Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Department of Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Clin Pharmacol Ther. 2018 May;103(5):787-794. doi: 10.1002/cpt.1035. Epub 2018 Mar 13.
The development of new knowledge around the genetic determinants of variable drug action has naturally raised the question of how this new knowledge can be used to improve the outcome of drug therapy. Two broad approaches have been taken: a point-of-care approach in which genotyping for specific variant(s) is undertaken at the time of drug prescription, and a preemptive approach in which multiple genetic variants are typed in an individual patient and the information archived for later use when a drug with a "pharmacogenetic story" is prescribed. This review addresses the current state of implementation, the rationale for these approaches, and barriers that must be overcome. Benefits to pharmacogenetic testing are only now being defined and will be discussed.
新的药物作用的遗传决定因素的知识的发展自然引发了一个问题，即如何利用这些新知识来改善药物治疗的效果。为此，人们采取了两种广泛的方法：一种是即时检验方法，即在开具药物处方时对特定变异进行基因分型；另一种是预先检验方法，即对个体患者进行多种遗传变异的基因分型，并将信息存档，以备日后开具有“药物遗传学故事”的药物时使用。这篇综述讨论了目前的实施情况、这些方法的基本原理以及必须克服的障碍。药物遗传学检测的益处才刚刚得到定义，我们也将对此进行讨论。
