Drozda Katarzyna, Müller Daniel J, Bishop Jeffrey R
Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, Illinois.
Pharmacotherapy. 2014 Feb;34(2):166-84. doi: 10.1002/phar.1398.
Advancements in pharmacogenomics have introduced an increasing number of opportunities to bring personalized medicine into clinical practice. Understanding how and when to use this technology to guide pharmacotherapy used to treat psychiatric and neurological (neuropsychiatric) conditions remains a challenge for many clinicians. Currently, guidelines exist to assist clinicians in the use of existing genetic information for drug selection and/or dosing for the tricyclic antidepressants, carbamazepine, and phenytoin. Additional language in the product labeling suggests that genetic information may also be useful for determining the starting and target doses, as well as drug interaction potential, for a number of other drugs. In this review, we outline the current status of pharmacogenomic testing for neuropsychiatric drugs as it pertains to information contained in drug labeling, consensus guidelines, and test panels, as well as considerations related to obtaining tests for patients.
药物基因组学的进展为将个性化医疗引入临床实践带来了越来越多的机会。对于许多临床医生来说,理解如何以及何时使用这项技术来指导用于治疗精神和神经(神经精神)疾病的药物治疗仍然是一项挑战。目前,已有指南协助临床医生在使用三环类抗抑郁药、卡马西平和苯妥英钠进行药物选择和/或给药时利用现有的基因信息。产品标签中的其他内容表明,基因信息对于确定许多其他药物的起始剂量和目标剂量以及药物相互作用潜力可能也有用。在本综述中,我们概述了神经精神药物的药物基因组学检测现状,包括其与药物标签、共识指南和检测小组中所含信息的相关性,以及与为患者进行检测相关的注意事项。