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A child's genotype predicted CYP2D6 phenotype correlates with parent initiated contact following tonsillectomy

Kara, Jacqueline M.
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1307985695

Abstract Details

2011, MS, University of Cincinnati, Medicine: Genetic Counseling.
Children are routinely prescribed codeine for pain management following tonsillectomy; however, the analgesic effects of codeine depend on its enzymatic conversion by cytochrome P450 2D6 (CYP2D6) to the active drug morphine. There are 4 classic phenotypes associated with the enzyme activity of CYP2D6; ultra-rapid metabolizer, extensive metabolizer, intermediate metabolizer, and poor metabolizer. The purpose of this study was to determine whether a CYP2D6 genotype-predicted phenotype was associated with parent initiated contact with a healthcare provider during a 3-week post-operative period when children were prescribed codeine for home pain management following tonsillectomy. This was a retrospective cohort study of 201 children between the ages of 6 and 15, who were scheduled for an elective tonsillectomy. At the time of surgery, blood was drawn and DNA was isolated and frozen. Cohort DNA was analyzed in batch for 23 CYP2D6 alleles after the three week post-operative period for all children. The association of parent initiated contact and the child’s CYP2D6 predicted phenotype was tested using logistic regression. A different CYP2D6 predicted phenotype effect was detected in different races. In white children, increasing CYP2D6 predicted metabolic capacity was significantly associated with higher probability of parent-initiated contact with a healthcare professional (p=0.0051), while in black children, no association was detected. Our study supports the need for future research investigating the clinical utility of pharmacogenetics testing to select and dose codeine and other narcotics for pain management.
John Greinwald Jr, MD (Committee Chair)
Cynthia Prows, , (Committee Member)
Daniel Prows, PhD (Committee Member)
Xue Zhang, PhD (Committee Member)
24 p.
Genetics
tonsillectomy; codeine; CYP2D6; poor metabolizer; adverse drug reaction; parent contact

Recommended Citations

Citations

  • Kara, J. M. (2011). A child's genotype predicted CYP2D6 phenotype correlates with parent initiated contact following tonsillectomy [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1307985695

    APA Style (7th edition)

  • Kara, Jacqueline. A child's genotype predicted CYP2D6 phenotype correlates with parent initiated contact following tonsillectomy. 2011. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1307985695.

    MLA Style (8th edition)

  • Kara, Jacqueline. "A child's genotype predicted CYP2D6 phenotype correlates with parent initiated contact following tonsillectomy." Master's thesis, University of Cincinnati, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1307985695

    Chicago Manual of Style (17th edition)

ucin1307985695
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© 2011, all rights reserved.
This open access ETD is published by University of Cincinnati and OhioLINK.