Complicated pain management in a CYP450 2D6 poor metabolizer

Adriana Elena Foster, Elizabeth Mobley, Zixuan Wang

Research output: Contribution to journalReview article

56 Citations (Scopus)

Abstract

We describe the case of a patient with significant adverse effects from posttraumatic analgesic therapy with opioid analgesics who was found by microarray analysis to have a CYP2D6 genotype predictive of a poor metabolizer phenotype. In addition to her poor tolerance and limited response to opioid analgesics, she developed further discomfort when the antiemetic promethazine was administered to treat her gastrointestinal adverse effects. In our discussion we review the literature about the clinical impact of CYP450 2D6 polymorphisms in treatment with the commonly used opioid analgesics codeine, oxycodone, hydrocodone, hydromorphone, and morphine, as well as the antiemetic promethazine. The case we present, as well as the literature we review, demonstrates the clinical utility of CYP2D6 genotyping in patients with adverse effects from analgesia therapy.

Original languageEnglish (US)
Pages (from-to)352-356
Number of pages5
JournalPain Practice
Volume7
Issue number4
DOIs
StatePublished - Dec 1 2007

Fingerprint

Pain Management
Opioid Analgesics
Promethazine
Cytochrome P-450 CYP2D6
Antiemetics
Hydrocodone
Hydromorphone
Oxycodone
Codeine
Microarray Analysis
Analgesia
Morphine
Analgesics
Therapeutics
Genotype
Phenotype

Keywords

  • Antiemetic
  • CYP2D6 poor metabolizer
  • Cytochrome P450
  • Opioid
  • Pain

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Complicated pain management in a CYP450 2D6 poor metabolizer. / Foster, Adriana Elena; Mobley, Elizabeth; Wang, Zixuan.

In: Pain Practice, Vol. 7, No. 4, 01.12.2007, p. 352-356.

Research output: Contribution to journalReview article

Foster, Adriana Elena ; Mobley, Elizabeth ; Wang, Zixuan. / Complicated pain management in a CYP450 2D6 poor metabolizer. In: Pain Practice. 2007 ; Vol. 7, No. 4. pp. 352-356.
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