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Anesthesia

Articles, Videos, and Resources

Implications of Pharmacogenomics for Anesthesia Providers

“The practice of anesthesia has long been considered an art and a science, with interpatient variability in drug response being the rule, rather than the exception. Pharmacogenomics, which studies the role of genetics in drug response, is emerging as a discipline that may impact anesthetic management. The purpose of this review is to provide clinicians […]

Pharmacogenetics Variations in Anesthesia

“Pharmacogenetics is an emerging discipline that attempted to understand the hereditary basis for differences in responsiveness or inter-individual variation to therapeutic agents. It is the study of variability in drug response as a result of heredity factors. The importance for pharmacogenetics for the clinician is to enable optimum therapeutic efficacy, to avoid toxicity of those […]

Principles of pharmacogenetics—implications for the anaesthetist

‘If it were not for the great variability among individuals, medicine might as well be a science and not an art.’ Sir William Osler’s observations in 189260 reflect a perception of medicine over 100 years ago, highlighting the lack of available objective data to make decisions that are tailored to individual patients. One hundred years […]

Pharmacogenomic variability and anaesthesia

The concept of ‘personalized medicine’ in which a knowledge of genetic factors guides prescribing tailored to the individual is popularly considered to be an inevitable consequence of completion of the International Human Genome Project. We should not forget, however, that a personal or family history of one of several uncommon pharmacogenetic conditions has influenced the […]

Presentation: Is it Pharmacogenetics or Pharmacogenomics?

Watch the PowerPoint PPT Presentation “Is it Pharmacogenetics or Pharmacogenomics?”

Special Issue on Pharmacogenomics and Anesthesia: Work Presented at the 2004 Journal Symposium

“IN this issue of Anesthesiology, we mark the beginning of another annual event. Last year, for the first time, the Journal published a “special issue” containing manuscripts of research presented at the Anesthesiology-sponsored Symposium at the Annual Meeting of the American Society of Anesthesiologists. In an accompanying editorial, the Editor-in-Chief, Michael M. Todd, M.D., stated […]

Pharmacogenetics of Anesthetic and Analgesic Agents

“PREDICTING a patient’s response to a particular drug has long been a goal of clinicians. A priori knowledge of which drug and dosage would be most effective for an individual patient, as well as which drugs might provoke idiosyncratic adverse reactions, would greatly facilitate medical care. The significance of such knowledge is highlighted by a […]

Pharmacogenetics and anesthetic drugs.

“The incidence and potential for serious adverse drug reactions (SADRs) in anesthesia are high due to the narrow therapeutic indices of anesthetic and analgesic drugs and high interindividual variability in drug responses. Genetic factors contribute to a majority of these SADRs. Pharmacogenetics (PG), the study of genetic effects on drug action, is strongly related to […]

Implications of pharmacogenomics for anesthesia providers.

“The practice of anesthesia has long been considered an art and a science, with interpatient variability in drug response being the rule, rather than the exception. Pharmacogenomics, which studies the role of genetics in drug response, is emerging as a discipline that may impact anesthetic management. The purpose of this review is to provide clinicians […]

Pharmacogenetics and anaesthesia: the value of genetic profiling

“Approximately 50 years ago, pharmacogenetics was described as a new field of medicine that may explain human drug action. Anaesthesia played a key role in the early investigations. An understanding of how a person’s DNA influences drug metabolism and effectiveness may allow individually tailored prescriptions, improving outcomes and safety. The ultimate goal of pharmacogenetic research […]

Pharmacogenetics and Anesthetic Drugs

“The incidence and potential for serious adverse drug reactions (SADRs) in anesthesia are high due to the narrow therapeutic indices of anesthetic and analgesic drugs and high interindividual variability in drug responses. Genetic factors contribute to a majority of these SADRs. Pharmacogenetics (PG), the study of genetic effects on drug action, is strongly related to […]

Anesthesia and Pharmacogenomics: Not Ready for Prime Time

“The age of interindividualized medicine has been upon us for several years. Pharmacogenomics has made significant contributions to several areas of medicine, including psychiatry, where it may be useful for drug selection, and oncology, where it may play a significant role in predicting drug efficacy and preventing potentially fatal adverse drug reactions.2 Despite its gains […]

Pharmacogenetics of Propofol and Depth of Anesthesia

Propofol, (2,6-diisopropylphenol) is a short-acting anesthetic drug used for induction and maintenance of anesthesia. The aim of this study is to evaluate plasma concentrations of propofol in relation to depth of anesthesia, measured by continuous EEG and to correlate plasma concentrations with genetic analyses of liver enzymes responsible for drug elimination. Our hypothesis is that […]

