Feb 25, 2016
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References
External links
Microsoft Certification Website
Category:Microsoft certification programs was suggested by the authors of the current study.
Although a number of clinically relevant differences have been identified among *CYP2D6* and *CYP3A4* metabolizers, the current study suggests that phenotypic tests are likely to yield more useful clinically relevant predictions of plasma concentrations of tramadol and its active metabolite *O*-desmethyltramadol in CYP2D6 and CYP3A4 metabolizers than a prediction of their total metabolism based on genotyping results. This is the case because genotyping alone has a rather low sensitivity to predict the true phenotype as already discussed. Although a direct comparison between the present study and the present work is not possible, our analyses of their original datasets showed that both methods have comparable performances in differentiating *CYP2D6* and *CYP3A4* metabolizers. Our *CYP2D6* and *CYP3A4* genotyping results had a slightly higher sensitivity (range, 51.9%--81.8%) than the results of the current study (range, 40.4%--83.3%), which might be due to different allele frequencies.
The current study has some limitations. First, we were unable to investigate the direct effect of *CYP3A4* polymorphisms on the pharmacokinetics of tramadol and *O*-desmethyltramadol in the present study. Moreover, we were not able to investigate whether *CYP2D6* and *CYP3A4* polymorphisms affected the pharmacodynamics of tramadol in the present study. To address these important questions, genotype-stratified, double-blinded, placebo-controlled, randomized trials using TCAs as an analgesic drug should be performed. Second, the study population included only female participants, and ethnic differences in the effects of CYP2D6 and CYP3A4 metabolizing enzymes on the pharmacokinetics and pharmacodynamics of tramadol and *O*-desmethyltramadol may exist. Moreover, the current results cannot be extrapolated to subjects with other ethnic backgrounds. Third, the current study used the validated gen 01e38acffe
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1年前. Visual Certexam 4.3.2 Activation Key
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