Abstract
There have been an increasing number of clinical studies investigating the relationship between interindividual genetic variability and the safety and efficacy of opioid analgesics. Despite the widespread use of opioids in pregnant and lactating women for the treatment of acute pain, few studies have investigated the interplay of genetic factors and pregnancy-related physiological alterations in relation to opioid metabolism and response. Some interesting avenues of research require further pursuit- including evidence of cytochrome P450 2D6 (CYP2D6) induction during pregnancy and its effect on the generation of the active opioid metabolites morphine, oxymorphone, O-desmethyltramadol, and hydromorphone following the administration of codeine, oxycodone, tramadol, and hydrocodone respectively. Studies investigating the duration of maternal CYP2D6 induction after delivery are also needed to shed light on genotype to phenotype correlations in breastfeeding mothers using opioid analgesics in the postpartum period.
Keywords: Opioids, pregnancy, lactation, pharmacogenetics, CYP2D6, childbearing, Morphine, P-glycoprotein, Tayside
Current Drug Metabolism
Title:Pharmacogenetics of Opioids for the Treatment of Acute Maternal Pain During Pregnancy and Lactation
Volume: 13 Issue: 6
Author(s): Parvaz Madadi, Denise Avard and Gideon Koren
Affiliation:
Keywords: Opioids, pregnancy, lactation, pharmacogenetics, CYP2D6, childbearing, Morphine, P-glycoprotein, Tayside
Abstract: There have been an increasing number of clinical studies investigating the relationship between interindividual genetic variability and the safety and efficacy of opioid analgesics. Despite the widespread use of opioids in pregnant and lactating women for the treatment of acute pain, few studies have investigated the interplay of genetic factors and pregnancy-related physiological alterations in relation to opioid metabolism and response. Some interesting avenues of research require further pursuit- including evidence of cytochrome P450 2D6 (CYP2D6) induction during pregnancy and its effect on the generation of the active opioid metabolites morphine, oxymorphone, O-desmethyltramadol, and hydromorphone following the administration of codeine, oxycodone, tramadol, and hydrocodone respectively. Studies investigating the duration of maternal CYP2D6 induction after delivery are also needed to shed light on genotype to phenotype correlations in breastfeeding mothers using opioid analgesics in the postpartum period.
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Cite this article as:
Madadi Parvaz, Avard Denise and Koren Gideon, Pharmacogenetics of Opioids for the Treatment of Acute Maternal Pain During Pregnancy and Lactation, Current Drug Metabolism 2012; 13 (6) . https://dx.doi.org/10.2174/138920012800840392
DOI https://dx.doi.org/10.2174/138920012800840392 |
Print ISSN 1389-2002 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5453 |
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