Pharmacogenetics and Obstetric Anesthesia and Analgesia

Read full “Pharmacogenetics and Obstetric Anesthesia and Analgesia” article by clicking on the link below. By C. Ortner, C. Ciliberto and R. Landau

Contribution of Cytochrome P450 and ABCB1 Genetic Variability on Methadone Pharmacokinetics, Dose Requirements, and Response

“Although the efficacy of methadone maintenance treatment (MMT) in opioid dependence disorder has been well established, the influence of methadone pharmacokinetics in dose requirement and clinical outcome remains controversial. The aim of this study is to analyze methadone dosage in responder and nonresponder patients considering pharmacogenetic and pharmacokinetic factors that may contribute to dosage adequacy. […]

Video: Update on Pharmacogenetics and Nitrous Oxide Toxicity

Watch the “Update on Pharmacogenetics and Nitrous Oxide Toxicity” video by Kirk Hogan, MD, JD.

Pain Management

PGx Articles, Videos, and Resources

Genetic Testing in Pain Medicine

Read full “Genetic Testing in Pain Medicine” article by clicking on the link below. By Andrea M. Trescot, MD

Pharmacogenetic Testing in Pain Medicine: Experts Weigh In

“In what area and how do you think pharmacogenetic testing can have the most clinical impact in pain medicine? Lynn R. Webster, MD: Pharmacogenetic testing can be implemented either proactively, as part of treatment planning, or reactively, to help understand a history of problematic drug responses. Although phenotyping individuals who are either poor metabolizers or […]

Pharmacogenetics of Chronic Pain Management

Objective The experience of chronic pain is one of the commonest reasons individuals seek medical attention, making the management of chronic pain a major issue in clinical practice. Drug metabolism and responses are affected by many factors, with genetic variations offering only a partial explanation of an individual’s response. There is a paucity of evidence […]

Interview: Could genetic testing help doctors treat pain more effectively?

“Approximately $300 billion is wasted each year on drugs that do not work in people who carry certain genes, according to experts. These people never receive the full benefit from these drugs, while others experience dangerous side effects. In order to treat individuals who have had many failures with drugs, some doctors are turning towards […]

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for Codeine Therapy in the Context of Cytochrome P450 2D6 (CYP2D6) Genotype

“Codeine is bioactivated to morphine, a strong opioid agonist, by the hepatic cytochrome P450 2D6 (CYP2D6); hence, the efficacy and safety of codeine as an analgesic are governed by CYP2D6 polymorphisms. Codeine has little therapeutic effect in patients who are CYP2D6 poor metabolizers, whereas the risk of morphine toxicity is higher in ultrarapid metabolizers. The […]

Using Pharmacogenetic Testing in a Pain Practice

“Pharmacogenetic testing (PGT) is an objective clinical tool that has the potential to help clinicians improve treatment in many areas of medicine, including pain management. PGT can be a vital component of personalized medicine, assisting clinicians in choosing medications based on patient genetics to increase benefit and decreased risks. PGT also can be a valuable […]

Pharmacogenetics and pain management: an opportunity to advance personalized patient care

“Chronic pain affects approximately 100 million U.S. adults at a cost of up to $635 billion annually in direct medical costs and lost productivity. As clinicians attempt to reduce pain and improve functionality in patients with chronic pain, pharmacotherapy remains a cornerstone of treatment. Typically, several medications with different mechanisms of action are employed to […]

VIDEO: Understanding Pain Management and Pharmacogenomics

Watch the “Understanding Pain Management and Pharmacogenomics” video.

VIDEO: Pain Management and Pharmacogenetics

Watch the “Pain Management and Pharmacogenomics” video.

Patient Testimonial: Samantha’s Experience With Pharmacogenetic Testing & Pain Management

“After Samantha suffered a fractured femur, her physician suggested pharmacogenetic testing (PGT) helped manage her pain and prescribe the right medication at the right time. Like many patients, Samantha was caught in the trial-and-error approach to prescribing medication, continuing to respond negatively to prescription medications. Her physician, Dr. Hugh Beatty, administered a Millennium PGT to […]

Patient Story: Pharmacogenetic Testing and Severe Chronic Pain

“Anita Gupta, PharmD, DO interviewed at the American Academy of Pain Management’s 26th Annual Meeting, No Life Limited By Pain 2015. More: http://www.aapainmanage.org/”

Patient Testimonial: How Pharmacogenetic Testing Helped Lisa Manage Her Pain

“Pharmacogenetic testing (PGT) helped Lisa’s physician prescribe the right pain medication at the right time. Too many patients rely on medication trial and error – prescribing medicine and observing patient response. As Lisa attempted to manage her pain with ineffective medication, her physician suggested Millennium Health PGT to predict Lisa’s likely response to a variety […]

