Precision Medicine in Toxicology

Precision medicine applies primarily to pharmacokinetics in toxicology. Mastering hepatic metabolism through an understanding of the genetics behind Phase I, or oxidation/reduction and some Phase II, or conjugation, enhances the scientific and clinical application of common drug toxicology. This rev...

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Bibliographic Details
Published inClinics in laboratory medicine Vol. 36; no. 4; p. 693
Main Authors Schwarz, Daniel A, George, M P, Bluth, Martin H
Format Journal Article
LanguageEnglish
Published United States 01.12.2016
Subjects
Cytochrome P-450 Enzyme Inhibitors
Cytochrome P-450 Enzyme System - drug effects
Cytochrome P-450 Enzyme System - metabolism
DNA - genetics
Enzyme Induction
Humans
Liver - metabolism
Oxidation-Reduction
Polymorphism, Single Nucleotide
Precision Medicine - methods
Cytochrome
Pharmacogenetics
Toxicology
Precision medicine
Metabolism
Pharmacogenomics
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Summary:Precision medicine applies primarily to pharmacokinetics in toxicology. Mastering hepatic metabolism through an understanding of the genetics behind Phase I, or oxidation/reduction and some Phase II, or conjugation, enhances the scientific and clinical application of common drug toxicology. This review includes basic hepatic metabolism, the common substrates, inducers and inhibitors of cytochrome P450 along with genetic variants behind the enzymes. Detailed metabolism of commonly measured opioids in clinical practice is provided. Finally, evidence based research and clinical correlations conclude that knowledge of inducers and inhibitors, in conjunction with genetic variations, are integral components for applied precision medicine in toxicology.
ISSN:1557-9832
DOI:10.1016/j.cll.2016.07.010