Personalized Anesthetic Pharmacology

Abstract

Data accumulated over time demonstrate that the adverse drug reactions are the major cause of iatrogenic morbidity and mortality. Billions of dollars are spent annually in the USA due to increased hospitalizations, extended hospital stays, additional clinical investigations, and increased pharmacotherapy costs. It is estimated that genetic factors contribute to as far as 20% of the total number of reported adverse drug reactions.

For these reasons alone, personalized prescribing should be considered to improve patient outcomes, as well as a cost-mitigation strategy. At the center of this personalized approach is pharmacogenomic testing, which performed once can provide lifetime benefits. The ultimate goal of pharmacogenomics is to understand how a patient’s genetic makeup influences drug action and its adverse reactions.

Personalized medicine, considering the genetic profile of the patient, lifestyle, and environmental factors, has the potential to add new value to health care and to change the current one drug-fits-all approach. It follows a different postulate: the right drug, for the right patient, at the right time.

In this chapter, we will focus on the vast number of genetic variations that were reported in the literature to influence the pharmacological parameters of anesthetic drugs while putting emphasis on the clinical utility of those findings.