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精神科药师对药物-基因相互作用和药物引起的表型转化的评估:病例报告。

Pharmacist assessment of drug-gene interactions and drug-induced phenoconversion in major depressive disorder: a case report.

机构信息

Office of Translational Research and Residency Programs, Tabula Rasa HealthCare, 228 Strawbridge Drive, Moorestown, NJ, 08057, USA.

Precision Pharmacotherapy Research & Development Institute, Tabula Rasa HealthCare, Lake Nona, FL, USA.

出版信息

BMC Psychiatry. 2022 Jan 20;22(1):46. doi: 10.1186/s12888-021-03659-4.

DOI:10.1186/s12888-021-03659-4
PMID:35057765
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8772164/
Abstract

BACKGROUND

Response to antidepressant therapy is highly variable among individuals. Pharmacogenomic (PGx) testing presents an opportunity to guide drug selection while optimizing therapy outcomes and/or decreasing the risk for toxicity.

CASE PRESENTATION

A patient with multiple comorbidities, including severe major depressive disorder (MDD), experienced adverse drug events and undesirable response to multiple antidepressant medications (i.e., bupropion, escitalopram, and venlafaxine). A clinical pharmacist assessed significant drug-gene, drug-drug, and drug-drug-gene interactions as well as other clinical factors to provide recommendations for antidepressant therapy optimization.

CONCLUSION

This case highlights the importance of PGx testing and the key role of pharmacists in identifying and mitigating drug-related problems and optimizing drug therapy in patients with MDD.

摘要

背景

抗抑郁治疗的反应在个体之间差异很大。药物基因组学(PGx)检测提供了一个机会,可以在优化治疗效果和/或降低毒性风险的同时指导药物选择。

病例介绍

一名患者患有多种合并症,包括严重的重度抑郁症(MDD),经历了药物不良反应和对多种抗抑郁药物(如安非他酮、依地普仑和文拉法辛)的不良反应。临床药师评估了重要的药物-基因、药物-药物和药物-药物-基因相互作用以及其他临床因素,为优化抗抑郁治疗提供了建议。

结论

本病例强调了 PGx 检测的重要性以及药师在确定和减轻与药物相关的问题以及优化 MDD 患者药物治疗方面的关键作用。

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本文引用的文献

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Int J Mol Sci. 2021 May 7;22(9):4967. doi: 10.3390/ijms22094967.
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Pharmacogenetics in Psychiatry: An Update on Clinical Usability.精神病学中的药物遗传学:临床实用性的最新进展
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A model-based cost-effectiveness analysis of pharmacogenomic panel testing in cardiovascular disease management: preemptive, reactive, or none?基于模型的心血管疾病管理中药物基因组学检测的成本效益分析:先发制人、反应性还是不检测?
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The clinical utility of combinatorial pharmacogenomic testing for patients with depression: a meta-analysis.组合式药物基因组学检测在抑郁症患者中的临床效用:一项荟萃分析。
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Pharmacogenomics of Antidepressant and Antipsychotic Treatment: How Far Have We Got and Where Are We Going?抗抑郁药和抗精神病药治疗的药物基因组学:我们已经走了多远,又将走向何方?
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Translating pharmacogenomics into clinical decisions: do not let the perfect be the enemy of the good.将药物基因组学转化为临床决策:不要让完美成为优秀的敌人。
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