We all have been made aware of drug-drug, drug-food/beverage and drug-medical condition interactions. Now, we know that your genetics determine how your body will metabolize certain drugs. The goal is to get the right drug in the right amount to treat your condition and genetics provides the answer.
Lifestyle Programs Tailored to Your Unique Genetic Profile
The Evidence for Patient Specific Medications
Pharmacogenomics is the study of how an individual’s genes affect the response to medications. This new field of study can provide patient specific medications and dosing recommendations that decrease adverse therapy and increase the probability of successful therapy. The choice of medications and the dosing is based upon the patient’s specific genetic profile. This field of medicine is part of the field described as Individualized or Personalized Medicine.
The key to pharmacogenomics is its ability to define a probability of the patient’s response to certain medications and doses based upon specific genes. It is estimated that genetics can account for between 20% – 95% of an individual’s response to a drug. These genetic factors along with epigenetic factors determine the outcome from treatment with a drug. The goal is to get the right drug in the right amount for you.
As patients, we have been made aware to avoid drug-drug, drug to food/beverage and drug-medical condition interactions. This task is increasingly more difficult for your physician and pharmacist as the number of newly developed and registered drugs increases every year. Drug interactions may make the drug you take less effective; cause unexpected, serious side effects or increase the action of a particular drug. However, beyond identifying possible adverse interactions, physicians do not try to individualize the therapy beyond a trial and error method of selecting the drug and the dosing because they do not have your genetic information.
Genetics and Drug Interactions
The response to a certain drug varies per patient. This person-to-person variability of a drug response is a major problem in daily clinical care. It can lead to therapeutic failure or other adverse effects. Therefore, genotyping tests are of increasing importance in optimizing drug therapy for an individual patient.
Enzymes known as Cytochrome p450s (CYP) found in the liver and small intestine are the major enzymes involved in the metabolism of medications in our body. There are over 60 CYP genes in the human genome and they are cited as clinically important in metabolizing up to 78% of the 200 most prescribed drugs in the US. CYP enzymes act on medications such as statins, NSAIDS, proton pump inhibitors, anti-depressants, anti-psychotics, anti-coagulants, beat blockers and other medications that are metabolized through the CYP pathway. Dosing guidelines for FDA approved drugs which take into consideration patient genotypes are published by the Clinical Pharmacogenetics Implementation Consortium.
Diet regulates the expression and function of CYP genes and therefore is an important consideration for pharmacogenetics. For example: diets that are high in fats or carbohydrates or diets high in cruciferous vegetables and fruits have direct impact on CYP enzymes and their expression and have the potential for positive or negative outcomes.
Take Action
Work with KlothoGenics and get your genetic profile and start incorporating pharmacogenomics into your overall health plan to provide significant positive outcomes.
Reference List
- Pharmacogenomics could lower health care costs, investigators report, Biotech Week, NewsRX, 2004.
- Pharmacogenomics — Drug Disposition, Drug Targets, and Side Effects, Evans, W.E. Pharm.D., and McLeod, H.L. Pharm.D., N Engl J Med 2003; 348:538-549 February 6, 2003
- Clinically significant drug interactions, Ament, PW, Bertolino, JG, Liszewski JL, Am Fam Physician 2000; 61(6):1745-1754.
- Drug interaction and Pharmacist, Ansari JA., J Young Pharm 2010;2(3):326-331
- Altered CYP expression and function in response to dietary factors: potential roles in disease pathogenesis, Murray M., Curr Drug Metab. 2006 Jan;7(1):67-81.
- Drug Interactions: Cytochrome P450 Drug Interaction Table, Flockhart D.A., Indiana University School of Medicine (2007).
- Functional pharmacogenetics/genomics of human cytochromes P450 involved in drug biotransformation, Zanger UM1, Turpeinen M, Klein K, Schwab M, Anal Bioanal Chem. 2008 Nov;392(6):1093-108.