We have learned from clinical genetics that a patient’s genotype is the most important factor underlying an individual’s response to a drug.
occurrence in patients over the age of 65. Patient genotyping allows for more appro- priate prescribing and also shiſts us further from the trial-and-error, human guinea pig approach that has prevailed to date. Tus, personalized medicine can greatly reduce adverse side effects and increase the effectiveness of drugs, leading to improved safety and beter outcomes. Genotyping the polymorphisms of the
cytochrome P450 genes forms the basis for a collection of complimentary tests, or pan- els, used together to guide the choice of the drugs prescribed for a variety of diseases or conditions. Genotyping the CYPs tells us how a patient metabolizes different classes of available drugs, and at the same time genotyping a patient’s genetic variation within a few genes relevant to a particular
disease state, can significantly improve the selection of medication prescribed. For instance, if a patient is a normal opiate responder based on his or her OPRM1 genotype (the gene that codes for the opiate receptor), but a poor metabolizer of the pro-drug forms of opiate drugs based on CYP2D6 genotype, then an increase in dosage of pain medication may be indi- cated in that circumstance. Genetic test panels targeting genes
related to specific conditions are cur- rently available in the marketplace, and can provide insight into treatment options. For example, there are genotyping panels for pain management, estrogen metabolism, color blindness, cardiovascular disease and mental illness. Many of these panels test for a combination of cytochrome P450 genes
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datia focus
summer 2014
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