Reducing the Guesswork in Drug Selection and Dosing
Scientific evidence indicates that pharmacogenetics, the study of how people's genetic make-up affects their response to medicines, could one day change the way physicians practice medicine. Genetic pharmacology promises to provide genetic information that, with state-of-the-art technology, can help clinical practitioners choose and dose medication that best meets the needs of the individual patient.
At Cincinnati Children's, research into pharmacogenetic testing is being put into practice through the Genetic Pharmacology Service (GPS), a multidisciplinary team headed by Tracy Glauser, MD, Richard Wenstrup, MD and Alexander Vinks, PharmD, PhD.
The GPS provides testing on a wide range of drugs selected because of strong scientific evidence that their tested gene variants alter drug metabolism. Following testing, the GPS offers dosing recommendations based on genotype, identification of potential drug-drug interactions, consultation, and educational materials for health care professionals, families and patients. The service comprises personnel from a variety of disciplines at Cincinnati Children's including genetics, pharmacology, statistics, bioinformatics and education.
By adding a patient's genetic information to his or her medical profile (age, weight, medication use, health behavior, environmental factors), physicians will be in a better position to reduce adverse reactions to drugs and ultimately make therapeutic drug treatments more effective. "One of the underlying assumptions of predictive and personalized medicine is that the delay in finding the right dose will no longer be acceptable, or at least should be reduced in a very meaningful way," says Dr. Wenstrup, professor of pediatrics in the Division of Human Genetics and director of the Molecular Genetics Laboratory.
"The trial and error approach in prescribing and gdosing medication, up until now, has just been an accepted part of the process," adds Dr. Glauser, professor of pediatrics in the Division of Neurology. "Genetic pharmacology changes all of that."
