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CHAPTER 25
Pharmacogenomics
CHAPTER OBJECTIVES
- Define pharmacogenomics.
- Detail some of the challenges associated with drug therapy.
- Review example applications of pharmacogenomics.
- Identify limitations and pitfalls to this developing technology.
KEY TERMS
Every practicing clinician has noticed differences among patients in terms of how they react to medicines. This includes not only prescription medications but also over-the-counter medications (i.e., those obtained without a prescription). Unfortunately, the only way to determine how a patient will react to a medication is via trial and error. Generally, a patient will try some new medicine and then report an adverse reaction soon after starting the treatment. The range of potential reactions varies, from a mild, itchy skin rash to a full-blown anaphylactic reaction that includes lip and tongue swelling and closing of the airway. Obviously, all healthcare providers want to avoid these types of adverse events in their patients.
Pharmacogenomics is the study of how genes affect a person’s response to drugs. A relatively new field, it combines pharmacology and genomics to develop effective and safe medications so that doses can be tailored to a person’s genetic makeup. Along the way, it attempts to explain variability of drug responses based on genetic differences between individuals. The goal is to understand the role that an individual’s genetic makeup plays in how well a medicine works, as well as which side effects are likely to occur in the individual’s body. This information can help tailor the development of drugs so that they are best suited for a particular individual or group. Pharmacogenetics refers to the role of inheritance in individual variation in drug metabolism. For most purposes, the terms pharmacogenetics and pharmacogenomics can be used interchangeably. Some potential benefits of pharmacogenomics are shown in Box 25-1.
KEY TERMS
Pharmacogenomics: the study of the combination of pharmacology and genomics; the aim is to develop effective and safe medications to compensate for genetic differences in patients that cause varied responses to a single therapeutic regimen.
Pharmacogenetics: the study of the interrelation of hereditary constitution and response to drugs.
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