In the case of severe and chronic pain that severely interferes with everyday life, rapid and effective pain treatment is the goal. Pharmacogenetics can provide crucial information for drug selection. This is because in the presence of genetic variants, certain drugs do not work or there is an increased risk of severe side effects.
Codeine and tramadol are two common analgesics that play an important role in pharmacogenetics. Both are prodrugs that must be converted to their active form in the body. In the case of codeine, it is converted to morphine by the CYP2D6 enzyme, while tramadol is converted to a more potent opioid by the same enzyme.
Genetic variations can affect the activity of CYP2D6, which can lead to differences in the efficacy and tolerability of these drugs. Some people are "fast metabolizers" and may experience severe side effects due to faster and increased conversion to morphine or a more potent opioid, while "slow metabolizers" may not experience full or any pain relief.
Non-steroidal anti-inflammatory drugs (NSAIDs) are another class of drugs commonly used in pain management. They work by inhibiting the production of prostaglandins, which are involved in the pain and inflammatory response. Genetic variations can affect the body's response to NSAIDs and influence the risk of side effects, such as gastrointestinal bleeding.
Pharmacogenetics enables personalized pain management by helping to determine the most appropriate medications and dosages for each individual. This can help maximize the effectiveness of treatment and minimize the risk of side effects.
