Tracheal Aspirate as an Alternative Biologic Sample for Pharmacogenomics Testing in Mechanically Ventilated Pediatric Patients

Hargreaves, Katherine A.; Pratt, Victoria M.; Medeiros, Elizabeth B.; Lynnes, Ty C.; Granfield, Caitlin A.; Skaar, Todd C.; Iwata‐Otsubo, Aiko; Tillman, Emma M.

doi:10.1111/cts.12847

Cited by 2 publications

(2 citation statements)

References 15 publications

(15 reference statements)

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“…When available, a scavenged sample from a previously scheduled clinical test was collected from the clinical laboratory. If leftover blood was not available, a saliva sample was collected using a commercially available kit (DNA Genotek, Ontario Canada) 11 . In some cases, a tracheal aspirate was collected from mechanically‐ventilated patients as previously described 9 .…”

Section: Methodsmentioning

confidence: 99%

“…If leftover blood was not available, a saliva sample was collected using a commercially available kit (DNA Genotek, Ontario Canada). 11 In some cases, a tracheal aspirate was collected from mechanically-ventilated patients as previously described. 9 Genomic DNA was extracted from blood, saliva, or tracheal aspirate using validated methods and quantified using commercially available kits following manufacturer's instructions.…”

Section: Genotypingmentioning

confidence: 99%

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A pilot study of ADRA2A genotype association with doses of dexmedetomidine for sedation in pediatric patients

et al. 2022

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Study Objective Dexmedetomidine is titrated to achieve sedation in the pediatric and cardiovascular intensive care units (PICU and CVICU). In adults, dexmedetomidine response has been associated with an ADRA2A polymorphism (rs1800544); CC genotype is associated with an increased sedative response compared with GC and GG. To date, this has not been studied in children. Design We conducted a pilot study to determine whether ADRA2A genotype is associated with dexmedetomidine dose in children. Measurements and Main Results Forty intubated PICU or CVICU patients who received dexmedetomidine as a continuous infusion for at least 2 days were genotyped for ADRA2A with a custom‐designed TaqMan® Assay. Ten (25%) subjects were wildtype (GG), 15 (37.5%) were heterozygous (GC), and 15 (37.5%) were homozygous (CC) variant. The maximum dexmedetomidine doses (mCg/kg/h) were not different between genotype groups CC (1, 0.3–1.2), GC (1, 0.3–1.3), and GG (0.8, 0.3–1.2), (p = 0.37); neither were mean dexmedetomidine doses for these respective genotype groups 0.68 (0.24–1.07), 0.72 (0.22–0.98), 0.58 (0.3–0.94), (p = 0.67). Conclusions These findings did not confirm the results from adult studies where ADRA2A polymorphisms correlate with dexmedetomidine response, therefore highlighting the need for pediatric studies to validate PGx findings in adults prior to implementation in pediatrics.

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Section: Methodsmentioning

confidence: 99%

Section: Genotypingmentioning

confidence: 99%

A pilot study of ADRA2A genotype association with doses of dexmedetomidine for sedation in pediatric patients

et al. 2022

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Development of a Multifaceted Program for Pharmacogenetics Adoption at an Academic Medical Center: Practical Considerations and Lessons Learned

Shugg,

Tillman,

Breman

et al. 2024

Clin Pharma and Therapeutics

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In 2019, Indiana University launched the Precision Health Initiative to enhance the institutional adoption of precision medicine, including pharmacogenetics (PGx) implementation, at university‐affiliated practice sites across Indiana. The overarching goal of this PGx implementation program was to facilitate the sustainable adoption of genotype‐guided prescribing into routine clinical care. To accomplish this goal, we pursued the following specific objectives: (i) to integrate PGx testing into existing healthcare system processes; (ii) to implement drug–gene pairs with high‐level evidence and educate providers and pharmacists on established clinical management recommendations; (iii) to engage key stakeholders, including patients to optimize the return of results for PGx testing; (iv) to reduce health disparities through the targeted inclusion of underrepresented populations; (v) and to track third‐party reimbursement. This tutorial details our multifaceted PGx implementation program, including descriptions of our interventions, the critical challenges faced, and the major program successes. By describing our experience, we aim to assist other clinical teams in achieving sustainable PGx implementation in their health systems.

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Tracheal Aspirate as an Alternative Biologic Sample for Pharmacogenomics Testing in Mechanically Ventilated Pediatric Patients

Cited by 2 publications

References 15 publications

A pilot study of ADRA2A genotype association with doses of dexmedetomidine for sedation in pediatric patients

A pilot study of ADRA2A genotype association with doses of dexmedetomidine for sedation in pediatric patients

Development of a Multifaceted Program for Pharmacogenetics Adoption at an Academic Medical Center: Practical Considerations and Lessons Learned

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