Negative urine opioid screening caused by rifampin-mediated induction of oxycodone hepatic metabolism
| Autor: | Gregory J. Tsongalis, Lionel D. Lewis, Steven H. Wong, Kiang-Teck J. Yeo, Hong-Kee Lee, Matthew McMullin, Bernard C. Schur |
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| Rok vydání: | 2005 |
| Předmět: |
Male
Narcotics Side effect Genotype Clinical Biochemistry Pharmacology Biochemistry Gas Chromatography-Mass Spectrometry Pharmacotherapy Pharmacokinetics Cytochrome P-450 Enzyme System medicine Cytochrome P-450 CYP3A Humans Molecular Structure business.industry Biochemistry (medical) Chronic pain General Medicine Drug interaction Middle Aged medicine.disease Opioid Cytochrome P-450 CYP2D6 Liver Rifampin business Oxycodone Pharmacogenetics medicine.drug |
| Zdroj: | Clinica chimica acta; international journal of clinical chemistry. 367(1-2) |
| ISSN: | 0009-8981 |
| Popis: | Introduction Oxycodone has become widely used in the clinic for the treatment of chronic pain. This reflects its favorable pharmacokinetics and side effect profiles. Case report We report a 60-y-old man who had a clinically significant drug interaction between rifampin and oxycodone, resulting in 3 consecutive negative urine oxycodone screens in a 2-month period, suggesting non-adherence. A combination of urine opioid metabolite quantification by GC/MS and CYP genotyping confirmed that he was compliant with his oxycodone therapy. Determination of the complete oxycodone metabolite profile and the CYP3A4/5 and 2D6 genotype allowed the physician to be confident that the patient was compliant with the medication (and not diverting it) and to increase his oxycodone dose to optimize his pain control. Conclusion This case demonstrates how the combination of analytical toxicology and pharmacogenetic analyses enhances a physician's ability to personalize drug therapy in patients with chronic pain syndromes. |
| Databáze: | OpenAIRE |
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