Knowledge and attitudes on pharmacogenetics among pediatricians
Shahad RahawiHetanshi NaikKathryn BlakeAniwaa Owusu ObengRachel WassermanYoshinori SekiVicky L. FunanageKimihiko OishiStuart A. Scott
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Abstract Pharmacogenetics is the study of how genetic variation influences the response to drugs. The concepts of race, ethnicity, and ancestry have long had a strong influence on pharmacogenetic discovery and on our understanding of population‐level differences in drug response. The primary goal of pharmacogenetics, however, is to identify the individual genetic determinants of drug activity so that therapy can be tailored to the individual patient. This article describes the relationship between the concepts of race, ethnicity, and ancestry and how these concepts have been applied to pharmacogenetics, and it provides examples of the benefits and pitfalls associated with the use of racial or ethnic labels in genetic studies. The future of pharmacogenetics, including the study of rare genetic variation and what this means for racial or ethnic disparities in pharmacogenetic discovery, is also discussed. Mt Sinai J Med 77:133–139, 2010. © 2010 Mount Sinai School of Medicine
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This chapter contains sections titled: Introduction Research approaches in pharmacogenetics and pharmacogenomics Hypertension pharmacogenetics Dyslipidemia pharmacogenetics Coronary artery disease and stroke pharmacogenetics Heart failure pharmacogenetics Dysrhythmia pharmacogenetics Conclusion References
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This chapter contains sections titled: Introduction Early Pharmacogenetics Studies (From 1900 to 1970) Pharmacogenetics of Drug Oxidation Pharmacogenetics of Drug Conjugation Pharmacogenetic Studies on Receptors and Transporters Pharmacogenomics, Genomewide Studies, and Personalized Medicine Conclusion References
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Despite growing numbers of pharmacogenetics studies, little pharmacogenetics-based prescribing information is available to practitioners. It is possible that the lack of prescribing data for commonly used drugs is due to a paucity of evidence-based pharmacogenetics literature for these agents.To investigate the relationship between pharmacogenetics prescribing data in drug package inserts (PIs) and pharmacogenetics research literature for agents represented in the top 200 prescribed drugs for 2003.A PubMed search (to August 7, 2004) was performed to identify pharmacogenetics studies relevant to the top 200 drugs. These data were compared with PIs for drugs in the top 200 list that contained pharmacogenetics prescribing information.Pharmacogenetics data in the literature were available for 71.3% of the top 200 drugs. The gene involved coded for a drug-metabolizing enzyme in 34.5% of the literature sampled. The remaining 65.5% of the pharmacogenetics studies contained information largely related to genetic variability in target proteins and drug transporters. Three drugs with PIs containing pharmacogenetics prescribing information deemed to be useful to guide therapy were in the top 200 list (celecoxib, fluoxetine, pantoprazole). There was no consensus on the strength of association between genetic variability and drug response for these agents.The lack of specific pharmacogenetics-based prescribing information in PIs for commonly used drugs does not seem to be related to a paucity of pharmacogenetics data in the research literature. Rather, other factors including, but not limited to, the uncertain clinical relevance of genetic associations may make practical prescribing recommendations difficult.
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Genetic and/or environmental factors lead to large inter-individual variability in the efficacy and the side effects of drugs.Pharmacogenetics is the study of genetically determined differences in drug response.It focuses on the genetic variations involved in drug metabolism, transporters and receptors, which result in the pharmacokinetic and pharmacodynamic differences.Recently, pharmacogenetic studies on anesthetics and analgesics have been carried out actively.The pharmacogenetics of the commonly used drugs in anesthetic practice is reviewed.(Korean J Anesthesiol 2008; 55: 527～37)
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Pharmacogenetics is the inherited basis of differences among individuals in their response to drugs. Genetic polymorphisms of drug-metabolizing enzymes may account for as much as 30% of interindividual differences in drug disposition and response. An increasing number of drug target polymorphisms have also been linked to differences in drug response. This chapter reviews some examples of the use of pharmacogenetics in clinical practice. Despite the increasing number of examples of genetic polymorphisms affecting drug response in the literature, pharmacogenetic data are rarely used in current clinical practice. The limitations that have prevented the use of pharmacogenetic testing in clinical practice are reviewed.
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Pharmacogenetics deals with genetically determined variations in response to drugs. Pharmacogenetics studies interindividual differences in DNA sequence that lead to a variable response to drug therapy. The ultimate goal of pharmacogenetics is to establish treatment on the principles of the personalized medicine in which each person, ie patient, is approached as an individual. The way to achieve this is to use molecular diagnostic methods to determine the pharmacogenetic status of the patient and to provide the possibility of adjusting the treatment to his needs.
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This chapter contains sections titled: The origins of pharmacogenetics The initial progress of pharmacogenetics Molecular genetic methods enlarged pharmacogenetics Multifactorial variation New problems and opportunities Summary and conclusions References
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