Pharmacogenetic testing

Question 1

Factors influencing drug response

Answer 1

• Age
• Sex
• Diagnostic accuracy
• Drug-drug interactions
• Renal and hepatic function
• Medical and psychiatric comorbidity
• Treatment adherence
• Pharmacodynamic variation
• Pharmacokinetic variation

Question 2

Pharmacogentic vs Pharmacogenomic

Answer 2

Pharmacogentic: Evaluating a single gene

Pharmacogenomic: Evaluating multiple genes

Question 3

Agencies

Answer 3

CPIC
ISPG
Dutch working group

Question 4

product options

Answer 4

• Genesight
  Most frequent seen (ohio)
  Sample report
  Green yellow red
  -Kinda oversimplified
  -Red doesn’t mean don’t use at all though
  Clinical consideration key
• Genomind
  2 products
  -Core anxiety and depression report
  -Full mental health report
  Low, altered, intermediate etc
  Gene drug interaction summary
  Continuum red to blue to show caution etc
  They have a pocket card
• CNSDose
• BBB test

all do CYP450 and the first 2 do many others

Question 5

the most evidence for what is tested

Answer 5

CYP2D6
CYP2C19
HLA-A
HLA-B

Question 6

implementation in practice

Answer 6

FDA reccs for patient and providers

2015 CPIC guidelines
-Before start or after AE or inadequate response
-Consider drug interaction

2019 ISPG statement
-Similar to FDA and CPIC
-HLA carba and oxcarba
-CYP