Pharmacogenomics can potentially guide drug choices

Pharmacogenomics is the study of gene expression on the ability to metabolize or break down medications. The term “gene expression” is important because we’re talking about how much your genes influence your response to a medication. Much like the director of a play or movie, your genes give instructions to other parts of your body. One of the things your genes direct is the production of enzymes required to break down (or “metabolize”) the drugs you take. These enzymes influence how effective a drug might be for you and how likely you are to experience negative side effects. Your unique combination of genes is called your genotype. Your genotype can tell us if you will make more or significantly less enzyme than other people. These enzymes help break down the medications into substances that can be more easily excreted by the body. However, in some cases these substances can be active and some are even harmful before they are excreted. This partially explains why some people will get no effect at all..

Pharmacogenomics in Oncology care

In the last decade, the use of genomics in oncology significantly impacted treatment decisions for many patients. Oncologists have a variety of treatment options; however one patient may experience serious adverse events whereas another patient receives no therapeutic effect. Within a population, substantial variation exists resulting in unpredictable responses. Pharmacogenomics, the study of the interaction between the genome and clinical drug response (Monte et al., 2012), evaluates the associations..

Personalized Medicine

 

Variable patient responses to drugs are a key issue for medicine and for drug discovery and development. Personalized medicine, that is the selection of medicines for subgroups of patients so as to maximize drug efficacy and minimize toxicity, is a key goal of twenty-first century healthcare. Currently, most personalized medicine paradigms rely on clinical judgment based on the patient's history, and on the analysis of the patients' genome to predict drug effects i.e., pharmacogenomics. However, variability in patient responses to drugs is dependent upon many environmental factors to which human genomics is essentially blind. A new paradigm for predicting drug responses based on individual pre-dose metabolite profiles has emerged in the past decade: pharmacometabonomics, which is defined as “the prediction of the outcome (for example, efficacy or toxicity) of a drug..

Understanding Hereditary Cancer

Hereditary cancer assessment evaluates a person's genetic risk of developing primary inherited cancers over their lifetime. Physicians can use the results of this test, along with medical and family history, to develop a strategy to reduce the risk of developing one of these many types of cancers. Testing helps doctors and patients:

• Determine if a patient has genetic mutations that correlate with increased risk of several types of primary inherited cancers

• Provides information to delay or avert the development of certain cancers

• Assists physicians in recommending solutions for healthy lifestyle management, medications and/or surgical procedures.

Identify Allergy Triggers Optimize Treatment Improve Quality of Life

Rhinitis Is One of the Most Frequently Reported Conditions in the United States. • Symptoms of allergic rhinitis include nasal congestion, rhinorrhea, sneezing, and itching of the nose 

• Allergic rhinitis and nonallergic rhinitis overlap, have overlapping symptoms, making accurate diagnosis a challenge.

• Headache, fatigue, cognitive impairment, and sleep disturbance may occur, leading to significant detriments to quality of life and performance at school and work.

Allergic Rhinitis is a Risk Factor for Asthma - Definitive Diagnosis and Appropriate Treatment May Prevent the Progression to Asthma.

• Increasing data support the concept of an allergic march—a progression of allergic diseases that begins in childhood and culminates in asthma.

• Asthma symptoms include coughing, wheezing, shortness of breath, chest tightness, and nighttime awakenings.

• Up to 90% of children and 50% of adults have an allergic component to their asthma10

• It is essential to identify and reduce exposure to relevant allergens and irritants in order to effectively manage asthma patients.

Now you can treat the cause of your allergies safely and effectively-without shots. We’re pleased to offer our patients allergy immunotherapy that you can take at home. It’s called sublingual immunotherapy-or allergy drops. Allergy drops work similar to allergy shots, slowly helping you build tolerance to the substance that causes your allergic reactions. The difference is that the antigen is placed under your tongue in liquid form. Not only are allergy drops more convenient, research also shows they are safe and effective for people of all ages.

Respiratory and Gastrointestinal Pathogens: Deadly and Difficult to Quickly Treat.

 

Flu-related deaths have been as high as 49,000 per season 90% of deaths occurred among adults over the age of 65. Quick detection and treatment is essential in nursing-home and long term care environments.

People at High Risk • Age 65+ • Asthma, COPD • Diabetes • Heart disease • Renal, hematologic, neurological diseases • Immunosuppression • Morbid obesity.

RESPIRATORY PANEL The Respiratory panel tests for a comprehensive set of upper respiratory, viral and bacterial pathogens, many of which present with nearly indistinguishable symptoms. The rapid and accurate identification of the causative agent assists the healthcare provider in selecting the most efficacious treatment for an upper respiratory tract infection.

GI PANEL The Gastrointestinal (GI) Panel tests for a comprehensive set of gastrointestinal pathogens. This is achieved by a simple stool swab for common pathogens associated with gastroenteritis. Quickly identifying the correct pathogen can ensure appropriate treatment, patient management and help decrease infectious gastroenteritis which can lead to severe illness or death.

The Problem of Antibiotic Resistance • Overall, 25% to 50% of antibiotic use may be inappropriate. • Antibiotics are prescribed in over 100 million ambulatory visits annually. • Respiratory conditions are the most common (41%) indication for antibiotic prescription. • Diagnostic uncertainty is the major driver of antimicrobial overuse and misuse.

Solving the Problem • Widespread use of precise respiratory virus detection has improved diagnostic accuracy. • Diagnostic testing has been linked to a more focused use of antimicrobials. • Testing may also help determine if viral infection is associated with bacterial coinfection.

Advanced cardiovascular testing

Four major US organizations (ADA*, ACCF*, AACC*, and NLA*) advocate lipoprotein in addition to conventional lipid testing.

Without such testing, there is little hope practicing clinicians can identify and aggressively treat asymptomatic coronary atherosclerosis before this deadly disease manifests a sudden heart attack or stroke.

- Thomas Dayspring, MD, FACP, FNLA, NCMP, 2011 National Lipid Association President’s Service Award Recipient

*ADA - American Diabetes Association *ACCF - American College of Cardiology Foundation *AACC - American Association for Clinical Chemistry *NLA - National Lipid Association

Pharmacogenomics: Increasing the safety and effectiveness of drug therapy

There are several genes responsible for differences in drug metabolism and response. Among the most common are the Cytochrome P450 (CYP) genes, encoding enzymes that control the metabolism of more than 70 percent of prescription drugs. People who carry variations in certain CYP genes often do not metabolize drugs at the same rate or extent as in most people, and this can influence response in many ways. Other genes known to affect drug response encode the receptors for regulatory molecules such as neurotransmitters, hormones, cytokines and growth factors, and cellular proteins such as enzymes, transporters, carriers, ion channels, structural proteins and transcription factors. Variations in these genes can lead to poor response and adverse drug reactions by disabling, inactivating, interfering with, or inaccurately inducing the signaling mechanisms or cellular machinery that must function for the body 

to respond properly to the drug; or by causing side effects that prevent continued  use of the drug.