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From evidence based medicine to mechanism based medicine. Reviewing the role of pharmacogenetics

Wilffert, B., Swen, J., Mulder, H., Touw, D., Maitland-Van der Zee, A-H., Deneer, V. & KNMP Working Grp Pharmacogenetics, Feb-2011, In : International Journal of Clinical Pharmacy. 33, 1, p. 3-9 7 p.

Research output: Contribution to journalArticleAcademicpeer-review

  • Bob Wilffert
  • Jesse Swen
  • Hans Mulder
  • Daan Touw
  • Anke-Hilse Maitland-Van der Zee
  • Vera Deneer
  • KNMP Working Grp Pharmacogenetics

Aim of the review The translation of evidence based medicine to a specific patient presents a considerable challenge. We present by means of the examples nortriptyline, tramadol, clopidogrel, coumarins, abacavir and antipsychotics the discrepancy between available pharmacogenetic information and its implementation in daily clinical practice. Method Literature review. Results A mechanism based approach may be helpful to personalize medicine for the individual patient to which pharmacogenetics may contribute significantly. The lack of consistency in what we accept in bioequivalence and in pharmacogenetics of drug metabolising enzymes is discussed and illustrated with the example of nortriptyline. The impact of pharmacogenetics on examples like tramadol, clopidogrel, coumarins and abacavir is described. Also the present status of the polymorphisms of 5-HT2A and C receptors in antipsychotic-induced weight gain is presented as a pharmacodynamic example with until now a greater distance to clinical implementation. Conclusion The contribution of pharmacogenetics to tailor-made pharmacotherapy, which especially might be of value for patients deviating from the average, has not yet reached the position it seems to deserve.

Original languageEnglish
Pages (from-to)3-9
Number of pages7
JournalInternational Journal of Clinical Pharmacy
Volume33
Issue number1
Publication statusPublished - Feb-2011

    Keywords

  • Drug metabolising enzymes, Mechanism based medicine, Pharmacodynamics, Pharmacogenetics, Pharmacokinetics, INDUCED WEIGHT-GAIN, HTR2C GENE POLYMORPHISMS, 5-HT2C RECEPTOR GENE, PHENYTOIN TOXICITY, THE-759C/T POLYMORPHISM, PSYCHIATRIC-PATIENTS, CYP2C POLYMORPHISMS, ANALGESIC TRAMADOL, METABOLIC SYNDROME, CLINICAL-PRACTICE

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