More than 25 million Americans experience pain each day, and more than 40 million experience severe pain within a three-month period. Pain can affect sleep, cause anxiety and contribute to a decline in overall health. Although pain is one of the most common reasons that patients consult a doctor, it is difficult to treat because each person experiences pain in a different way.
Usage and Side Effects of Pain Management Medications
Doctors try to select pain management medications that will adequately relieve pain without causing major side effects. Factors that affect the dosage and effectiveness of medicines include age, sex, weight, ethnicity and overall health. In addition, a patient’s genetic makeup can cause pain medications to be ineffective or produce side effects.
Common side effects from pain medications include drowsiness, nausea, constipation, dry mouth, shortness of breath, diarrhea and headaches. However, adverse drug reactions can be serious, causing internal bleeding, respiratory arrest, heart arrhythmia or liver damage. Often, clinicians use a trial-and-error method to find appropriate medications and doses that are effective and well-tolerated by the patient.
Pain medications fall into several categories. Each has specific analgesic effects and is assimilated by particular cellular enzymes. Opioids are often used to treat moderate to severe pain such as post-surgical pain, cancer or situations where other medications fail to provide relief. Non-steroidal anti-inflammatories are used for low to moderate pain and to reduce inflammation for maladies such as arthritis, back pain, migraines or minor injuries. Adjuvant analgesics, or drugs used for other purposes such as depression, are prescribed for specific types of pain such as neuropathy. Opioids are the most commonly prescribed type of drug for pain in the U.S.
Pharmacogenetics and Pain Medications
Pharmacogenetics studies the way that an individual’s genetic characteristics affect the way medicines are processed, transported and eliminated by the body. Some people have genetic variants that cause rapid metabolism of a drug, which may not provide any therapeutic benefit. Other people have variants that cause poor metabolism of a drug, which can cause serious side effects or toxicity.
Many drugs used to treat pain fall within the cytochrome P450 family of enzymes. Within this class, gene CYP2D6 is responsible for the metabolism of more than 20 percent of all drugs, particularly pain management medications. Genetic variants of CYP2D6 affect metabolism of opioids such as codeine and tramadol. Patients with variants of this gene may experience severe side effects from opiates or not get any therapeutic benefit.
Gene CYP2C9 affects the metabolism of approximately 15 percent of all drugs, including many non-steroidal anti-inflammatories such as ibuprofen and diclofenac. Patients with variants in this gene may experience serious side effects such as gastric bleeding.
The Benefits of Pharmacogenetic Testing with Rxight®
Rxight® Pharmacogenetic Testing provides valuable information about a patient’s genetic characteristics to clinicians and pharmacists. Doctors can select pain management medicines that reduce the potential for side effects and provide the best therapeutic effects. People who are afraid of adverse drug reactions may not take the medications prescribed by a doctor and sacrifice the benefit of pain relief. When patients are confident about the safety and efficacy of a drug treatment plan, they are more likely to take the medicine. Reduction or elimination of pain can lead to better overall health and improved quality of life.