VIDEO: Optimized Medication Outcomes through Pharmacogenomics — Part I: Basic Principles

Watch the “Optimized Medication Outcomes through Pharmacogenomics — Part I: Basic Principles” video. “The sometimes dramatic variation in a patient’s response to medications has long been recognized by physicians. Inter-individual differences in medication efficacy and safety profiles have been attributed to genetic as well as non-genetic factors. However, genetics is generally believed to account for […]

A review of the role of genetic testing in pain medicine

“Pain clinicians have always been challenged by the variability of response to pain treatment. Differences in the degree of pain stimulation and pain sensitivity, weight and age differences, prior opioid use and tolerance, as well as the differences in bioavailability of various opioid formulations have been cited as causes for the wide variability in analgesia […]

Have Difficult-to-Treat Pain Patients? Try Genetic Testing

“PALM SPRINGS, California — A patient was in a motor vehicle accident that shattered his right leg. He started taking morphine extended-release tablets (MS Contin, Purdue Pharma) at a dose of 100 mg up to three times daily with escalating doses over 4 years, but he still had persistent back and leg pain that he […]

Cardio & Pharmacogenomics

Cardio & Pharmacogenomics Articles, Videos, and Resources

Pharmacogenetics and Cardiovascular Disease—Implications for Personalized Medicine

“The past decade has seen tremendous advances in our understanding of the genetic factors influencing response to a variety of drugs, including those targeted at treatment of cardiovascular diseases. In the case of clopidogrel, warfarin, and statins, the literature has become sufficiently strong that guidelines are now available describing the use of genetic information to […]

Cardiovascular pharmacogenomics: current status and future directions

“Drugs are widely used and highly effective in the treatment of heart disease. Nevertheless, in some instances, even drugs effective in a population display lack of efficacy or adverse drug reactions in individual patients, often in an apparently unpredictable fashion. This review summarizes the genomic factors now known to influence variability in responses to widely […]

Potential Role of Pharmacogenetic Testing in Clinical Care: Warfarin and Clopidogrel

“Human Genome’s Potential Role in Reducing Health Care Costs and Saving Lives The numbers are staggering.According to the Institute of Medicine (IOM), at least 1.5 million Americans are injured each year by medication mistakes and every hospital patient is exposed to at least one medication error each day (National Institute of Medicine. Preventing Medication Errors. […]

Cardiovascular pharmacogenomics

“Testing for genetic modifiers of clopidogrel response: A prototype for individualized medicine Scripps Green Hospital in La Jolla, CA, was the first medical center in the U.S. to adopt genotyping for cardiac patients undergoing angioplasty and stent procedures.The test, which determines whether the patient’s DNA includes a genetic variant of CYP2C19 as a heterozygous allele […]

Cardiovascular Pharmacogenomics

“Patients vary in their responses to drug therapy, and some of that variability is genetically determined. This review outlines general approaches used to identify genetic variation that influences drug response. Examples from specific therapeutic areas are presented, such as cholesterol management, arrhythmias, heart failure, hypertension, warfarin anticoagulation, and antiplatelet agents. A brief view of potential […]

Clinical Application of Cardiovascular Pharmacogenetics – Journal of the American College of Cardiology

“Pharmacogenetics primarily uses genetic variation to identify subgroups of patients who may respond differently to a certain medication. Since its first description, the field of pharmacogenetics has expanded to study a broad range of cardiovascular drugs and has become a mainstream research discipline. Three principle classes of pharmacogenetic markers have emerged: 1) pharmacokinetic; 2) pharmacodynamic; […]

Presentation: Pharmacogenetics: From DNA to Dosage – Just A Click Away

“Rationale Provide real-time decision support thereby facilitating individualized drug therapy to maximize efficacy, minimize adverse drug reactions, and reduce health care costs PREDICT Initiative Assemble multidisciplinary, multidepartment team Pathology, Informatics, Pharmacy, Clinicians, Ethics, Legal, Regulatory Proof of Concept Which drug/gene relationship should test the model? Genotyping Which methodology? Research or CLIA lab? Informatics Data management, […]

VIDEO: Pharmacogenomics in Cardiac Drugs

“Dr. Peter O’Donnell, from the University of Chicago’s Committee on Clinical Pharmacology and Pharmacogenomics, and Dr. Matthew Sorrentino, a Professor of Medicine in the Section of Cardiology at the University of Chicago, in Illinois, dialogue on their article appearing in the June 2015 issue of Mayo Clinic Proceedings, where they completed a rigorous examination of […]

