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Tailored Drug Therapy for Pain Control

Choosing the right drug at the right time for each patient can be a difficult task. This is especially true when trying to find the right dose for patients suffering from chronic pain. The science behind such decisions is called pharmacogenomics.

New information about drug metabolism may change how medications are prescribed. Drug metabolism refers to how and when drugs are broken down and then used by the body. Scientists have found at least one enzyme called CYP2D6 that helps metabolize opioids . Opioids are narcotic pain relievers.

Some people metabolize drugs faster than others. Fast metabolizers may not get much benefit from the drug. Slow metabolizers may have a severe reaction because too much of the drug is in the body too long. The ideal effect of pain meds occurs with poor metabolizers because they have the highest steady-state concentration of the active ingredient.

A recent study of 61 chronic pain patients taking pain relievers showed that most patients were able to metabolize the drug because only one copy of the CYP2D6 gene was defective. Those who had a bad drug reaction to opioids had no working CYP2D6. Genetic testing from blood samples was used to analyze this enzyme.

In the future, genetic testing of this type will help doctors predict how patients will respond to a drug. It will make it easier to tailor specific treatment for each patient. And hopefully, adverse drug reactions can be prevented.

In the future, pharmacogenomics may open a new way to evaluate, predict, select, and monitor drug therapy for many diseases and conditions.

References: Linda Pembrook. CYP2D Metabolism Predicts Opioid Response. In Pain Medicine News. May/June 2007. Vol. 5. No. 3. Pp. 20.

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