Pharmacogenomics for Primary Care: An Overview

Abstract

Most of the prescribing and dispensing of medicines happens in primary care. Pharmacogenomics (PGx) is the study and clinical application of the role of genetic variation on drug response. Mounting evidence suggests PGx can improve the safety and/or efficacy of several medications commonly prescribed in primary care. However, implementation of PGx has generally been limited to a relatively few academic hospital centres, with little adoption in primary care. Despite this, many primary healthcare providers are optimistic about the role of PGx in their future practice. The increasing prevalence of direct-to-consumer genetic testing and primary care PGx studies herald the plausible gradual introduction of PGx into primary care and highlight the changes needed for optimal translation. In this article, the potential utility of PGx in primary care will be explored and on-going barriers to implementation discussed. The evidence base of several drug-gene pairs relevant to primary care will be outlined with a focus on antidepressants, codeine and tramadol, statins, clopidogrel, warfarin, metoprolol and allopurinol. This review is intended to provide both a general introduction to PGx with a more in-depth overview of elements relevant to primary care.

The Urgent Need for Management of Biological Samples and Data Accessibility in Latin America

“…In Europe, biobanks like one in Poland, have used different management models, preserving essential fundamental information for the benefit of public health ( Sak et al, 2012 ). Moreover, biobanks are very useful for establishing pharmacogenetic relationships for research drug interactions with genes identified in a population ( Muller et al, 2020 ; Rollinson et al, 2020 ).…”

Precision Medicine and Adverse Drug Reactions Related to Cardiovascular Drugs

“…Alterations in 'off-target' receptors, caused by genetic variants, can result in unusual adverse effects which are difficult to predict. It is also true that increased drug concentration, caused by a genetic variation to the pharmacokinetic processing, can induce further 'off-target' adverse effects, an example of which includes myotoxicity in simvastatin use [3]. Differences in genetic code can also influence how a drug acts in the body, which underpins the drug's pharmacodynamic properties.…”

Technologies for Pharmacogenomics: A Review

“…Nonetheless, the outlined principles hold true for somatic mutations [13][14][15]. Additionally, implementation and adoption of PGx in clinical practice is outside the scope of this review and has been extensively discussed in previous publications [16][17][18].…”