Pgx in practice Flashcards
Goal of Pgx
The goal of PGX in practice is to offer the right drug at the right time with the right dose to the right person
Where pgx into drug therapy
Genetic polymorphisms: PK or PD
PK: ADME
PD: receptors, ion channels, enzymes, immune system
Drug labeling
> 300 drugs have pharmacogenomic information in the labeling
Hierarchy of SNPs
Identify a known SNP with a large clinical effect and adjust drug therapy or dosage
Genome wide screening (including variants of unknown significance) with bioinformatic prediction to adjust drug therapy or dosage
Progression to the omics era
- PGx
- Proteomics
- Metabolomics
- Transcriptions
- Microbiomics
- Etc
Personalized medicine
A form of medicine that uses information about a person’s genes, lifestyle, and environment to prevent, diagnose, and treat disease
Barriers to personalized medicine
- Drug-approval process
-FDA requirements
-Clinical practice guidelines - Traditional clinical practice models
-Lack of incorporation of clinical guidelines
-Lack of proof of value - Translating basic science to practice
-lack of incorporation into clinical guidelines - Technology
-cost/turnaround time are longer
-clinicians cannot keep up with large amount of information
Trial designs in precision medicine
- Basket trials: match patients with rare mutations, regardless of tumor histology
- Umbrella trials: investigational drug chosen based on PGX Biomarker
Barrier 2 traditional practice model
Medical team lacks expertise
Traditional practice model leaves physicians and pharmacists to cover these areas
Barrier 3 Translating basic science
- Drug label
- Clinical guidelines
- Primary literature
- CPIC: optimize drug therapy
Barrier 4 Technology
Partial solution: clinical decision support systems are being integrated into clinical practice
