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Per Med. 2018 Nov 28. doi: 10.2217/pme-2018-0116. [Epub ahead of print]

Continuing war on pain: a personalized approach to the therapy with nonsteroidal anti-inflammatory drugs and opioids.

Author information

1
Department of Pharmacology, University of Zagreb Faculty of Pharmacy & Biochemistry, A Kovačića 1, 10000 Zagreb, Croatia.
2
OneOme LLC, 807 Broadway St NE #100, Minneapolis, MN 55413, USA.
3
St Catherine Specialty Hospital, 10000 Zagreb & 49210 Zabok, Croatia.
4
Department of Forensic Sciences, Eberly College of Science, 517 Thomas St, State College, Penn State University, PA 16803, USA.
5
Department of Pediatrics, School of Medicine, University of Split, Soltanska 2, 21000 Split, Croatia.
6
Department of Pediatrics, School of Medicine, University of Osijek, Ulica Cara Hadrijana 10, 31000 Osijek, Croatia.
7
Department of Pediatrics, Faculty of Dental Medicine and Health, University ofOsijek, Crkvena 21, 31000 Osijek, Croatia.
8
Children's Hospital Srebrnjak, Srebrnjak 100, 10000 Zagreb, Croatia.

Abstract

Successful pain management requires the delivery of analgesia with minimal risk of adverse drug reactions. Nonsteroidal anti-inflammatory drugs and opioids remain the mainstay of treatment for the majority of patients. Unfortunately, almost 50% of all patients experience inadequate pain relief and serious side effects. Allelic variants in genes coding for target proteins, transporters and enzymes, which govern analgesic drugs action and their fate in the organism, might explain inter-individual variability in pain severity and in drug-induced pain relief and toxicities. Additionally, it seems that epigenetic changes contribute to the highly variable response to pain treatment. Therefore, pharmacogenomic testing might be a valuable tool for personalization of pain treatment, with a multidisciplinary team approach involved.

KEYWORDS:

analgesic effect; epigenetics; genes; nonsteroidal anti-inflammatory drugs; opioids; pain treatment; pharmacogenetics; side effects; toxicity

PMID:
30484741
DOI:
10.2217/pme-2018-0116

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