Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for the use of potent volatile anesthetic agents and succinylcholine in the context of RYR1 or CACNA1S genotypes.

Gonsalves SG1, Dirksen RT2, Sangkuhl K3, Pulk R4, Alvarellos M3, Vo T5, Hikino K6, Roden D7, Klein T3, Mark Poler S8, Patel S9, Caudle KE10, Gordon R11, Brandom B12, Biesecker LG1,13.

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Abstract

The identification in a patient of one of the 50 variants in the RYR1 or CACNA1S genes reviewed here should lead to a presumption of malignant hyperthermia susceptibility. Malignant hyperthermia susceptibility 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). This article is protected by copyright. All rights reserved.