by PGx Medical | Sep 15, 2016 | Journal articles
If medication is not working for you, could new testing tell you if your genes are to blame?
Up to 99 percent of us may have small variations in our genes that can also impact how we react to common medications. (ISTOCKPHOTO)
By: Mark Dunnenberger
We all know a medication that works well for one person might not work for another – or even cause some people unwanted side effects. These differences in response can be caused by factors such as age, gender or other drugs and supplements that a person might be taking.
However, up to 99 percent of us may have small variations in our genes that can also impact how we react to common medications, including pain relievers, antidepressants and blood thinners.
Now, through a new kind of genetic testing in a field known as pharmacogenomics, some doctors are able to identify a number of these variations to help predict how their patients might respond to a new medication.
These tests are very different than genome sequencing services that provide data on your ancestry, analysis of disease-related genes or information on your risk of developing certain diseases. Instead, the tests look for specific gene variants that can help physicians minimize the trial and error of prescribing certain medications and help narrow down medication choices, especially when it comes to treatments for pain and psychiatric medications.
Understanding the basics of pharmacogenomics:
1. Pharmacogenomics will not tell you why your eyes are blue or predict your risk of cancer. Unlike other genetic tests, pharmacogenomics does not measure disease risk. Instead, it helps doctors identify treatments that are most likely to work by examining how your genes affect your response to medications.
2. The tests cannot give information about how you may respond to every single medication. Currently, research only supports testing for certain drugs, most commonly those for cardiology, pain management and depression/mental illness.
3. A pharmacogenomics test has value throughout your life. By studying a set of your genes, clinical experts can analyze a broad amount of information regarding drug therapy for many conditions, including psychiatric disorders, pain management and cardiology. Because your genes don’t change over time, you only need one test to discover genetic information that could be applied to future care. At some hospital-based testing centers, results can be added to your electronic medical record for easy access and used as a reference for medication and treatment choices throughout your life.
4. Pharmacogenomics is especially helpful for non-responders – people who have tried numerous drugs to find ones that effectively treat their symptoms. For some people, the tests can help explain why they didn’t respond to medications in the past, or provide peace of mind in knowing they are not genetically predisposed to a negative outcome on a new medication.
5. Make sure that the medications covered by the genes being tested are related to your current clinical situations or medications.
6. Pharmacogenetic testing is “not a crystal ball” and will not tell you the perfect drug for your condition. It can, however, narrow down your options and help doctors prescribe the right medicine faster avoiding the “trial and error” process.
7. Is no news good news? No specific feedback from your genomics test means that your suboptimal response to a particular medication is not the result of your genetics, but could be caused by other factors such as diet or age.
Especially when it comes to pain medication and psychiatric medications, pharmacogenomics testing can minimize the trial and error of prescribing medications, plus help a physician to narrow down treatment choices.
PGx Medical specializes in education and implementation of pharmacogenetic testing in the field of aging services. If you are interested in learning more, contact PGx Medical at info@pgxmed.com or 405-509-5112.
Read entire article at: health.usnews.com
by brant bullard | Jul 21, 2016 | Journal articles
The amazing benefits of pharmacogenetic testing
The Senior Health Guide of Central Oklahoma interviews, Dr. Stuart Schrader, DO of Crossway Medical Center, and Clay Bullard, President of PGx Medical. (more…)
by brant bullard | Jul 4, 2016 | Journal articles
As many as 10 percent of people do not receive pain relief from opioids.
The pain was too intense to ignore. Sixteen years later, Tony Cirrincione still remembers it. He was on a weekend ski trip, and he staggered into the ski lodge, leaving his wife in charge of their son and the five other Cub Scouts they’d brought along. Wincing at the dull ache in his back, he tried to stretch away what had to a muscle cramp. But the bursts of pain grew only more intense, erupting at more frequent intervals. Soon he was in the emergency room in Chicago. Kidney stones that had him doubled over the triage station. Waiting for the prescription opioid Dilaudid (hydromorphone) to take hold. But it never did.
According to Genome Magazine, as many as 10 percent of people do not receive pain relief from opioids. That’s a staggering statistic in a country where more than 75 million people live with chronic pain. Many individuals, like Cirrincione, who don’t respond to certain prescription pain relievers have no idea why. But a type of genetic testing is bringing answers to a growing number of them. (more…)
by brant bullard | Jun 12, 2016 | Journal articles
About half of all medical patients get a drug, in any given year, that could interact with their genes and cause serious side effects.
Article: Scientificamerican.com
Inexpensive gene tests, as yet only available in a few hospitals, could avoid these life-threatening problems. Yet lack of insurance reimbursement and confusion over when and how to alter drug prescriptions hold back tests’ widespread use.
Korei Parker is a boisterous seven-year-old with an infectious smile who improvises her own songs and loves to share them out loud. On an April day two years ago ago in Memphis, Tenn., where she lives, Korei came home from school with strange bruises. She had bumped into some things, she said—maybe a desk—but not hard enough to cause deep marks. Her mother, Rhonda, called their pediatrician and set up an appointment for later that week. But the next morning Korei woke up with new splotches across her arm and forehead. And when Korei brushed her teeth, her gums started to bleed. (more…)
by brant bullard | May 14, 2016 | Journal articles
Pharmacogenomic testing is an evidence-based tool that provides information about a patient’s response to medications and can help guide healthcare professionals when dosing medications.
