Multiple adverse drug reactions and genetic polymorphism testing

Ana Lucía Arellano; Marta Martin-Subero; Mar Monerris; Adrián Llerena; Magí Farré; Eva Montané

doi:10.1097/MD.0000000000008505

Multiple adverse drug reactions and genetic polymorphism testing

Ana Lucía Arellano, Marta Martin-Subero, Mar Monerris, Adrián Llerena, Magí Farré, Eva Montané

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Abstract

Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. Rationale: Defects in drug metabolic pathways could explain why some patients have a history of multiple adverse drug reactions (ADR); therefore we aimed to analyze genetic polymorphisms in a patient with multiple ADR related to drugs with a common hepatic metabolic pathway through CYP2D6. Patient concerns: We report a patient with psychosis and hypertension related to amitriptyline, tramadol, and duloxetine within a 2-year period. Interventions and Outcomes: A pharmacogenetic test was performed to assess the causative role of the CYP2D6 enzyme, but did not demonstrate a metabolic deficiency. Lessons: Although negative results in the reported case; typing for cytochrome P450 isoenzyme polymorphisms could be a useful diagnostic tool in some patients with a history of multiple ADR.

Original language	English
Article number	e8505
Journal	Medicine (United States)
Volume	96
Issue number	45
DOIs	https://doi.org/10.1097/MD.0000000000008505
Publication status	Published - 1 Nov 2017

Keywords

CYP2D6
adverse drug reactions
drug metabolism
genetic polymorphism
multiple drug intolerance syndrome

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title = "Multiple adverse drug reactions and genetic polymorphism testing",

abstract = "Copyright {\textcopyright} 2017 the Author(s). Published by Wolters Kluwer Health, Inc. Rationale: Defects in drug metabolic pathways could explain why some patients have a history of multiple adverse drug reactions (ADR); therefore we aimed to analyze genetic polymorphisms in a patient with multiple ADR related to drugs with a common hepatic metabolic pathway through CYP2D6. Patient concerns: We report a patient with psychosis and hypertension related to amitriptyline, tramadol, and duloxetine within a 2-year period. Interventions and Outcomes: A pharmacogenetic test was performed to assess the causative role of the CYP2D6 enzyme, but did not demonstrate a metabolic deficiency. Lessons: Although negative results in the reported case; typing for cytochrome P450 isoenzyme polymorphisms could be a useful diagnostic tool in some patients with a history of multiple ADR.",

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doi = "10.1097/MD.0000000000008505",

language = "English",

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T1 - Multiple adverse drug reactions and genetic polymorphism testing

AU - Arellano, Ana Lucía

AU - Martin-Subero, Marta

AU - Monerris, Mar

AU - Llerena, Adrián

AU - Farré, Magí

AU - Montané, Eva

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. Rationale: Defects in drug metabolic pathways could explain why some patients have a history of multiple adverse drug reactions (ADR); therefore we aimed to analyze genetic polymorphisms in a patient with multiple ADR related to drugs with a common hepatic metabolic pathway through CYP2D6. Patient concerns: We report a patient with psychosis and hypertension related to amitriptyline, tramadol, and duloxetine within a 2-year period. Interventions and Outcomes: A pharmacogenetic test was performed to assess the causative role of the CYP2D6 enzyme, but did not demonstrate a metabolic deficiency. Lessons: Although negative results in the reported case; typing for cytochrome P450 isoenzyme polymorphisms could be a useful diagnostic tool in some patients with a history of multiple ADR.

AB - Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. Rationale: Defects in drug metabolic pathways could explain why some patients have a history of multiple adverse drug reactions (ADR); therefore we aimed to analyze genetic polymorphisms in a patient with multiple ADR related to drugs with a common hepatic metabolic pathway through CYP2D6. Patient concerns: We report a patient with psychosis and hypertension related to amitriptyline, tramadol, and duloxetine within a 2-year period. Interventions and Outcomes: A pharmacogenetic test was performed to assess the causative role of the CYP2D6 enzyme, but did not demonstrate a metabolic deficiency. Lessons: Although negative results in the reported case; typing for cytochrome P450 isoenzyme polymorphisms could be a useful diagnostic tool in some patients with a history of multiple ADR.

KW - CYP2D6

KW - adverse drug reactions

KW - drug metabolism

KW - genetic polymorphism

KW - multiple drug intolerance syndrome

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DO - 10.1097/MD.0000000000008505

M3 - Article

VL - 96

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M1 - e8505

ER -

Multiple adverse drug reactions and genetic polymorphism testing

Abstract

Keywords

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