Pharmacogenetics variations in Anesthesia

Abstract

Pharmacogenetics is an emerging discipline that attempted to understand the hereditary basis for differences in responsiveness or inter-individual variation to therapeutic agents. It is the study of variability in drug response as a result of heredity factors. The importance for pharmacogenetics for the clinician is to enable optimum therapeutic efficacy, to avoid toxicity of those drugs whose metabolism is catalyzed by polymorphic isoenzymes, and to contribute to the rational design of new drugs. The experience of anesthetists suggests that there is great heterogeneity in anaesthetic requirements in the way patients recover from uncomplicated anaesthesia, as well as their requirements for postoperative analgesia. Some of these differences can be explained by genetically determined differences in transport proteins, in drug targets and in enzyme functions. Some environmental factors such as smoking, diet, and other drugs play very important role to interact with genetic factors to modulate drug effects. Recovery from general anaesthesia is dependent on factors governing drug sensitivity and drug disposition and recovery from a single dose of i.v. anaesthetic agent is dependent on redistribution, whereas recovery after a prolonged infusion is more dependent on metabolism and elimination of the drugs. © 2012 Puri A.