Intro to Pharmacogenomics Flashcards
What is personalized medicine?
Tailoring of medical treatment to individualized characteristics of each pt
The science of individualized prevention and therapy instead of one size fits all medicine
What is the problem with one size fits all medicine?
- some people show toxicity and no benefits
- some show both toxicity and benefit
- some not toxic but beneficial
- some not toxic and not beneficial
What is precision medicine?
- an emerging approach for disease treatment and prevention that considers individual variability in genes, environment (pollutants), lifestyle
- eg. blood transfusion
Diff b/w precision and personalized medicine?
- personalized is an older term
- could be misinterpreted to imply treatments and preventions are being develops uniquely for each individual
- precision is preferred but often interchangeable
What are some interactions that need to be considered? (3)
- drug gene
- gene env
- env drug
How does diet affect drug response? (2)
food interferes with absorption of some orally adminsitered drugs
- ex. Vitamin C or copper can increase absorption, tyramine rich food while on MAO inhibitors can lead to hypertensive crisis
need to adjust amount of food intake
- vitamin K containing food during warfarin treatment
- alterations in salt intake
How does ambient conditions affect drug response?
- changes in seasons, ambient temperature and altitude may result in variability
- ethanol toxicity is increased in winter as excessive dilation caused by ethanol that leads to excessive heat loss
- high ambient temp results in rapid anesthesia with inhalant volatile anesthetics as high temp increases vapor pressure of anesthetics and increase respiratory rate
- high alt with low atmospheric pressure reduces potential of body to oxidize drugs, low oxygen in system
How does pollutants affect drug response?
- cause synergistic effect with genetic polymorphisms resulting in high incidence of atherosclerosis
- air pollutants and cig smoking can result in induction of CYP450 enzymes that may result in carcinogenic metabolites for some meds
How does ethnicity affect drug response?
- certain ethnicities have worse asthma prognosis in presence of air pollutants
- certain ethnicities share common genetic polymorphism
- variant allele frequencies may be more prevalent in certain ethnic groups
Intrinsic factors
genetic: gender, race, polymorphism, genetic disease
physiological/pathological: age, liver, kidney, CV function, diseases
in b/w genetic and physiological: height, bodyweight, ADME, receptor sensitivity
Extrinsic factors
what is in b/w extrinsic and intrinsic?
environmental: climate, pollution, culture, language, education, medical practice, diagnostic, approach, drug compliance
smoking, alcohol, food habits, stress is b/w intrinsic and extrinsic
What is pharmacogenetics?
study of effect of variations of DNA sequence on drug response in metabolism/clearance (PK) and action (PD) of drug delivered
What is diff b/w pharmacogenetics vs pharmacogenomics?
pharmacogenetics: focuses on influence of single genes on drug response
pharmacogenomics: broader view of entire genome and their response to drug therapy
interchangeable use
what is genotype?
genetic makeup of individual
what is phenotype?
observable physical and biochemical characteristics of an organism determined by genotype and env
