Date of Award
Master of Science (MS)
First Advisor or Mentor
Pharmacogenetics refers to the relationship between phenotypic variation in metabolism and response to certain drugs. The interface of pharmacogenetics and forensic toxicology is not well explored. A major component of the opioid metabolic pathway has to do with a family of cytochromes called cytochrome P450 (CYP450). CYP450 refers to a general family of enzymes capable of catalyzing the oxidative biotransformation of lipophilic substances, CYPs are further categorized into families and sub-families (Roller, 2015; Zanger & Schwab, 2013). The gene CYP2D6 belongs to the CYP2 family which is responsible for the biotransformation of xenobiotics. This study looked at the effect of the highly polymorphic CYP2D6 gene on the results of a prescription drug monitoring tool called “Comprehensive Oral Fluid Rx Evaluation (CORE)” for Oxycodone. A range of high likelihood and low likelihood phenotype frequencies across several biogeographical groups from Whirl-Carrillo et al. (2012,2021) were used to predict the possible effect of CYP2D6 genetic polymorphisms on out-of-range CORE results. The results of this study found that CYP2D6 genetic polymorphisms are a possible but not very likely cause for out-of-range results. Other possible causes for out-of-range results are non-adherence, drug-gene interactions, drug-drug-gene interactions and herbal remedies. Suggestions for further research include documentation of ethnicity, and co-medications for CORE testing patients, and looking at a medication in which CYP2D6 is the major metabolic pathway.
Lewis, Aliya D., "The Impact of Pharmacogenetics on Oral Fluid Steady State Drug Testing Results" (2022). CUNY Academic Works.