Source: Journal of Shoulder and Elbow Surgery - Category: Orthopaedics Authors: Tags: Review Article Source Type: research
CONCLUSION: The role of medical school training on opioid prescribing patterns among Ontario physicians differs from that in the United States likely due to greater homogeneity of curricula among Canadian schools. Ensuring physicians trained abroad receive additional pain management/addiction training may help address part of the opioid epidemic in Ontario. PMID: 32508120 [PubMed - as supplied by publisher]
Source: Canadian Journal of Psychiatry - Category: Psychiatry Authors: Tags: Can J Psychiatry Source Type: research
Abstract Management of chronic pain presents a major challenge, since many currently available treatments lack efficacy and have problems such as addiction and tolerance. Loss of function mutations in the SCN9A gene lead to a congenital inability to feel pain, with no other sensory deficits aside from anosmia. SCN9A encodes the voltage-gated sodium (NaV) channel 1.7 (NaV1.7), which has been identified as a primary pain target. However, in developing NaV1.7-targeted analgesics, extreme care must to be taken to avoid off-target activity on other NaV subtypes that are critical for survival. Since spider venoms are an...
Source: Biochemical Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Biochem Pharmacol Source Type: research
Having trouble viewing this email? View it as a Web page. NIDCR's Summer 2020 E-Newsletter In this issue: NIDCR News Funding Opportunities NIH/HHS News Funding Notices Science Advances Subscribe to NICDR News Grantee News   NIDCR News NIDCR Announces Availability of COVID-19 Research Funding On May 5, NIDCR issued two Notices of Special Interest highlighting the urgent need for research on coronavirus disease 2019. This research may be conducted either via the National Dental PBRN infrastruc...
Source: NIDCR Science News - Category: Dentistry Source Type: news
More News: Addiction | Cancer & Oncology | Genetics | Health Insurance | Insurance | Pain | Pain Management