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BJA Advance Access originally published online on June 25, 2004
British Journal of Anaesthesia 2004 93(3):440-450; doi:10.1093/bja/aeh200
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2004

Principles of pharmacogenetics—implications for the anaesthetist

G. Iohom1, D. Fitzgerald2 and A. J. Cunningham1,2,*

1 Department of Anaesthesia and Intensive Care Medicine, Beaumont Hospital, Dublin 9, Ireland. 2 Royal College of Surgeons in Ireland, Dublin 2, Ireland

* Corresponding author. E-mail: anthonyc@rcsi.ie

Keywords: anaesthesia, general; genetic factors, polymorphism; metabolism, poor metabolizers; metabolism, ultrarapid metabolizers; pharmacogenetics

The first 150 words of the full text of this article appear below.


   Introduction
 
‘If it were not for the great variability among individuals, medicine might as well be a science and not an art.’ Sir William Osler's observations in 189260 reflect a perception of medicine over 100 years ago, highlighting the lack of available objective data to make decisions that are tailored to individual patients. One hundred years later, scientists are on the verge of being able to identify inherited differences between individuals, which may predict each patient's response to a particular drug. This ability will have undoubted benefits in the discovery, development, and delivery of new medicines. Sir William Osler, if he were alive today, would be forced to reconsider his view of medicine as an art not a science.

Pharmacogenetics emerged as a discipline that attempted to understand the hereditary basis for differences in responsiveness or inter-individual variation to therapeutic agents.85 Variation in a drug effect may vary from . . . [Full Text of this Article]


   Medical genetics
 
Genes and alleles
Phenotype and genotype
Markers
Polymorphisms
Genotyping
Linkage studies
Association studies

   Pharmacogenetics—focusing on drug targets
 
Enzymes
Phase I enzymes
Phase II enzymes
Transporter proteins
Receptors

   Anaesthetic implications
 
Enzymes
Plasma cholinesterase
CYP enzymes
Angiotensin converting enzyme
Transporter proteins
Receptors
Ryanodine receptor (RYR1)
µ-Opioid receptor (MOR)
GABAA receptor

   Future developments
 

   Conclusions
 

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