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Too Slow to Flow

CYP2D6 ultraslow metabolism of metoprolol

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A Case Approach to Perioperative Drug-Drug Interactions

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Abstract

This case discusses a drug–gene interaction involving and ultraslow metabolism of metoprolol by a cytochrome P450 (CYP) 2D6 allele, leading to excessive bradycardia in the clinical setting of a high dermatomal level of spinal anesthetic.

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References

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Author information

Authors and Affiliations

  1. Kansas Professional Anesthesia & Pain Management Specialists, Wichita, KS, USA

    Scott W. Cantwell MD

  2. Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA

    Toby N. Weingarten MD & Juraj Sprung MD, PhD

Authors
  1. Scott W. Cantwell MD
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  2. Toby N. Weingarten MD
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  3. Juraj Sprung MD, PhD
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Corresponding author

Correspondence to Scott W. Cantwell MD .

Editor information

Editors and Affiliations

  1. Anesthesia Services Department, Philadelphia Veterans Affairs Med Center, Philadelphia, PA, USA

    Catherine Marcucci MD

  2. Department of Anesthesiology, Oregon Health and Science University, Portland, OR, USA

    Michael P. Hutchens MD

  3. Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA

    Erica D. Wittwer MD, PhD , Toby N. Weingarten MD , Juraj Sprung MD, PhD  & Wayne T. Nicholson MD, PharmD, MSc , ,  & 

  4. Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, OR, USA

    Kirk Lalwani MD

  5. Department of Anesthesiology, University of Pittsburgh School of Med Liliane S. Kaufmann Building, Pittsburgh, PA, USA

    David G. Metro MD

  6. Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL, USA

    Randal O. Dull MD, PhD

  7. Department of Anesthesiology, Perioperative Medicine, Oregon Health and Science University, Portland, OR, USA

    Christopher E. Swide MD

  8. Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA

    F. Jacob Seagull PhD

  9. Department of Anesthesiology and Perioperative Medicine, Portland, OR, USA

    Jeffrey R. Kirsch MD (Professor and Chair) (Professor and Chair)

  10. Department of Psychiatry, University of Maryland Medical System VA Maryland Health Care System, Baltimore, MD, USA

    Neil B. Sandson MD

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Cantwell, S.W., Weingarten, T.N., Sprung, J. (2015). Too Slow to Flow. In: Marcucci, C., et al. A Case Approach to Perioperative Drug-Drug Interactions. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7495-1_127

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  • DOI: https://doi.org/10.1007/978-1-4614-7495-1_127

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7494-4

  • Online ISBN: 978-1-4614-7495-1

  • eBook Packages: MedicineMedicine (R0)

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