Pharmacogenomics of cytochrome p450 of nimodipine metabolism after aneurysmal subarachnoid hemorrhage

Sarah H. Peacock, Courtney James, Marion T. Turnbull, Jennifer B. Cowart, Joel M. Reid, W. David Freeman

Research output: Contribution to journalArticle

Abstract

INTRODUCTION Aneurysmal subarachnoid hemorrhage (aSAH) is a type of stroke that is life threatening with high rates of mortality, and many survivors are left with permanent neurologic deficits. Nimodipine is the treatment of choice for aSAH with the goal of reduction of delayed cerebral ischemia. It is the only evidence-based medication that has been shown to have improved outcomes for delayed cerebral ischemia; therefore, it is important for neuroscience nurses to be knowledgeable of the pharmacology and pharmacogenomics properties of this medication, including cytochrome P450 (CYP450) enzymes. METHODS AND RESULTS This article reviews the CYP450 enzyme system including a review of the pharmacotherapy and pharmacogenomics of nimodipine for patients with aSAH illustrated with case study of a patient with abnormal drug metabolism. CONCLUSION CYP450 enzymes can be inhibited or induced by multiple medications resulting in clinically significant differences in drug metabolism. Food and Drug Administration-approved medication nimodipine is the only medication shown to improve outcomes in patients with aSAH. Hence, it is important to have awareness of potential drug-to-drug interactions and pharmacogenomics of nimodipine when caring for critically ill patients with aSAH.

Original languageEnglish (US)
Pages (from-to)238-242
Number of pages5
JournalJournal of Neuroscience Nursing
Volume51
Issue number5
DOIs
StatePublished - Oct 1 2019

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Keywords

  • CYP450
  • delayed cerebral ischemia
  • nimodipine
  • pharmacogenomics
  • pharmacotherapy
  • precision medicine
  • subarachnoid hemorrhage

ASJC Scopus subject areas

  • Surgery
  • Endocrine and Autonomic Systems
  • Clinical Neurology
  • Medical–Surgical

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