Pharmacogenomics

Central to the practice of anesthesiology is the goal of safety and maximal efficacy for every individual patient. Genetics can influence drug metabolism, drug transport, and drug response target of action of drugs used in the anesthetic practice. This chapter provides a primer for those new to the concepts of pharmacogenomics and the historical role that anesthesia has played in the development of the field of pharmacogenomics/genetics. The majority of the chapter looks at pharmacologic classes of medications used in the anesthetic practice and the current role of pharmacogenetics in the pharmacokinetics and pharmacodynamics of commonly used anesthetic and analgesic drugs. Finally, the area of pharmacogenetics continues to evolve, and we cite examples where polymorphisms may influence the selection of perioperative medications to provide the safest and most efficacious care for each patient.