Optimizing Individualized Drug Therapy in the ICU

Drugs are designed to treat medical conditions for the general population. Idiosyncratic reactions to drugs are determined by the individual’s respective genetic variations that direct effectiveness and side effects. Adverse drug reactions rank within the top ten leading causes of death in the developed world. The field of pharmacogenomics has advanced in the last fifty years, picking up significant momentum with recent biotechnological developments that allow scientists to investigate the human genome and provide individualized drug therapy that will increase the efficacy of drugs and decrease the incidence of adverse drug reactions. Pharmacogenomics has reached a milestone in making personalized medicine accessible and effective. The medical community shares this responsibility for the emerging focus on pharmacogenomics with regulatory agencies and bioinformatics specialists as they struggle to streamline vast libraries of information and reconcile public and regulatory approval on this critical path to the next level of health care.

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Ten Years of Experience Support Pharmacogenetic Testing to Guide Individualized Drug Therapy

Pharmaceutics ◽

10.3390/pharmaceutics14010160 ◽

2022 ◽

Vol 14 (1) ◽

pp. 160

Author(s):

María Celsa Peña-Martín ◽

Belén García-Berrocal ◽

Almudena Sánchez-Martín ◽

Elena Marcos-Vadillo ◽

María Jesús García-Salgado ◽

...

Keyword(s):

Drug Therapy ◽

Adverse Events ◽

Precision Medicine ◽

Drug Efficacy ◽

Response To Treatment ◽

Individual Response ◽

Test Results ◽

Individualized Drug Therapy ◽

The Individual ◽

Multimorbid Patients

Precision medicine utilizing the genetic information of genes involved in the metabolism and disposition of drugs can not only improve drug efficacy but also prevent or minimize adverse events. Polypharmacy is common among multimorbid patients and is associated with increased adverse events. One of the main objectives in health care is safe and efficacious drug therapy, which is directly correlated to the individual response to treatment. Precision medicine can increase drug safety in many scenarios, including polypharmacy. In this report, we share our experience utilizing precision medicine over the past ten years. Based on our experience using pharmacogenetic (PGx)-informed prescribing, we implemented a five-step precision medicine protocol (5SPM) that includes the assessment of the biological–clinical characteristics of the patient, current and past prescription history, and the patient’s PGx test results. To illustrate our approach, we present cases highlighting the clinical relevance of precision medicine with a focus on patients with a complex history and polypharmacy.

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