Department of Pharmaceutical Sciences, School of Pharmacy.
Department of Pharmacy and Therapeutics, School of Pharmacy, and.
Clin J Am Soc Nephrol. 2018 Oct 8;13(10):1561-1571. doi: 10.2215/CJN.02730218. Epub 2018 May 23.
Pharmacogenomics is a tool for practitioners to provide precision pharmacotherapy using genomics. All providers are likely to encounter genomic data in practice with the expectation that they are able to successfully apply it to patient care. Pharmacogenomics tests for genetic variations in genes that are responsible for drug metabolism, transport, and targets of drug action. Variations can increase the risk for drug toxicity or poor efficacy. Pharmacogenomics can, therefore, be used to help select the best medication or aid in dosing. Nephrologists routinely treat cardiovascular disease and manage patients after kidney transplantation, two situations for which there are several high-evidence clinical recommendations for commonly used anticoagulants, antiplatelets, statins, and transplant medications. Successful use of pharmacogenomics in practice requires that providers are familiar with how to access and use pharmacogenomics resources. Similarly, clinical decision making related to whether to use existing data, whether to order testing, and if data should be used in practice is needed to deliver precision medicine. Pharmacogenomics is applicable to virtually every medical specialty, and nephrologists are well positioned to be implementation leaders.
药物基因组学是从业者使用基因组学提供精准药物治疗的工具。所有的从业者在实践中都可能会遇到基因组数据，期望他们能够成功地将其应用于患者护理。药物基因组学检测负责药物代谢、转运和药物作用靶点的基因中的遗传变异。这些变异会增加药物毒性或疗效不佳的风险。因此，药物基因组学可用于帮助选择最佳药物或辅助给药。肾病学家通常治疗心血管疾病，并管理肾移植后的患者，这两种情况都有几项针对常用抗凝剂、抗血小板药物、他汀类药物和移植药物的高证据临床推荐。药物基因组学在实践中的成功应用要求提供者熟悉如何访问和使用药物基因组学资源。同样，是否使用现有数据、是否进行检测以及数据是否应在实践中使用的临床决策，对于提供精准医学也是必要的。药物基因组学几乎适用于每一个医学专业，而肾病学家是实施的领导者。
