title: Pharmacogenetics of opioid response.
abstract: For opioids requiring CYP2D6 O-demethylation to active metabolites, poor metabolizers have reduced metabolite formation and minimal pain reduction. Clinically, this has only reliably been shown for tramadol. Ultra-rapid metabolizers have an increased risk of toxicity especially for codeine. ABCB1 genetics show no consistent findings. In Asian populations, the high OPRM1 118A>G frequency associates with higher opioid dosage requirements. Clinical translation of opioid genetics is premature because many important pain and addiction phenotype factors contribute.
authors: Discipline of Pharmacology, School of Medical Sciences, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia; Centre for Personalised Cancer Medicine, University of Adelaide, Adelaide, Australia; Department of Clinical Pharmacology, Royal Adelaide Hospital, Adelaide, Australia.
authors: A A
authors: AA
authors: Somogyi
authors: J K
authors: JK
authors: Coller
authors: D T
authors: DT
authors: Barratt
mesh_terms: D000701:Analgesics, Opioid / Q000493:pharmacokinetics / Q000627:therapeutic use*; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics*; D014453:Glucuronosyltransferase / Q000235:genetics*; D006801:Humans; D010146:Pain / Q000188:drug therapy* / Q000235:genetics
chemical_list: D000701:Analgesics, Opioid; D003577:Cytochrome P-450 Enzyme System; D014453:Glucuronosyltransferase