by brant bullard | Feb 17, 2014 | News
What is pharmacogenomics?
Pharmacogenomics uses information about a person’s genetic makeup, or genome, to choose the drugs and drug doses that are likely to work best for that particular person. This new field combines the science of how drugs work, called pharmacology, with the science of the human genome, called genomics.
What might pharmacogenomics mean for you?
Until recently, drugs have been developed with the idea that each drug works pretty much the same in everybody. But genomic research has changed that “one size fits all” approach and opened the door to more personalized approaches to using and developing drugs.
Depending on your genetic makeup, some drugs may work more or less effectively for you than they do in other people. Likewise, some drugs may produce more or fewer side effects in you than in someone else. In the near future, doctors will be able to routinely use information about your genetic makeup to choose those drugs and drug doses that offer the greatest chance of helping you.
Pharmacogenomics may also help to save you time and money. By using information about your genetic makeup, doctors soon may be able to avoid the trial-and-error approach of giving you various drugs that are not likely to work for you until they find the right one. Using pharmacogenomics, the “best-fit” drug to help you can be chosen from the beginning.
How is pharmacogenomic information being used today?
Doctors are starting to use pharmacogenomic information to prescribe drugs, but such tests are routine for only a few health problems. However, given the field’s rapid growth, pharmacogenomics is soon expected to lead to better ways of using drugs to manage heart disease, cancer, asthma, depression and many other common diseases.
One current use of pharmacogenomics involves people infected with the human immunodeficiency virus (HIV). Before prescribing the antiviral drug abacavir (Ziagen), doctors now routinely test HIV-infected patients for a genetic variant that makes them more likely to have a bad reaction to the drug.
Another example is the breast cancer drug trastuzumab (Herceptin). This therapy works only for women whose tumors have a particular genetic profile that leads to overproduction of a protein called HER2.
The U.S. Food and Drug Administration (FDA) also recommends genetic testing before giving the chemotherapy drug mercaptopurine (Purinethol) to patients with acute lymphoblastic leukemia. Some people have a genetic variant that interferes with their ability to process the drug. This processing problem can cause severe side effects and increase risk of infection, unless the standard dose is adjusted according to the patient’s genetic makeup.
The FDA also advises doctors to test colon cancer patients for certain genetic variants before administering irinotecan (Camptosar), which is part of a combination chemotherapy regimen. The reasoning is that patients with one particular variant may not be able to clear the drug from their bodies as quickly as others, resulting in severe diarrhea and increased infection risk. Such patients may need to receive lower doses of the drug. Read more at genome.gov
Where Can I Find More Information About Pharmacogenomics?
PGx Medical
Empowerment at the Source of Treatment
Individualized Care – Personalized Medicine
www.pgxmed.com
405-509-5112
For feedback or to schedule a phone conference, email:
info@pgxmed.com
by brant bullard | Feb 14, 2014 | News
Why Genetics Matter for Medication
I care for adult patients in my practice, but I have two great reasons to keep a watchful eye on the pediatric medical community: my kids.
With that in mind, I paid special attention when the FDA issued a boxed warning for codeine prescribed to children after tonsillectomy or adenoidectomy.
It’s the perfect example of pharmacogenetics at work. Pharmacogenetics is the concept of prescribing medicine based on a patient’s individual genetics. For some children, it just might be a life-saver. The risk — and the reason for a warning Codeine is a drug used to relieve pain, including the pain that comes after surgery to remove tonsils or adenoids. However, some adults and children have genetic variations that cause their bodies to process codeine much faster than others.
Codeine converts into morphine as the body processes it. Because of genetics, some people are “ultra-rapid metabolizers,” meaning their bodies change codeine into morphine very quickly. This causes an excess amount of morphine in the body that can lead to serious breathing problems. In rare but serious cases, this process can lead to death.
What parents can do
As a parent, what do you do about this risk? The good news: There is a pharmacogenetic test that determines how your body, or your child’s, will process codeine. If your child’s physician wants to prescribe codeine, be sure to ask about the test.
While not guaranteed, most insurance companies cover the cost of genetic tests for medications that have FDA boxed warnings for pharmacogenetics. If you’re concerned about cost, though, be sure to contact your individual insurance provider to confirm.
It’s important to note that adverse reactions to codeine can occur even if your child has not had their tonsils or adenoids removed. If your child is given codeine for any reason, watch out for extreme sleepiness or trouble breathing. If these symptoms occur, contact your physician or emergency services immediately. Your child’s physician may want to use a different medication for pain instead.
–Kathryn Teng, MD Cleveland Clinic.org
To read entire article, click here
For more information on Pharmacogenetic Testing, contact:
PGx Medical
Empowerment at the Source of Treatment
Individualized Care – Personalized Medicine
Info@pgxmed.com
405-509-5112
by brant bullard | Dec 27, 2013 | Journal articles, News
Excerpt: Many studies from around the world show a correlation between increasing age and adverse drug reaction (ADR) rate, at least for some medical conditions. More than 80% of ADRs causing admission or occurring in hospital are type A (dose-related) in nature, and thus predictable from the known pharmacology of the drug and therefore potentially avoidable. Frail elderly patients appear to be particularly at risk of ADRs and this group is also likely to be receiving several medicines. The toxicity of some drug combinations may sometimes be synergistic and be greater than the sum of the risks of toxicity of either agent used alone. In order to recognize and to prevent ADRs (including drug interactions), good communication is crucial, and prescribers should develop an effective therapeutic partnership with the patient and with fellow health professionals.
Citation: Br J Clin Pharmacol. 2004 February; 57(2): 121–126.
doi: 10.1046/j.1365-2125.2003.01875.x
P A Routledge, M S O’Mahony,1 and K W Woodhouse1
Access full white paper here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884428/
by brant bullard | Dec 27, 2013 | Journal articles, News
Excerpt: “Genetic variability can also be useful in understanding ineffective or unsafe prescriptions. In US alone, >3 billion prescriptions are written annually and millions of people depend on prescription and over the counter drugs to sustain their health. It has been estimated that >3 million of those prescriptions are either incorrect or ineffective. A non-efficacious drug decreases chances of survival while increasing additional cost to the patient. Deaths due to adverse drug reactions (ADRs) rank 4th-6th leading cause of deaths in US [8]. The cost associated with ADRs is expected to be >177 billion annually. Pharmacogenomics has the potential to minimize ADRs and some of the ADRs previously considered unpreventable may now be preventable due to better understanding of genetic variability [9–12]. These postmarketing experiences support the idea that pharmacogenetics should be involved early on in the drug development process and these postmarketing lessons are very beneficial in predicting clinical outcomes to a much better extent.”
>> Read & Print Full Article
Citation: Gupta D (2013) Pharmacogenomics in Drug Discovery and Development. J Develop Drugs 2:e126. doi: 10.4172/2329-6631.1000e126
by brant bullard | Oct 27, 2013 | Journal articles, News
Excerpt: Poor medication adherence is a well-known problem, particularly in patients with chronic conditions, and is associated with significant morbidity, mortality and health-care costs. Multi-faceted and personalized interventions have shown the greatest success. Pharmacogenetic (PGx) testing may serve as another tool to boost patients’ confidence in the safety and efficacy of prescribed medications. Here, we consider the potential impact (positively or negatively) of PGx testing on medication-taking behavior.
>> Read entire journal article
Citation: S B Haga and N M A LaPointeThe Pharmacogenomics Journal (2013) 13, 481–483; doi:10.1038/tpj.2013.33; published online 3 September 2013
