Paweł Radkowski, Karol Śliwa, Daria Synia, Agnieszka Witowska, Justyna Opolska, Tomasz Jędrzejak, Milena Samiec

Effects of genetic polymorphism on the pharmacodynamics and pharmacokinetics of representatives of the two main groups of muscle relaxant drugs during general anaesthesia
2024-07-25

Background. The presented paper discusses the influence of genetic polymorphism on the pharmacokinetics and pharmacodynamics of muscle relaxant drugs used during general anesthesia. The authors take a closer look at the effects of commonly used drugs in anesthesiology: succinylcholine, mivacurium, rocuronium and others. The primary aim of the study was to demonstrate the relationship between the expression of individual genes encoding enzymes modifying the action of the mentioned drugs and the influence of genetics on their elimination from the body.

Aim of the study. The essence of the presented study is the best possible customization and selection of a ‘tailor-made’ drug for individual patients, which is particularly important in avoiding complications associated with the use of common muscle relaxants.

Material and methods. To write the article, the authors searched  scientific databases, including PubMed and Google Scholar. The bibliography largely consists of publications from the last 5 years.

Results and conclusions. The examples of DNA polymorphisms presented in this study, together with the described common side effects of drugs used in general anesthesia, indicate the important role of pharmacogenetics in selecting the most appropriate drug for individual patients during surgery, which, as we have attempted to demonstrate, influences better treatment outcomes and helps to minimize possible side effects.

Relevance of the study to contemporary practice: Our study is one of the few to collect all available data on the genetic association with the pharmacodynamics and pharmacokinetics of muscle relaxant drugs, which nowadays seems extremely important as general anesthesia is used more frequently than ever before. Knowledge of the patient’s genetics could help predict the mode of action of the most common muscle relaxants and tailor anesthesia specifically for that patient, which in turn would help improve patient comfort during surgery and reduce the incidence of adverse reactions associated with general anesthesia.

Keywords: neuromuscular blocking drugs, polymorphism, butyrylcholinesterase (BCHE), rocuronium, succinylcholine.

© Farm Pol, 2024, 80(3): 157–164