VIDEO: Pharmacogenetics in Cardiovascular Disease

Marc Sabatine, MD, MPH Chairman, Thrombolysis in Myocardial Infarction (TIMI) Study Group Senior Physician, Cardiovascular Medicine at Brigham and Women’s Hospital Professor, Harvard Medical School

VIDEO: Linnea Baudhuin – Clinical Applications in Pharmacogenetics

“Watch on LabRoots at: http://labroots.com/user/webinars/det… As a component of individualized medicine, pharmacogenetics (PGx) focuses on how genetic factors influence individual responses to specific medications. The clinical goals of pharmacogenetics are to identify the right drug at the right dose for each patient. The majority of known PGx-related variability is due to variation in genes encoding […]

Mental Health & Pharmacogenomics

Mental Health and Pharmacogenomics Articles, Videos, and Resources

VIDEO: Pharmacogenetics in mental health and addiction

“Find out more about the emerging study of personalized medicine and pharmacogentics with Dr. James Kennedy from CAMH. More information about the study can be found at http://impact.camhx.ca/en/home.php”

VIDEO: Personalized medicine for behavioral health patients – Medical Minute

“To many questions in life the answer is right in front of you. You just have to look closely; sometimes very closely. Doctors at Avera are looking at a patient’s most basic instruction manual to find the best way to deliver treatment.”

The Promise and Reality of Pharmacogenetics in Psychiatry

“Existing psychotropic medications for the treatment of mental illnesses, including antidepressants, mood stabilizers, and antipsychotics, are clinically sub-optimal. They are effective in only a subset of patients or produce partial responses, and they are often associated with debilitating side effects that discourage adherence. There is growing enthusiasm in the promise of pharmacogenetics to personalize the […]

Pharmacogenetics Role in Mental Health

“In a 2011 article titled Pharmacogenetics of antidepressant response, Porcelli, Drago and Seretti perform a meta-analysis of dozens of research articles on pharmacogenomics to determine both the state of the research and identify which genetic markers might be implicated in the metabolism of various psychotropic medications and therefore, which might have a factor in the […]

The Potential Utility of Pharmacogenetic Testing in Psychiatry

“Over the last decade, pharmacogenetics has become increasingly significant to clinical practice. Psychiatric patients, in particular, may benefit from pharmacogenetic testing as many of the psychotropic medications prescribed in practice lead to varied response rates and a wide range of side effects. The use of pharmacogenetic testing can help tailor psychotropic treatment and inform personalized […]

Psychiatric Pharmacogenetics in Clinical Practice

“Description Pharmacogenetics is an area of personalized medicine that aims to provide safer‚ more efficient‚ and customized drug therapies based on an individual’s unique genetic (i.e., DNA) profile. This workshop will focus on: optimizing psychiatric drug treatment using genetic information and considering drug-drug interactions providing an introduction to psychiatric pharmacogenetics expanding into the clinical applications […]

Psychiatric Pharmacogenomics

“Despite the potential of psychiatric pharmacogenomics to reduce adverse events, optimize drug dosing, and guide treatment decisions, clinicians have been slow to accept the rapidly evolving science, report pharmacogenomics experts. “A clear role in drug toxicity and efficacy has been established for some gene-drug combinations, yet implementation of pharmacogenomics tests in clinical practice lags behind […]

Future of Psychiatric Medication May Lie in Pharmacogenetics

“As psychiatric research evolves, highly personalized treatment for mental illness may be possible in the years to come. As pharmaceutical companies strive to develop new therapies to treat mental illness, some clinician scientists say that the focus should be on tailoring treatment to an individual’s genetic makeup. Pharmacogenetics is the study—and technology—that analyzes how genetic […]

Pharmacogenetics, Wellness, and Recovery

“Most pharmaceutical treatments for major mental illnesses were discovered by trial and error and little is known about how they work. They are typically effective in only a minority of patients and are associated with severe side effects that discourage adherence. As a result most persons under treatment end up shifting drugs in a sometimes […]

Documents: Pharmacogenetics and Mental Health

“Pharmacogenetics is the science of how medications are broken down in the body. This is determined genetically and variations affect medication therapeutic efficiency and side effects.”

Patient Testimonial: Brian’s Experience with Pharmacogenetic Testing & Mental Health

“Brian suffered from depression for 25 years, and just like many other mental health patients, he was prescribed many medications that were ineffective. Looking for new therapies to combat his illness, he found Dr. Edgar Castillo-Armas, a clinician who has gone beyond the trial and error approach. He provided Brian with Millennium PGT℠ to help […]