The Future: Pharmacogenetics in Primary Care

• Published in: Primary care reports Vol. 20; no. 10
• Main Authors: Black, Elizabeth L, Hocum, Brian T, Black, Kevin J
• Format: Journal Article
• Language: English
• Published: Atlanta Relias Learning 01.10.2014
• Subjects: Anticoagulants; Biomarkers; Cardiovascular disease; Clinical outcomes; Clopidogrel; Cytochrome; Diabetes; Drug dosages; Drug therapy; Drugs; Family medical history; Genomes; Geriatrics; Haplotypes; Health care; Hypertension; Mental depression; Older people; Pain; Patient satisfaction; Pharmaceuticals; Pharmacology; Primary care; Psychotropic drugs; Schizophrenia; Side effects; Statins; Studies; Toxicity; Warfarin
• ISSN: 1040-2497; 2168-765X

Executive Summary With the rapidly increasing number of drugs available to the primary care physician’s armamentarium, the rational and judicious use of pharmacogenetics (PGx) can improve drug selection by increasing the likelihood of effectiveness and reduce harmful side effects. * Adverse drug events contributed to 13.5 million outpatient and ED visits over a recent 3-year period, with the elderly particularly vulnerable. * The increased utilization of health care resources may be contributing up to 13% of the total spending on healthcare in the United States. * The FDA refers to alleles that influence drug effectiveness and toxicity as "pharmacogenetic biomarkers.” PGx biomarkers are further classified as either pharmacokinetic (PK) or pharmacodynamic (PD). PK biomarkers affect how the body absorbs, distributes, metabolizes, and excretes drugs. PD biomarkers are less well understood. These biomarkers affect the action of drugs at the molecular level. * Clinical scenarios commonly targeted for pharmacogenomic investigation include statin, warfarin anticoagulation, clopidogrel, pain management, and a host of psychotropic medications.