This is a non-ticketed session.

There are a group of patients with chronic pain who benefit from pain management strategies including NSAIDs, Adjunct medications and opioids. The potential benefit of using opioids in non-cancer pain is accepted as standard of care by most but it must be done judiciously with knowledge of potential complications including addiction, adverse drug related behavior, misuse and death. There is a significant variation in the population regarding the CYP2D6 hepatic enzyme. This results in the population being classified as
•Poor metabolizers
•Intermediate metabolizers
•Extensive metabolizers
•Ultra-rapid metabolizers
Pharmacogenetics allows the CYP2D6 to be determined and the influence the phenotype on pharmacokinetics (t1/2, Cl, VD) to be modeled. This results in optimum plasma concentrations of active metabolites (morphine, hydromorphone, oxymorphone) that are above the MEC and below the MSC. The result is better efficacy for pain reduction and less chance of opioid toxicity and overdose.

1. To understand the influence of CYP2D6 polymorphisms on patient response to opioids;
2. To understand the advantages and disadvantages of opioid use in TMD; and
3. To understand the potential benefit of personalized pharmacogenetic pain management.