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BJA Advance Access published online on May 29, 2009
British Journal of Anaesthesia, doi:10.1093/bja/aep130
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© The Author [2009]. Published by Oxford University Press on behalf of The Board of Directors of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Pharmacogenomic variability and anaesthesia

R. Searle and P. M. Hopkins*

Section of Translational Anaesthetic and Surgical Sciences, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK

* Corresponding author: Academic Unit of Anaesthesia, St James's University Hospital, Leeds LS9 7TF, UK. E-mail: p.m.hopkins{at}leeds.ac.uk

The concept of ‘personalized medicine’ in which a knowledge of genetic factors guides prescribing tailored to the individual is popularly considered to be an inevitable consequence of completion of the International Human Genome Project. We should not forget, however, that a personal or family history of one of several uncommon pharmacogenetic conditions has influenced the use of the implicated drug(s) during anaesthesia for the past 50 yr. Although this has been important for those affected, pharmacogenomics heralds the prospect of an individual's genetic profile informing every prescription. Progress has been rapid in some areas, notably cancer chemotherapy where response to treatment can be predicted on the basis of the genetic profile of the tumour cells. The situation is different for most currently available drugs, including those used by anaesthetists, where genetic variability to drug response is presumed to be the result of a complex interaction of multiple factors. We review the nature and investigation of pharmacogenomic variability and contrast the progress made with research into opioid variability with the more limited literature concerning i.v. and inhalation anaesthetics.

Keywords: anaesthetics gases, nitrous oxide; anaesthetics i.v.; anaesthetics volatile; genetic factors; malignant hyperthermia; pharmacodynamics; pharmacology agonists


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Developmental pharmacology, pharmacogenomic variability and anaesthesia
Karel Allegaert
British Journal of Anaesthesia, 4 Jun 2009 [Full text]

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