Managing chronic pain is a challenge because of each patient’s unique tolerance to pain, and differing reactions to prescribed medications. Unpleasant opioid side effects, such as nausea, vomiting, constipation and sedation, are common with pain management medication. The side effects can lead to work absences, poor work performance, the risk of job loss, and a diminished quality of life. An individual’s genetic makeup may predispose them to adverse effects of pain and reduced efficacy of medications. Pharmacogenomics may help connect the dots towards mitigating adverse drug reactions among genetically-vulnerable individuals.
Potential Benefits of Testing with the Pain Management Genetic Panel:
- Decreased adverse drug reactions
- Reduced trial and error period for an effective medication
- Improved dosage recommendations for therapeutic effect
To make optimal prescribing decisions for drugs, it is imperative to have information on each patient’s unique genetic background. Importantly, there are several common, well-documented genetic variations that substantially reduce or increase the functionality of enzymes involved in metabolism of frequently prescribed pain management drugs. If a patient harbors one of these mutations it may have a dramatic impact on their ability to metabolize many commonly prescribed analgesics, resulting in reduced efficacy of the medication, or increased risk of adverse drug reactions.
Kashi Health’s Pain Management Panel provides the genetic information needed to make the best possible selection of analgesic drugs and dosing regimens for patients. This intelligent approach to the prescription of pain management medications can drastically improve patient outcomes.
Gene Tests Included in the Pain Management Panel
|GENES TESTS||EFFECT ON PAIN MANAGEMENT|
|CYP2D6||Key role in the metabolism of opioids including: codeine, tramadol, and oxycodone|
|CYP2C19||Impacts dosages requirements for tricyclic antidepressants|
|CYP2C9||Crucial to the breakdown of NSAIDS including: diclofenac, naproxen, and ibuprofen|
|COMT||Effects morphine dosage requirements and perceptions of pain|
Results from Kashi Health’s Pain Management Panel classify patients by how effectively they metabolize a medication. This classification is based on how many copies of functional or variant alleles they inherited. In general, the genetic variability of CYP genes can be grouped into four phenotypes: ultra-rapid metabolizers (UM), normal (extensive) metabolizers (EM), intermediate metabolizers (IM) and poor metabolizers (PM).
|TYPE OF METABOLIZER||GENETIC VARIABILITY EFFECTS|
|Ultra-rapid metabolizer (UM)||Increased enzymatic activity due to duplications or multiplications of the functional allele|
|Extensive metabolizer (EM)||Normal enzymatic activity due to the presence of at least one functional allele|
|Intermediate metabolizer (IM)||Moderately-decreased enzymatic activity with either two decreased activity alleles or one decreased activity allele and one null allele|
|Poor metabolizer (PM)||Lack of enzyme activity as a result of two null (non-functional) alleles|
We will send you the test kit with 3 buccal swabs. You need to send it back to Invivo Clinical via guaranteed 1 pm next day delivery at your own cost. The results come back to us and we will post them into your patient portal.
If you like to discuss the results we can do this in a separate consultation with Dr Frey.