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CPIC® Guideline for Potent Volatile Anesthetic Agents and Succinylcholine and RYR1 and CACNA1S

Most recent guideline publication:

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

Updates since publication:

None

Tables  provided in the main manuscript of the guideline:

Table 1. Assignment of RYR1 and CACNA1S phenotype based on genotype
Table 2. Recommended therapeutic use of inhaled anesthetics and succinylcholine in relation to RYR1 and CACNA1S phenotype

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

Tables and figures included in the supplement or referenced in the guidelinea:

Supplemental Table S1. Evidence linking RYR1 and CACNA1S genotype with malignant hyperthermia
RYR1 allele definition table 
RYR1 allele functionality table 
RYR1 frequency table 
RYR1 consult text and implementation workflow
CACNA1S allele definition table 
CACNA1S allele functionality table 
CACNA1S frequency table 
CACNA1S consult text and implementation workflow

Gene resource mapping

RYR1 gene resource mappings 

CACNA1S gene resource mappings 

Drug resource mapping

Desflurane

Enflurane

Halothane

Isoflurane 

Methoxyflurane 

Sevoflurane 

Succinylcholine 

Clinical decision support:b

Succinylcholine/volatile anesthetic pre- and post-test alerts and flow chart 

aSome of the tables included in the guideline may have been updated online, particularly to reflect newly described or newly characterized alleles. These include the gene-specific information tables (https://www.pharmgkb.org/page/pgxGeneRef) that support CPIC guidelines by providing information regarding star (*) allele definitions, allele function, allele frequency by major ethnic groups, translations of diplotype to phenotype, and gene resource mappings.

bThese resources support the adoption of CPIC guidelines into the electronic health record with clinical decision support and provide information that clinical implementers find helpful.