Pharmakogenetik und pädiatrische Schmerztherapie

Zusammenfassung

Neue Erkenntnisse über die Struktur des Genoms und die Entdeckung genomischer Varianten haben die genetische Diagnostik sowohl für komplexe und akute Erkrankungen als auch für den Bereich Pharmakogenetik interessant werden lassen.

Für einige Bereiche, z. B. der großen Gruppe der metabolisierenden Enzyme, liegen schon Untersuchungen vor, die zeigen, dass genetische Varianten einen Einfluss auf Effektivität und Nebenwirkungen von Arzneimitteln haben. So erfahren Patienten mit einer Defizienz für das Cytochrom P450-Isoenzym 2D6 keine oder nur eine reduzierte Analgesie durch Codein und Tramadol. Auch für die Wirksamkeit und die Nebenwirkungen von Nichtopioid-Analgetika können genetische Varianten eine Rolle spielen.

Erkenntnisse aus dem Bereich der Pharmakogenetik werden es in Zukunft erlauben, die Therapie der individuellen (genetischen) Konstellation anzupassen.

Summary

The human genome project has revealed data on genomic variation which may influence the pharmacological responses. In pain therapy, the genetic background influencing the efficacy of opioid therapy is of special interest. Screening for variations in expression of drug metabolizing enzymes has been suggested as a potential tool for improving the quality of therapy. CYP2D6 genetic variability is supposed to be a major factor of adverse drug reaction, possibly influencing length of hospital stay and total treatment costs. Further candidate genes involved in pain perception, pain processing and pain management like opioid receptors, transporters and other targets of pharmacotherapy are under investigation.

In the future, genetic differences influencing efficacy, side effects and adverse outcome of pharmacotherapy will become important aspects for optimal pain management.

Schlüsselwörter

Genetik - metabolisierende Enzyme - Cytochrom P450 - Tramadol - Codein - Paracetamol

Keywords

Genetics - metabolizing enzymes - cytochrom P450 - tramadol - codeine - acetaminophen

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