Question

In the context of pharmacogenetics, imagine two unrelated patients named Mary and Roberta. They both have similar sugaries and explain to their doctor that they are feeling a lot of pain as they recover from the procedure. Mary is an ultra-rapid metabolizer of opiod-based pain medication. Roberta is a very slow metabolizer for the same medication. Not knowing how each patient metaboilzes the medication, their doctor prescribes the same moderate dose for both of them. Who is at risk for overdosing and why? Who is not achieving the intended level of pain control and why?

Answer 1

Since, it is to be noted that with metabisation of opioids, they are cleared from the liver which decreases the risk of liver failure and other side effects. Hence, long availability of opioids is dangerous. Hence, in this case we can observe that Mary will metabolize the medication quickly which will clear the opioids whereas in case of Roberta the opioids will be available for longer time. Finally, we can conclude that Roberta is at greater risk of overdosing as she can not metabolize the medication quickly and it will lead to liver failure. Now, since opioid is present for longer duration in case of Roberta then she will achieve intended level of pain control, whereas in case of Mary she will achieve not achieve intended level of pain control as she metabolizes the opioid quickly.