Related Experiment Video
Updated: May 28, 2026
14:56
An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 27, 2010
CYP2D6 phenotype and post-surgical pain control with hydrocodone and oxycodone
Christelle Lteif1, Rachel A Myers2, Erica N Elwood1
1Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, FL, United States.
Frontiers in Pharmacology
|May 27, 2026
Summary
CYP2D6 metabolizer status did not impact hydrocodone or oxycodone pain relief after surgery. Multimodal pain management may lessen the effects of pharmacogenetics on opioid response.
Area of Science:
- Pharmacogenetics
- Pain Management
- Drug Metabolism
Background:
- Hydrocodone and oxycodone are common postoperative pain relievers metabolized by CYP2D6.
- The influence of CYP2D6 metabolizer status on their effectiveness is unclear.
- This study investigated CYP2D6 phenotype's impact on pain and opioid use.
Purpose of the Study:
- To evaluate the association between CYP2D6 phenotype and postoperative pain intensity.
- To assess the relationship between CYP2D6 phenotype and opioid consumption.
- To determine if CYP2D6 genotype affects analgesic response to hydrocodone and oxycodone.
Main Methods:
- Secondary analysis of the ADOPT PGx Acute Pain Trial.
- Compared CYP2D6 poor (PM) and intermediate (IM) metabolizers to normal (NM) metabolizers.
- Assessed opioid use and pain intensity, adjusting for covariates.
Main Results:
- No significant association was found between CYP2D6 phenotype and hydrocodone or oxycodone consumption or pain intensity.
- Similar results were observed in the tramadol positive control group.
- Concomitant non-opioid analgesic use was high across all cohorts.
Conclusions:
- CYP2D6 metabolizer status did not influence postoperative pain control or opioid use for hydrocodone, oxycodone, or tramadol.
- Multimodal analgesic strategies may attenuate the pharmacogenetic effects of CYP2D6 on opioid response.
- The clinical impact of CYP2D6 on these analgesics appears limited in multimodal settings.
Related Concept Videos
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
01:25Analgesia and Pain Management
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
01:28Pharmacogenetics of Phase I Enzymes: Cytochrome P450 Isozymes
Cytochrome P450 (CYP450) enzymes are a superfamily of heme-containing monooxygenases that play a pivotal role in Phase I drug metabolism by catalyzing oxidation and reduction reactions.These enzymes transform lipophilic xenobiotics into more hydrophilic metabolites, facilitating subsequent Phase II conjugation and eventual excretion. The CYP450 family is classified into families (e.g., CYP1–CYP3) and subfamilies (e.g., CYP2A, CYP2C), based on amino acid sequence homology.CYP450 isoenzymes,...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
01:23Peripheral Artery Disease V: Postoperative Nursing Management
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...