Pharmacogenomics Flashcards
parmacogenomics
study of how genes affect a person’s response to drugs, pharmacology + genomics
factors that influence drug response
age, diet, DDIs, genetics, kidney function, liver function, weight
how does genetic variation influence drug response
drug metabolizing enzymes, drug transporters (PK); drug target, drug receptors (PD)
genotype
genetic makeup of an organism
phenotype
traits of an organism that are expressed
CYP3D6 gene and genetic variation
does not work the same in everyone, differences in the gene that code these enzymes, leads to over production in some and no production in others
*1
wild type of a gene, does not guarantee normal function
how genetics impact prescribing
genotype –> phenotype –> clinical recommendation
benefits of pharmacogenetics
decrease healthcare costs, improve patient outcomes, avoid unnecessary treatment, increase medication compliance
when pharmacogenetics plays a role in patient care
BEFORE patient receives a dose
how codeine is affected by pharmacogenomics
different phenotypes for CYP2D6 gene, some people overly produce it –> ultra rapid metabolism to morphine, others dont produce it at all –> no pain relief
when codeine should not be used
in children who received tonsillectomy/adenoidectomy, in patients who are ultra rapid metabolizers or poor metabolizers, those who have not been genetically tested
CPIC
international consensus guidelines on pharmacogenomics that are actionable, peer reviewed, freely available, evidence based; tells you what you should do about a particular drug AFTER genetic testing has been done
PharmGKB
online resource that collects, curates and disseminates knowledge about the impact of human genetic variation on drug responses
