How to Manage Individualized Drug Therapy: Application of Pharmacogenetic Knowledge of Drug Metabolism and Transport

2000 ◽  
Vol 38 (9) ◽  
Author(s):  
Christian Meisel ◽  
Ivar Roots ◽  
Ingolf Cascorbi ◽  
Ulrich Brinkmann ◽  
Jürgen Brockmöller
Keyword(s):  
Drug Therapy ◽  
Drug Metabolism ◽  
Individualized Drug Therapy

Pharmacology and Drug Therapy in Critically Ill Elderly Patients

1992 ◽  
Vol 3 (1) ◽  
pp. 137-148 ◽  
Author(s):  
Mary K. Walker
Keyword(s):  
Older Adults ◽  
Critical Care ◽  
Drug Therapy ◽  
Drug Metabolism ◽  
Elderly Patients ◽  
Treatment Modality ◽  
Drug Disposition ◽  
Structure And Function ◽  
Living Things ◽  
And Function

Aging is a complex, normal, and inevitable process affecting all living things. The physiologic changes of aging, by definition, are postmaturational, occurring after adult maturity is achieved. Changes with aging are primary, irreversible, and progressive. While the processes of aging are neither pathology nor disease, they present important changes in structure and function that alter drug disposition, metabolic rate, and excretion. These changes present special challenges to clinicians in critical care settings for whom pharmacotherapy is a common treatment modality. This article explores the physiologic changes associated with aging and the implications of these changes for management of critically compromised elders. Drug metabolism, distribution, utilization, and excretion in older adults are examined

Pharmacogenomics and ???Individualized Drug Therapy???

2003 ◽  
Vol 3 (6) ◽  
pp. 361-370 ◽  
Author(s):  
Daniel W Nebert ◽  
Lucia Jorge-Nebert ◽  
Elliot S Vesell
Keyword(s):  
Drug Therapy ◽  
Individualized Drug Therapy

scholarly journals Ultrarapid drug metabolism: PCR-based detection of CYP2D6 gene duplication

1998 ◽  
Vol 44 (5) ◽  
pp. 914-917 ◽  
Author(s):  
Linda S W Steijns ◽  
Jan Van Der Weide
Keyword(s):  
Drug Therapy ◽  
Side Effects ◽  
Gene Duplication ◽  
Drug Metabolism ◽  
Therapeutic Efficacy ◽  
Psychiatric Patients ◽  
Clinical Importance ◽  
Metabolic Capacity ◽  
Cyp2d6 Gene ◽  
Pcr Assays

Abstract The enzyme debrisoquine 4-hydroxylase (CYP2D6), which metabolizes many widely used drugs, is highly polymorphic. The activity of the enzyme ranges between subjects from ultrafast to a complete absence. Therefore, metabolic capacity varies, producing intersubject differences in therapeutic efficacy and side effects at standard recommended doses. Up to 7% of Caucasians may demonstrate ultrarapid drug metabolism (UM) because of inherited alleles with multiplicate functional CYP2D6 genes, causing an increased amount of enzyme to be expressed. Identification of UM subjects is of potential clinical importance for adjustment of doses in drug therapy, as well as to avoid misidentification of noncompliance. In our study, we tested recently designed PCR assays for the detection of the UM genotype. We found a 3.5% prevalence of UMs carrying duplicate active CYP2D6 genes in a population consisting of 202 psychiatric patients.

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