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Pharmacogenomics and adverse drug reactions in diagnostic and clinical practice
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Vangelis G. Manolopoulos
Veröffentlicht/Copyright:
1. Juli 2007
Abstract
Pharmacogenetics and pharmacogenomics deal with genetically determined variations in how individuals respond to drugs. They hold the potential to revolutionize drug therapy. The clinical need for novel approaches to improve pharmacotherapy stems from the high rate of adverse reactions to drugs and their lack of effectiveness in many individuals. Despite the accumulation of research findings showing the potential for clinical benefit for several drug-metabolizing enzymes and some receptors that constitute drug targets, the translation of these findings into tangible clinical applications occurs very slowly. The main steps for clinical implementation of pharmacogenomics include: a) education of clinicians and all other parties involved in the use and benefits of pharmacogenomics; b) execution of large prospective clinical and pharmacoeconomic studies showing the benefit of pharmacogenomic genotyping; c) provision of incentives to develop tests; d) development of specific clinical guidelines; and e) creation of a solid regulatory and ethical framework. Furthermore, the potential should be explored to use existing therapeutic drug monitoring laboratories to introduce pharmacogenomic testing into hospitals. Overall, our thesis is that pharmacogenomics is already a reality in clinical practice and is bound to continue gaining acceptance by clinicians in the coming years.
Clin Chem Lab Med 2007;45:801–14.
Keywords: adverse drug reactions; CYP2D6; CYP2C9; CYP2C19; genetic polymorphism; pharmacogenetics; pharmacogenomics; therapeutic drug monitoring; thiopurine S-methyltransferase (TPMT); uridine diphosphate glucuronosyltransferase (UGT1A1)
Received: 2007-4-17
Accepted: 2007-5-22
Published Online: 2007-07-01
Published in Print: 2007-07-01
©2007 by Walter de Gruyter Berlin New York
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Artikel in diesem Heft
- Pharmacogenomics and Personalized Medicine – a global reality check
- Pharmacogenomics and adverse drug reactions in diagnostic and clinical practice
- Impact of genetic polymorphisms on the risk of lipid disorders in patients on anti-HIV therapy
- Polymorphisms in genes involved in DNA repair and metabolism of xenobiotics in individual susceptibility to sporadic diffuse gastric cancer
- Effect of 13-cis-retinoic acid on the genetic expression profile of human umbilical vein endothelial cells (HUVECs) determined by microarray
- Association between T102C and A–1438G polymorphisms in the serotonin receptor 2A (5-HT2A) gene and schizophrenia: relevance for treatment with antipsychotic drugs
- A1166C polymorphism of the angiotensin AT1 receptor (AT1R) gene alters endothelial response to statin treatment
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