Genetic Testing for Opioid Pain Management: A Primer.
Genetic Testing for Opioid Pain Management: A Primer.
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DOI：
10.1007/s40122-017-0069-2
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发表时间：
2017-06
期刊：
影响因子：
4
通讯作者：
Trescot A
中科院分区：
文献类型：
--
作者：
Agarwal D;Udoji MA;Trescot A
患者看到他们的初级保健医生（PCP）的各种医疗条件，慢性疼痛是最常见的之一。处方药（特别是阿片类药物）的使用增加导致药物不良反应增加，并提高了我们对药物反应变异性的认识。阿片类药物和其他疼痛佐剂被广泛使用，涉及这些镇痛药的药物相互作用可能是有问题的，并可能致命。药物遗传学提高了我们对药物疗效和反应的理解，为个体化的医疗管理打开了大门，并产生了一系列伦理和经济方面的考虑。由于这是一个相对较新的领域，基因检测尚未完全纳入初级保健环境。本文的目的是回顾常用阿片类药物的代谢，讨论经济和伦理问题，并为PCP提供如何将基因检测纳入常规使用以改善临床实践和患者管理的理解。
Patients see their primary care physicians (PCPs) for a variety of medical conditions, chronic pain being one of the most common. An increased use of prescription medications (especially opioids) has led to an increase in adverse drug reactions and has heightened our awareness of the variability in response to medications. Opioids and other pain adjuvants are widely used, and drug–drug interactions involving these analgesics can be problematic and potentially lethal. Pharmacogenetics has improved our understanding of drug efficacy and response, opened doors to individual tailoring of medical management, and created a series of ethical and economic considerations. Since it is a relatively new field, genetic testing has not been fully integrated into the primary care setting. The purpose of this paper is to review the metabolism of commonly prescribed opioids, discuss the economic and ethical issues, and provide PCPs with an understanding of how to incorporate genetic testing into routine use to improve clinical practice and patient management.