According to the new guidelines from the American Psychiatric Association, healthcare providers should focus on “judicious” use of antipsychotic medications when treating people with dementia.
The guidelines, published this week in the American Journal of Psychiatry, acknowledge antipsychotics can be appropriate for people with dementia who exhibit severe or agitation or psychosis. But providers should assess each patient’s symptoms and and possible nonpharmacological interventions before administering the drugs, experts cautioned.
“Over the last few years there have been a number of additional studies that suggest there can be harms with these medications,” author Laura Fochtmann, M.D., told MedPage Today. “As the number of older individuals with dementia increases, we want to be assured that patients are getting the most appropriate form of treatment.”
The guidelines include recommendations to taper and eventually discontinue antipsychotic use if patients experience significant side effects or see no significant response after a 4-week trial. Patients who show an “adequate” response to antipsychotics should also have their doses tapered within 4 months of starting on the drug, unless they exhibit a recurrence of symptoms during tapering or withdrawal, the authors said.
With pharmacogenomic testing, healthcare professionals can avoid the “trial and error” or guessing game. They will have an evidence based tool to help guide them in dosing.
“You don’t always have the luxury of waiting 4-6 weeks when you are dealing with a patients who is agitated or displaying aggression. To wait 4 weeks and find out the medication isn’t working, or that the medication you gave them is having an adverse reaction with another medication they are taking, that is hard on everyone,” said Clay Bullard, President of PGx Medical.
PGx Medical is headquartered in Oklahoma but offers education and implementation of their Metabolic Validation Program across the country. “Our program is designed to help healthcare professionals avoid the “trial and error” process and offer their patients more precise, pinpoint therapy. By knowing which medications a patient has the ability to metabolize properly, allows the healthcare provider to accurately prescribe medications. That doesn’t mean they won’t have side effects from that medication, it just means their body will metabolize the medications the way the drug manufacturer intended, therefore giving them therapy.”
Bullard went on to say, “dementia patients can’t always tell you if their medications are, or are not working. So to have a customized patient report which includes personalized result interpretations and actionable treatment recommendations for each patient, it really helps shorten the timeframe giving that individual therapy a lot sooner.”
When a dementia patient is treated with medications that work and lessens the agitation and aggression, it may help offset the fatigue and burnout on the staff and caregivers.
For more information on the PGx Medical Metabolic Validation Program, contact:
PGx Medical
Individualized Care – Personalized Medicine
info@pgxmed.com
405-509-5112
Source:
American Psychiatric Association
American Journal of Psychiatry
MedPage Today
by brant bullard | Mar 30, 2016 | Journal articles
An estimated 1.5 million beneficiaries are receiving treatment at more than 15,000 long-term care facilities around the country.
The CMS proposed a rule aimed at dramatically improving the quality of care Medicaid and Medicare beneficiaries are receiving in nursing homes.
According to modernhealthcare.com, an estimated 1.5 million beneficiaries are receiving treatment at more than 15,000 long-term care facilities or nursing homes around the country that participate in the Medicare and Medicaid programs.
The 403-page proposed rule released in 2015 contains numerous proposals to reduce unnecessary hospital readmissions and infections, increase quality of care and introduce new safety measures.
President Barack Obama announced the new rules in July 2015 at the White House Conference on Aging.
Some of the changes include making sure that nursing home staff members are properly trained on caring for residents with dementia and in preventing elder abuse. Other changes include improving care planning, including discharge planning for all residents with involvement of the facility’s interdisciplinary team and consideration of the caregiver’s capacity, giving residents information they need for follow-up, and ensuring that instructions are transmitted to any receiving facilities or services. Lastly, the CMS is looking to strengthen the rights of nursing home residents, including placing limits on when and how binding arbitration agreements may be used.
The CMS is the leading payer in the nation for long-term care services. Approximately 64% of nursing home residents have their care paid for by Medicaid, another 14% are covered by Medicare and 22% have another payer, according to the American Health Care Association, a nursing home trade group.
If finalized, the proposals would cost the nursing home industry $729 million in the first year the rule is in effect and $638 million in year two, according to the CMS.
Richard Mollot, executive director at National Consumer Voice for Quality Long-Term Care, said he also wanted more controls to ensure that senior citizens are not unnecessarily prescribed anti-psychotics, which has been a problem at nursing homes.
“When anti-psychotics are used long term, there is an increased risk of death,” Mollot said. Read entire article at modern healthcare.com
Clay Bullard, president of PGx Medical believes by managing a residents medications you can improve quality of care not only for the resident, but also for the staff. “All of a sudden, residents with behavioral issues aren’t a problem any longer when you have them on medications they are able to receive therapy from, and you can reduce cost by eliminating unnecessary medications. It’s a win-win for everyone.”
For information on Metabolic Validation, via pharmacogenomic testing, contact:
PGx Medical
Individualized Care – Personalized Medicine
info@pgxmed.com
405-509-5112
