Pharmacogenomics: The hereafter of drug therapy?
Drug intervention remains the Mainstay of medical specialty ( this is quoted straight FIX ) . In certain state of affairss a drug may hold life endangering side effects where the patient may hold an inauspicious reaction to the drug itself, or in dire instances where a patient ‘s life is at interest and the drug out of the blue has no consequence. These state of affairss are the grounds to why Pharmacogenomics was established and now offers penetration into the aetiological mechanisms.
A instance survey showed:
“A immature pregnant adult females who underwent a sectio caesariae was given suxomethonium which usually acts as a musculus relaxant n the initiation of anesthesia, she was paralysed for 6 hours after the process, doing it necessary to give her assisted airing by inhalator. Blood trials revealed that she suffered from pseudocholinesterase ( buturycholinesterase ) deficiency” ( Fagerlund and Braaten 2001 ) .
Our instance survey exhibits that every individual has a different familial makeup and that The “one size tantrums all” Jesse J.swen et Al. ( 2007 ) attitude towards drugs and doses does non ever suffice.
Clinical Pharmacogenomics assures this thought of individualized medical specialty accordingly diminishing inauspicious drug reactions and increasing the safety and efficaciousness of drug prescription. A recent survey ( Hess and Cooper 1999 ) indicated that most variable drug reactivity is caused by mutants in the genome known as polymorphisms.
The most common mutants found doing familial fluctuation are known as individual nucleotide polymorphisms ( SNPs ) where there ‘s a individual switch in the nucleotide bases ; permutation, omission or interpolation. A recent survey ( SL et al. 2000 ) indicated that these polymorphisms are to be accountable for 90 % of all inter-individual fluctuation. A polymorphous cistron can hold tragic effects for a individual as a alteration in the nucleotide sequence of a cistron alters the messenger RNA strand which transfers the Deoxyribonucleic acid sequence for the cryptography of an amino acid and if the correct amino acid is non produced it finally leads to the incorrect protein being produced. This fluctuation can therefore affect drug safety and efficaciousness if a protein that is usually a drug mark or involved in the drug conveyance is altered. ( Veenstra and Higashi 2000 ) .
Metabolizing enzymes are another cause to research as fluctuations in these cistrons can ensue in array of different phenotypes. One of import household of enzyme metabolisers are the “cytochrome P450” and history for most of stage 1 metamorphosis of drugs, in analyzing this household it gives an penetration into some of the causes of inauspicious drug reactions and stairss to take in order to forestall these.
Case study 2
“Codeine is uneffective as an analgetic in 6-7 % of a Caucasic population due to homozygosity for non-functional CYP2D6 mutation alleles.CYP2D6 deficient patients will non change over codeine to morphine. Postoperative hurting intervention with codeine incorporating drugs will hence hold limited consequence in patients with this trait.” ( Fagerlund and Braaten 2001 ) .
This instance shows the affect of polymorphisms and if non known to the physician treating could take to tragic effects and therefore implements the function of Pharmacogenomics.
Assesing the cost effectivity in using pharmacogenomics to clinical pattern. There are two countries in this field in seeking to forestall inauspicious drug reactions. 1 is pharmacogenetics which normally indicates “genetically determined variableness in the metamorphosis of drugs” ( fagerlund and Braaten 2001 )
The term “Pharmacogenetics” normally indicates
In order to to the full understand what the organic structure does to a drug we must hold a basic cognition of what the drug does to the organic structure besides ; Describe pharmacokinetics and kineticss foremost as you need to cognize them in order to analyze pharmacogenomics.
The Future of pharmacogenomics
Challenges and advantages.
Ethical motives and costs
- hypertext transfer protocol: //www.ncbi.nlm.nih.gov/pubmed/10976393? ordinalpos=1 & A ; itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA & A ; linkpos=5 & A ; log $ =relatedreviews & A ; logdbfrom=pubmed ( nexus for polymorphism article )
- Recombinant DNA techniques quickly superseded standard methods of protein word picture for familial analysis during the 1980s, and studies of the molecular features of legion enzymes, including the P450 ( CYP450 ) enzymes of drugmetabolism, shortly appeared in the literature.