2007, Number 6
Acta Pediatr Mex 2007; 28 (6)
Flores-Pérez J, Cruz-Reyes IA, Flores-Pérez C
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ABSTRACTMetabolic polymorphism can alter the efficiency of a treatment or influence the occurrence of adverse reactions. Cytochrome 450, includes CYP2D6 which metabolizes 20% of drugs such as antipsychotic and antidepressive.
Several studies have shown significant racial differences in the prevalence of phenotypes of CYP2D6, but there is not enough information on this subject in pediatric populations.
Polymorphism of cytochrome is of great importance in pediatric pharmacotherapy, because of its therapeutic limitations are due to the lack of knowledge of metabolic characterization as well as, the lack of monitoring of the treatment results.
Pharmacogenetic techniques are important inasmuch as they help physicians to prescribe more adequate doses of antipsychotic drugs which are currently effective only in 30% of the patients.
“Personalized medicine” is important in psychiatry in order to optimize the dose of psychoactive drugs, by means of the use of CYP2D6 phenotyping, which allows to classify patients as slow, fast, intermediate and ultrarapid metabolizers.
Phenotyping is done with the use of dextromethorphan as an indicator of the metabolism of CYP2D6. After oral administration of a single 0.5 mg/kg dose of DM, its urinary concentration and that of its metabolite (dextrorphan) are measured with HPLC method for fluorescence detection.