PHARMACOGENOMIC TESTING CAN HELP
DOCTORS PROTECT A PATIENT'S
5 RIGHTS OF MEDICATION SAFETY
DOCTORS PROTECT A PATIENT'S
5 RIGHTS OF MEDICATION SAFETY
FOR MORE DETAILS ON THE FIVE RIGHTS OF MEDICATION SAFETY
CLICK ON THE BLUE TO VISIT OUR WEB PAGE - FIVE RIGHTS OF MEDICATION SAFETY
CLICK ON THE BLUE TO VISIT OUR WEB PAGE - FIVE RIGHTS OF MEDICATION SAFETY
WHAT IS PHARMACOKINETICS VS. PHARMACODYNAMICS?
Pharmacogenomic testing:
Relevance in Medical Practice
Why drugs work in some patients but not in others
CLEVELAND CLINIC JOURNAL OF MEDICINE
Click and Scroll Down - To Read the Cleveland Clinic Journal of Medicine article - written by Researchers at the Department of Pharmacology & Division of Pharmaceutics Resources - Division of Clinical Trials, College of Medicine, & The Program in Pharmacogenomics, The Ohio State University
Relevance in Medical Practice
Why drugs work in some patients but not in others
CLEVELAND CLINIC JOURNAL OF MEDICINE
Click and Scroll Down - To Read the Cleveland Clinic Journal of Medicine article - written by Researchers at the Department of Pharmacology & Division of Pharmaceutics Resources - Division of Clinical Trials, College of Medicine, & The Program in Pharmacogenomics, The Ohio State University
Pharmacogenomics:
Increasing the safety and
effectiveness of drug therapy
Click and Scroll Down - To read the journal article from the AMA - American Medical Association, The Arizona Center for Education & Research on Therapeutics, and The Critical Path Institute
Increasing the safety and
effectiveness of drug therapy
Click and Scroll Down - To read the journal article from the AMA - American Medical Association, The Arizona Center for Education & Research on Therapeutics, and The Critical Path Institute
DISCOVERING THE INVISIBLE PATIENT
WITH PHARMACOGENETIC TESTING
PAIN MEDICINE NEWS - Thursday, 10/01/2009 at 2:24 PM
Discovering the Invisible Patient with Pharmacogenetic Testing
Posted by Antonella Carlozzi, PharmD
We are discovering more and more the important role genes play in how our bodies process drugs. Pharmacogenetic testing provides a way to look at a patients’ genes that play a role in drug metabolizing. Identifying unique characteristics of these genes can assist in individualizing pharmacotherapy for chronic pain treatment.1
Clinicians understand that visible differences between patients, such as age and weight, can affect how that patient will respond to pain treatment. What is currently less understood are the important invisible differences that also affect therapy. A primary cause of variation in drug response is interindividual variations in the genes that encode for the “proteins and enzymes involved in the transport and metabolism of drugs”.2 As Meijerman explains, “interindividual differences in the pharmacokinetics (PK) of drugs represent a major clinical problem. Because of these differences, plasma levels of drugs are poorly predictable, which might lead to unexpected toxicities or undertreatment of patients”.2 By identifying these genetic variations through a one-time genetic test, we can better prescribe a pharmacotherapy regimen that is optimal for each individual patient.
Specifically, “it is the role of the highly polymorphic CYP2D6 gene that is of the greatest clinical interest with respect to the observed interindividual variability in the opioid response”.1 The CYP2D6 gene metabolizes many drug classes, including the opioids. Variation in the DNA encoding for these enzymes can cause them to metabolize faster or slower.1 As also illustrated in the UDM handbook:
DNA sequence variations are associated with:
“The use of CYP2D6 genotyping to make therapeutic recommendations to improve therapeutic efficacy and to prevent toxicity in patients is promising and clinically relevant”.2 Pharmacogenetic testing can provide us with “invisible” genetic information on a patient’s propensity for a drug reaction that allows us to further objectify each individual’s pain regimen, and thus minimize the practice of trial-and-error prescribing.1
WITH PHARMACOGENETIC TESTING
PAIN MEDICINE NEWS - Thursday, 10/01/2009 at 2:24 PM
Discovering the Invisible Patient with Pharmacogenetic Testing
Posted by Antonella Carlozzi, PharmD
We are discovering more and more the important role genes play in how our bodies process drugs. Pharmacogenetic testing provides a way to look at a patients’ genes that play a role in drug metabolizing. Identifying unique characteristics of these genes can assist in individualizing pharmacotherapy for chronic pain treatment.1
Clinicians understand that visible differences between patients, such as age and weight, can affect how that patient will respond to pain treatment. What is currently less understood are the important invisible differences that also affect therapy. A primary cause of variation in drug response is interindividual variations in the genes that encode for the “proteins and enzymes involved in the transport and metabolism of drugs”.2 As Meijerman explains, “interindividual differences in the pharmacokinetics (PK) of drugs represent a major clinical problem. Because of these differences, plasma levels of drugs are poorly predictable, which might lead to unexpected toxicities or undertreatment of patients”.2 By identifying these genetic variations through a one-time genetic test, we can better prescribe a pharmacotherapy regimen that is optimal for each individual patient.
