Opioid-Related Genetic Polymorphisms of Cytochrome P450 Enzymes after Total Joint Arthroplasty: A Focus on Drug-Drug-Gene Interaction with Commonly Coprescribed Medications

Brendan J Farley; Mohamed E Awad; Paige Anderson; Ali S Esseili; Justin Hruska; Gamal Mostafa; Khaled J Saleh

doi:10.1016/j.ocl.2022.06.001

Opioid-Related Genetic Polymorphisms of Cytochrome P450 Enzymes after Total Joint Arthroplasty: A Focus on Drug-Drug-Gene Interaction with Commonly Coprescribed Medications

Orthop Clin North Am. 2022 Oct;53(4):361-375. doi: 10.1016/j.ocl.2022.06.001. Epub 2022 Sep 14.

Authors

Brendan J Farley¹, Mohamed E Awad², Paige Anderson³, Ali S Esseili⁴, Justin Hruska⁵, Gamal Mostafa⁶, Khaled J Saleh⁷

Affiliations

¹ FAJR Scientific, Resident Research Partnership, 9308 Hickory Ridge Rd, Suite 301, Northville, MI, 48167, USA; Department of Orthopaedic Surgery, West Virginia University, 6040 University Town Centre Dr Drive, Morgantown, WV 26501, USA.
² FAJR Scientific, Resident Research Partnership, 9308 Hickory Ridge Rd, Suite 301, Northville, MI, 48167, USA; NorthStar Anesthesia, Detroit Medical Center, 4201 St Antoine Street, Detroit, MI 48201, USA; Michigan State University College of Osteopathic Medicine, 965 Wilson Rd, East Lansing, MI 48824, USA.
³ FAJR Scientific, Resident Research Partnership, 9308 Hickory Ridge Rd, Suite 301, Northville, MI, 48167, USA; Cedarville University, 251 N Main St, Cedarville, OH 45314, USA.
⁴ FAJR Scientific, Resident Research Partnership, 9308 Hickory Ridge Rd, Suite 301, Northville, MI, 48167, USA; University of Michigan, 4901 Evergreen Rd, Dearborn, MI 48128, USA.
⁵ NorthStar Anesthesia, Detroit Medical Center, 4201 St Antoine Street, Detroit, MI 48201, USA; Department of Anesthesiology, Wayne State University- Detroit Medical Center, 4201 St Antoine Street, Detroit, MI, 48201, USA.
⁶ Wayne State University, School of Medicine, 3990 John R St, Detroit, MI 48201, USA.
⁷ FAJR Scientific, Resident Research Partnership, 9308 Hickory Ridge Rd, Suite 301, Northville, MI, 48167, USA; Michigan State University College of Osteopathic Medicine, 965 Wilson Rd, East Lansing, MI 48824, USA; Department of Surgery, John D. Dingell VA Medical Center, 4646 John R St, Detroit, MI 48201, USA.. Electronic address: kjsaleh@gmail.com.

PMID: 36208880
DOI: 10.1016/j.ocl.2022.06.001

Abstract

Pharmacogenomic testing, together with the early detection of drug-drug-gene interactions (DDGI) before initiating opioids, can improve the selection of dosage and reduce the risk of adverse drug interactions and therapeutic failures following Total Joint Arthroplasty. The variants of CYP genes can mediate DDGI. Orthopedic surgeons should become familiar with the genetic aspect of opioid use and abuse, as well as the influence of the patient genetic makeup in opioid selection and response, and polymorphic variants in pain modulation.

Keywords: Drug–drug–gene interaction; Opioid; Pain; Pharmacogenomics; Total joint arthroplasty.

Publication types

Review

MeSH terms

Analgesics, Opioid*
Arthroplasty
Cytochrome P-450 Enzyme System / genetics
Drug Interactions
Humans
Polymorphism, Genetic*

Substances

Analgesics, Opioid
Cytochrome P-450 Enzyme System