Lab Services

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Advanced Pain Care strives to provide the most effective pain management by custom-tailoring our approach to each of our patients. To help us do this, we have implemented a genetic testing program to identify the best and appropriate treatment plan to reduce pain.

An individual's genetic makeup may predispose them to adverse effects of pain and reduced efficacy of medications (1). Our genetic testing, designed to provide genetics-based information on a patient's DNA, can help our health care providers mitigate adverse drug reactions and find the best plan for managing chronic pain.

As it stands today, the labels of more than 100 United States Food and Drug Administration-approved medications include information about the effect of genetic variations on drug efficacy (4). In order for our physicians to optimize their prescribing decisions for these drugs, it is increasingly advised that we have information on our patients’ unique genetic background (5). There are several common, well-documented genetic variations that substantially reduce or increase the functionality of enzymes involved in the metabolism of frequently prescribed pain management drugs (5,6). If a patient possesses one of these mutations, it may have a dramatic effect on their ability to metabolize many commonly prescribed analgesics, resulting in reduced efficacy of the medication, or increased risk of adverse drug reactions (2, 3, 5).

A simple swab of the cheek can provide our physicians with the genetic information they need to select the best analgesic drugs and dosing regimens if it is determined that medication is the best plan for patients suffering from pain. This intelligent approach to prescribing pain management medications can drastically improve patient wellness and quality of life.

Benefits of Genetic Testing in Pain Management

  • Improved dosage recommendations for therapeutic effect
  • Reduced trial and error period for an effective medication
  • Decreased risk of adverse drug reactions

References

  1. Janicki PK. Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches. Deer TR et al. eds. 2013.
  2. Phillips KA et al. Potential Role of Pharmacogenomics in Reducing Adverse Drug Reactions. JAMA. 2001; 286(18):2270.
  3. Xu Y and Johnson A. Opioid therapy pharmacogenomics for noncancer pain: efficacy, adverse events, and costs. Pain Res Treat. 2013; 2013:943014.
  4. U.S. Food and Drug Administration. Table of Pharmacogenomic Biomarkers in Drug Labeling. 08/18/2014. Available at: http://www.fda.gov/drugs/scienceresearch/researchareas/pharmacogenetics/ucm083378.htm.
  5. Trescot AM and Faynboym S. A Review of the Role of Genetic Testing in Pain Medicine. Pain Physician. 2014; 17:425-445.
  6. Samer CF et al. Applications of CYP450 testing in the clinical setting. Mol Diagn Ther. 2013; 17(3):165-84.
  7. Jannetto PJ and Bratanow NC. Pharmacogenomic considerations in the opioid management of pain. Genome Med. 2010; 2:66.
  8. Hicks JK et al. Clinical Pharmacogenetics Implementation Consortium guideline for CYP2D6 and CYP2C19 genotypes and dosing of tricyclic antidepressants. Clin Pharmacol Ther. 2013; 93(5):402-8.
  9. Lamba J et al. PharmGKB summary: very important pharmacogene information for CYP3A5. Pharmacogenet Genomics 2012; 22(7):555-8.
  10. Sadhasivam S and Chidambaran V. Pharmacogenomics of opioids and perioperative pain management. Pharmacogenomics. 2012; 13(15):1719-40.