Pharmacogenetics

PHARMACOGENETICS and pharmacogenomics potentially provide a means of drug dosage optimisation and aid the identification of responders, non-responders and patients more likely to experience adverse effects. Although pharmacogenetics has provided important insights into inter-patient differences in drug effects, clinical applications are relatively limited at present and mainly involve identifying variability in drug metabolism. In particular, all patients receiving perhexiline should be phenotyped or genotyped, and phenotyping/genotyping is highly recommended for patients prescribed azathioprine. Exploration of larger sets of genes - up to the whole genome - holds considerable promise for predicting drug responses in individual patients, but many challenges will need to be overcome before pharmacogenomics becomes an integral component of patient care.