Specifically, “it is the role of the highly polymorphic CYP2D6 gene that is of the greatest clinical interest with respect to the observed interindividual variability in the opioid response”.1 The CYP2D6 gene metabolizes many drug classes, including the opioids. Variation in the DNA encoding for these enzymes can cause them to metabolize faster or slower.1 As also illustrated in the UDM handbook:
DNA sequence variations are associated with:
- Lack of enzymatic activity (poor metabolizer)
- Reduced enzymatic activity (intermediate metabolizer)
- Enhanced enzymatic activity (ultra-rapid metabolizer)
“The use of CYP2D6 genotyping to make therapeutic recommendations to improve therapeutic efficacy and to prevent toxicity in patients is promising and clinically relevant”.2 Pharmacogenetic testing can provide us with “invisible” genetic information on a patient’s propensity for a drug reaction that allows us to further objectify each individual’s pain regimen, and thus minimize the practice of trial-and-error prescribing.1
- Urine Drug Monitoring: Opioids Handbook - (Click here to download)
- Meijerman Irma, Sanderson Linda M., Smits Paul, Beijnen Jos H., Jan H.M. Schellens. “Pharmacogenetic Screening of the Gene deletion and Duplication of CYP2D6.” Drug Metabolism Reviews, 39: 45–60, 2007.
Personalized Medicine
Personalized medicine is the tailoring of medical treatment to the individual characteristics of each patient. Personalized medicine is now possible because sophisticated molecular and informatics tools are available to physicians to individualize patient treatment. New methods to select drugs or treatments tailored to each patient make better treatment outcomes possible with fewer adverse reactions to treatment. Personalizing treatment represents a substantial shift in medical practice from what worked for a “typical” patient to what now works for each “individual” patient.
Personalized Medicine is also known as Patient-Specific Medicine.
Pharmacogenomics
UNDERSTANDING THE IMPORTANCE OF PHARMACOKINETICS AND ADME
The term pharmacogenomics refers to the study of how genes affect the way a patient responds to medication. Genomic differences can influence the efficacy of medications, can be the source of serious drug side-effects, and can increase the risk of drug-to-drug interactions. By having an evidence-based report of a patient’s genomic drug suitability profile, a clinician can better understand how their specific patients may react to a medication.
Two concepts serve as the backbone of pharmacogenomics. The first is pharmacokinetics, which can be defined generally as the study of how the body metabolizes a drug. Each drug has its own unique metabolic profile, meaning each drug has a specific set of enzymes responsible for catalyzing the absorption, distribution, metabolism, and excretion (ADME) of a medication.
Numerous genomic variants affect how much of these enzymes an individual can produce. Having too little enzyme can cause a drug to build up in a patient’s system and result in adverse drug reactions (ADR’s). Producing too much of an enzyme may cause the patient’s body to excrete a medication too quickly, preventing the drug from ever reaching optimal therapeutic levels. The amount of enzyme available for each individual can be predicted through genomic testing.
The second concept behind pharmacogenomics is pharmacodynamics, which is the process by which a drug affects the body. Pharmacodynamics discerns how and to what degree a drug binds to its intended receptors in the brain. Some of the inter-individual variability in receptor binding can be predicted by genomic variants.
A CLIA certified lab tests and interprets numerous pharmacokinetic and pharmacodynamic genomic variants to help clinicians better understand how their specific patient may tolerate a medication in advance of making a prescription decision. We recognize that every patient is a unique individual, and this should be reflected in their medical treatment.
Personalized medicine is the tailoring of medical treatment to the individual characteristics of each patient. Personalized medicine is now possible because sophisticated molecular and informatics tools are available to physicians to individualize patient treatment. New methods to select drugs or treatments tailored to each patient make better treatment outcomes possible with fewer adverse reactions to treatment. Personalizing treatment represents a substantial shift in medical practice from what worked for a “typical” patient to what now works for each “individual” patient.
Personalized Medicine is also known as Patient-Specific Medicine.
Pharmacogenomics
UNDERSTANDING THE IMPORTANCE OF PHARMACOKINETICS AND ADME
The term pharmacogenomics refers to the study of how genes affect the way a patient responds to medication. Genomic differences can influence the efficacy of medications, can be the source of serious drug side-effects, and can increase the risk of drug-to-drug interactions. By having an evidence-based report of a patient’s genomic drug suitability profile, a clinician can better understand how their specific patients may react to a medication.
Two concepts serve as the backbone of pharmacogenomics. The first is pharmacokinetics, which can be defined generally as the study of how the body metabolizes a drug. Each drug has its own unique metabolic profile, meaning each drug has a specific set of enzymes responsible for catalyzing the absorption, distribution, metabolism, and excretion (ADME) of a medication.
Numerous genomic variants affect how much of these enzymes an individual can produce. Having too little enzyme can cause a drug to build up in a patient’s system and result in adverse drug reactions (ADR’s). Producing too much of an enzyme may cause the patient’s body to excrete a medication too quickly, preventing the drug from ever reaching optimal therapeutic levels. The amount of enzyme available for each individual can be predicted through genomic testing.
