Abstract

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.

Highlights

  • One of the main objectives in health care is a safe and efficacious pharmacological intervention

  • A total of 1540 patients were studied in the Pharmacogenetics and Precision Medicine

  • 92% of patients had gene variants affecting the metabolism of CYP2D6 substrates

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Summary

Introduction

One of the main objectives in health care is a safe and efficacious pharmacological intervention. Drug response is highly variable and may depend on genetic variation, among other factors. The field of pharmacogenetics and genomics studies the impact of genes and genetic variation on drug absorption, distribution, metabolism, excretion ( referred to ADME), as well as the response of an individual (or lack thereof) to a given drug or combination of drugs [1]. Pharmaceutics 2022, 14, 160 ideally obtained before treatment initiation, can be a powerful tool to enhance patient care and treatment outcomes [2]. Individual drug response is based on the pharmacokinetic and pharmacodynamic properties of the therapeutic agent(s), among others. Pharmacokinetics (PK) describes the processes and fate of the drug, taking into account absorption, distribution, metabolism, and excretion

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