Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for the Use of Potent Volatile Anesthetic Agents and Succinylcholine in the Context of RYR1 or CACNA1S Genotypes

Stephen G Gonsalves¹, Robert T Dirksen², Katrin Sangkuhl³, Rebecca Pulk⁴, Maria Alvarellos³, Teresa Vo⁵, Keiko Hikino⁶, Dan Roden⁷, Teri E Klein³, S Mark Poler⁸, Sephalie Patel⁹, Kelly E Caudle¹⁰, Ronald Gordon¹¹, Barbara Brandom¹², Leslie G Biesecker^{1

13}

Affiliations

¹ Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA.
² Department of Pharmacology & Physiology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
³ Department of Biomedical Data Science, Stanford University, Stanford, California, USA.
⁴ Center for Pharmacy Innovation and Outcomes, Geisinger Medical Center, Danville, Pennsylvania, USA.
⁵ Department of Pharmacy Practice, College of Medicine Internal Medicine, College of Pharmacy, University of South Florida, Tampa, Florida, USA.
⁶ Committee on Clinical Pharmacology and Pharmacogenomics, The University of Chicago, Chicago, Illinois, USA.
⁷ Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
⁸ Departments of Anesthesiology, Geisinger Medical Center, Danville, Pennsylvania, USA.
⁹ Department of Anesthesiology, H. Lee Moffitt Cancer Center, Tampa, Florida, USA.
¹⁰ Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
¹¹ Department of Anesthesiology, University of California San Diego, San Diego, California, USA.
¹² Department of Anesthesiology, Mercy Hospital UPMC, North American MH Registry of MHAUS, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
¹³ Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

PMID: 30499100
PMCID: PMC6513720
DOI: 10.1002/cpt.1319

Practice Guideline

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for the Use of Potent Volatile Anesthetic Agents and Succinylcholine in the Context of RYR1 or CACNA1S Genotypes

Stephen G Gonsalves et al. Clin Pharmacol Ther. 2019 Jun.

. 2019 Jun;105(6):1338-1344.

doi: 10.1002/cpt.1319. Epub 2019 Jan 24.

Authors

Affiliations

¹ Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA.
² Department of Pharmacology & Physiology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
³ Department of Biomedical Data Science, Stanford University, Stanford, California, USA.
⁴ Center for Pharmacy Innovation and Outcomes, Geisinger Medical Center, Danville, Pennsylvania, USA.
⁵ Department of Pharmacy Practice, College of Medicine Internal Medicine, College of Pharmacy, University of South Florida, Tampa, Florida, USA.
⁶ Committee on Clinical Pharmacology and Pharmacogenomics, The University of Chicago, Chicago, Illinois, USA.
⁷ Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
⁸ Departments of Anesthesiology, Geisinger Medical Center, Danville, Pennsylvania, USA.
⁹ Department of Anesthesiology, H. Lee Moffitt Cancer Center, Tampa, Florida, USA.
¹⁰ Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
¹¹ Department of Anesthesiology, University of California San Diego, San Diego, California, USA.
¹² Department of Anesthesiology, Mercy Hospital UPMC, North American MH Registry of MHAUS, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
¹³ Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

PMID: 30499100
PMCID: PMC6513720
DOI: 10.1002/cpt.1319

Erratum in

CORRIGENDUM: Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for the Use of Potent Volatile Anesthetic Agents and Succinylcholine in the Context of RYR1 or CACNA1S Genotypes.
[No authors listed] [No authors listed] Clin Pharmacol Ther. 2019 Dec;106(6):1408. doi: 10.1002/cpt.1670. Clin Pharmacol Ther. 2019. PMID: 31713238 No abstract available.

Abstract

The identification in a patient of 1 of the 50 variants in the RYR1 or CACNA1S genes reviewed here should lead to a presumption of malignant hyperthermia susceptibility (MHS). MHS can lead to life-threatening reactions to potent volatile anesthetic agents or succinylcholine. We summarize evidence from the literature supporting this association and provide therapeutic recommendations for the use of these agents in patients with these RYR1 or CACNA1S variants (updates at https://cpicpgx.org/guidelines and www.pharmgkb.org).

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest

LGB receives salary from the NIH, is a member of the Illumina Corporation medical ethics board and receives royalties from Genentech Inc.

References

1. Saba R, Kaye AD & Urman RD Pharmacogenomics in Anesthesia. Anesthesiol Clin 35, 285–94 (2017). - PubMed
1. Hwang JH, Zorzato F, Clarke NF & Treves S Mapping domains and mutations on the skeletal muscle ryanodine receptor channel. Trends Mol Med 18, 644–57 (2012). - PubMed
1. Capes EM, Loaiza R & Valdivia HH Ryanodine receptors. Skelet Muscle 1, 18 (2011). - PMC - PubMed
1. Rosenberg H, Pollock N, Schiemann A, Bulger T & Stowell K Malignant hyperthermia: a review. Orphanet J Rare Dis 10, 93 (2015). - PMC - PubMed
1. Glahn KP et al. Recognizing and managing a malignant hyperthermia crisis: guidelines from the European Malignant Hyperthermia Group. Br J Anaesth 105, 417–20 (2010). - PubMed

Publication types

Actions
Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Substances

Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Other Literature Sources
- The Lens - Patent Citations Database

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for the Use of Potent Volatile Anesthetic Agents and Succinylcholine in the Context of RYR1 or CACNA1S Genotypes

Affiliations

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for the Use of Potent Volatile Anesthetic Agents and Succinylcholine in the Context of RYR1 or CACNA1S Genotypes

Authors

Affiliations

Erratum in

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources