利用药物基因组学和治疗药物监测来指导门诊心理健康综合药物管理中的药物选择和剂量确定。
Using pharmacogenomics and therapeutic drug monitoring to guide drug selection and dosing in outpatient mental health comprehensive medication management.
作者信息
Brown Jacob T, Bishop Jeffrey R, Schneiderhan Mark E
机构信息
Associate Professor, Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, Minnesota; Associate Professor, Medical School, Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota.
Associate Professor, Department of Pharmaceutical Sciences and Pharmacy Practice, University of Minnesota College of Pharmacy, Duluth, Minnesota; Psychiatry Provider, Human Development Center, Duluth, Minnesota.
出版信息
Ment Health Clin. 2020 Jul 2;10(4):254-258. doi: 10.9740/mhc.2020.07.254. eCollection 2020 Jul.
Pharmacogenomic (PGx) testing aided by therapeutic drug monitoring (TDM) has the potential to improve medication-related outcomes in some individuals prescribed psychiatric medications. Many commonly prescribed psychiatric medications are metabolized through polymorphic drug metabolizing enzymes such as cytochrome p450 (CYP) 2D6 (CYP2D6) and CYP2C19. Through PGx testing, clinicians can make biologically informed choices when selecting a new medication, and TDM may help inform dose adjustments or assess exposures to current treatments. Herein, we describe 2 complex case reports of individuals with multiple psychiatric diagnoses and extensive histories of medication failures who underwent PGx testing in addition to TDM as part of a pharmacist-led comprehensive medication therapy management evaluation in a community mental health clinic setting.
在治疗药物监测（TDM）辅助下的药物基因组学（PGx）检测，有可能改善某些服用精神科药物患者的用药相关结局。许多常用的精神科药物是通过多态性药物代谢酶进行代谢的，如细胞色素P450（CYP）2D6（CYP2D6）和CYP2C19。通过PGx检测，临床医生在选择新药时可以做出基于生物学的明智选择，而TDM可能有助于指导剂量调整或评估当前治疗的暴露情况。在此，我们描述了2例复杂病例报告，这些患者有多种精神科诊断且有大量用药失败史，他们在社区心理健康诊所环境中，作为药师主导的综合药物治疗管理评估的一部分，除了接受TDM外还接受了PGx检测。
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