The second concept behind pharmacogenomics is pharmacodynamics, which is the process by which a drug affects the body. Pharmacodynamics discerns how and to what degree a drug binds to its intended receptors in the brain. Some of the inter-individual variability in receptor binding can be predicted by genomic variants.
A CLIA certified lab tests and interprets numerous pharmacokinetic and pharmacodynamic genomic variants to help clinicians better understand how their specific patient may tolerate a medication in advance of making a prescription decision. We recognize that every patient is a unique individual, and this should be reflected in their medical treatment.
INTRODUCTION TO GENETICS
The following is a basic introduction to the foundations of genetics. For more in-depth explanations, please refer to the links at the bottom of the page.
Genetics is defined as the biological study of the variations in organisms; it’s the study of the biological differences that make all living things unique. It’s easiest to start by describing the basic building blocks of all living organisms: cells. The human body is composed of trillions of cells. They provide structure for the body, take in nutrients from food, convert those nutrients into energy, and carry out specialized functions. Each cell is made up of several pieces, one of which is called the nucleus. A cell’s nucleus contains the majority of hereditary material known as DNA.
DNA, or deoxyribonucleic acid, is the hereditary material in humans and almost all other organisms. The information in DNA is stored as a code made up of four chemical bases: adenine (A), guanine (G), cytosine (C), and thymine (T). Human DNA consists of about 3 billion bases, and more than 99 percent of those bases are the same in all people. The order, or sequence, of these bases determines the information available for building and maintaining an organism, similar to the way in which letters of the alphabet appear in a certain order to form words and sentences.
DNA bases pair up with each other, A with T and C with G, to form units called base pairs. Each base is also attached to a sugar molecule and a phosphate molecule. Together, a base, sugar, and phosphate are called a nucleotide. Nucleotides are arranged in two long strands that form a spiral called a double helix. The structure of the double helix is somewhat like a ladder, with the base pairs forming the ladder’s rungs and the sugar and phosphate molecules forming the vertical sidepieces of the ladder. Long ladders of DNA are bundled with proteins into organized structures called chromosomes, which are responsible for carrying genomic material. Humans have 46 chromosomes.
Genes are specified portions of the DNA ladder, which act as instructions to make molecules called proteins. In humans, genes vary in size from a few hundred DNA bases to more than 2 million bases. The Human Genome Project has estimated that humans have between 20,000 and 25,000 genes. Every person has two copies of each gene, one inherited from each parent. Most genes are the same in all people, but a small number of genes (less than 1 percent of the total) are slightly different between people. Alleles are forms of the same gene with small differences in their sequence of DNA bases. These small differences contribute to each person’s unique physical features. The set of all genes that specify your traits is known as your genome. The composition of the genes is called a genotype. The study of multiple genes in an organisms genome is called genomics.
More Information: To learn more about genetics, check out the following links:
The following is a basic introduction to the foundations of genetics. For more in-depth explanations, please refer to the links at the bottom of the page.
Genetics is defined as the biological study of the variations in organisms; it’s the study of the biological differences that make all living things unique. It’s easiest to start by describing the basic building blocks of all living organisms: cells. The human body is composed of trillions of cells. They provide structure for the body, take in nutrients from food, convert those nutrients into energy, and carry out specialized functions. Each cell is made up of several pieces, one of which is called the nucleus. A cell’s nucleus contains the majority of hereditary material known as DNA.
DNA, or deoxyribonucleic acid, is the hereditary material in humans and almost all other organisms. The information in DNA is stored as a code made up of four chemical bases: adenine (A), guanine (G), cytosine (C), and thymine (T). Human DNA consists of about 3 billion bases, and more than 99 percent of those bases are the same in all people. The order, or sequence, of these bases determines the information available for building and maintaining an organism, similar to the way in which letters of the alphabet appear in a certain order to form words and sentences.
DNA bases pair up with each other, A with T and C with G, to form units called base pairs. Each base is also attached to a sugar molecule and a phosphate molecule. Together, a base, sugar, and phosphate are called a nucleotide. Nucleotides are arranged in two long strands that form a spiral called a double helix. The structure of the double helix is somewhat like a ladder, with the base pairs forming the ladder’s rungs and the sugar and phosphate molecules forming the vertical sidepieces of the ladder. Long ladders of DNA are bundled with proteins into organized structures called chromosomes, which are responsible for carrying genomic material. Humans have 46 chromosomes.
Genes are specified portions of the DNA ladder, which act as instructions to make molecules called proteins. In humans, genes vary in size from a few hundred DNA bases to more than 2 million bases. The Human Genome Project has estimated that humans have between 20,000 and 25,000 genes. Every person has two copies of each gene, one inherited from each parent. Most genes are the same in all people, but a small number of genes (less than 1 percent of the total) are slightly different between people. Alleles are forms of the same gene with small differences in their sequence of DNA bases. These small differences contribute to each person’s unique physical features. The set of all genes that specify your traits is known as your genome. The composition of the genes is called a genotype. The study of multiple genes in an organisms genome is called genomics.
More Information: To learn more about genetics, check out the following links:
