Carolyn's Daily Posts: 2011

April 8, 2011

Pharmacogenomics Can Improve Patient Meds




     When I began taking heart medications I entered new territory. I hated taking medication of any kind, and only did so when I was desperately in need. The new regimen made me feel like I was a part of a giant pharmaceutical experiment. Plus, I was aware there could be side effects. And, as always, I questioned whether or not I truly needed the medication.


What if when you went to the doctor’s office, instead of making an educated guess about what medication to prescribe, your doctor gave you a genetic test that indicated which medication was right for you?


     Such tests might predict how your response to a drug or determine if you are in a group of patients who would suffer side effects.

     Pharmacogenetics, a.k.a. pharmacogenomics, is the intersection of two fields, pharmacology and genetics. This youthful field that studies how genetic variations affect the ways people respond to drugs.

     The genetic variations are manifested in two ways:

  • The differences in the drug targets: this will usually lead to differences in how well the drug works
  • The differences in the enzymes that metabolize drugs: this can result in differences in either efficacy or toxicity.

     It’s possible that genes not directly involved in a particular pathway could end up being predictive of clinical outcomes.


     It’s known that samples of tumor tissue from different women with breast cancer will have different molecular make-ups, breaking the disease up into different categories that in effect are different diseases called the same thing. In the future, subdivisions of the disease will provide diagnoses of the molecular profile of the patient’s specific disease subcategory. Each subcategory could have a different treatment with a different outcome.

     Researchers must find the markers that indicate the connection between drug response and genetic make-up


     Pharmacogenomics may be most successful in areas such as oncology, where there are many therapies but each one works for only a small percentage of patients—it’s not unusual to have seventy percent of patients be nonresponsive for a chemotherapeutic drug. This may be due to the fact that within particular types of cancer there can be extreme molecular variability.


     The above research provides hop in that medications can be geared accurately toward the specific illness the patient has, instead of the medications being on a trial and error basis. However, as always, there is a down side: the improper use of the genetic records. As always, also, there is hope that the use of the records will be done only where needed, not to track individuals in society.


Pharmacogenomics, Celia M. Henry, C & EN, , August 13, 2001, pp 37




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