PMID- 22689709
OWN - NLM
STAT- MEDLINE
DCOM- 20121220
LR  - 20201209
IS  - 1531-1937 (Electronic)
IS  - 0897-1900 (Linking)
VI  - 25
IP  - 4
DP  - 2012 Aug
TI  - Clinical application of pharmacogenomics.
PG  - 417-27
LID - 10.1177/0897190012448309 [doi]
AB  - The purpose of this review is to discuss the clinical application of 
      pharmacogenomics for select drug therapies (eg, proton pump inhibitors [PPIs], 
      codeine, and carbamazepine) and to highlight limitations and challenges that 
      preclude implementation of pharmacogenomics into clinical practice. Genetic 
      polymorphisms of cytochrome P450 (CYP) enzymes and the presence of the human 
      leukocyte antigen (HLA)-B*1502 allele influence drug disposition and/or response. 
      A portion of PPI pharmacokinetic and pharmacodynamic variability can be explained 
      by CYP2C19 genotype. However, conflicting evidence exists related to Helicobacter 
      pylori cure rates based on CYP2C19 genotype. For codeine, adverse drug reactions 
      in neonates through breast-feeding from CYP2D6 ultra-rapid metabolizers have been 
      reported. However, there is lack of conclusive evidence regarding the overall 
      influence of CYP2D6 polymorphisms on codeine efficacy and toxicity. Although 
      CYP2C19 and CYP2D6 genotyping tests are available, clinical utility remains low. 
      The presence of the HLA-B*1502 allele is associated with carbamazepine-induced 
      Stevens-Johnson syndrome (SJS) and/or toxic epidermal necrolysis (TEN). 
      Pharmacogenomic testing is required prior to initiating carbamazepine in 
      high-risk patients. Lack of sufficient resources, provider knowledge, and 
      ethical, legal, and social issues are several limitations and challenges to 
      implementing pharmacogenomic testing in clinical practice.
FAU - Ma, Joseph D
AU  - Ma JD
AD  - Skaggs School of Pharmacy & Pharmaceutical Sciences, University of California, 
      San Diego, La Jolla, CA 92093, USA. joema@ucsd.edu
FAU - Lee, Kelly C
AU  - Lee KC
FAU - Kuo, Grace M
AU  - Kuo GM
LA  - eng
GR  - 1U38GD000070/GD/OGDP CDC HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PT  - Review
DEP - 20120611
PL  - United States
TA  - J Pharm Pract
JT  - Journal of pharmacy practice
JID - 8900945
RN  - 0 (Analgesics, Opioid)
RN  - 0 (Anticonvulsants)
RN  - 0 (Proton Pump Inhibitors)
RN  - 33CM23913M (Carbamazepine)
RN  - 9035-51-2 (Cytochrome P-450 Enzyme System)
RN  - UX6OWY2V7J (Codeine)
SB  - IM
MH  - Analgesics, Opioid/*administration & dosage/adverse effects
MH  - Anticonvulsants/*administration & dosage/adverse effects
MH  - Carbamazepine/*administration & dosage/adverse effects
MH  - Codeine/*administration & dosage/adverse effects
MH  - Cytochrome P-450 Enzyme System/genetics
MH  - Dose-Response Relationship, Drug
MH  - Genotype
MH  - Humans
MH  - *Pharmacogenetics/standards
MH  - Polymorphism, Genetic/drug effects
MH  - Proton Pump Inhibitors/*administration & dosage/adverse effects
MH  - Risk Factors
EDAT- 2012/06/13 06:00
MHDA- 2012/12/21 06:00
CRDT- 2012/06/13 06:00
PHST- 2012/06/13 06:00 [entrez]
PHST- 2012/06/13 06:00 [pubmed]
PHST- 2012/12/21 06:00 [medline]
AID - 0897190012448309 [pii]
AID - 10.1177/0897190012448309 [doi]
PST - ppublish
SO  - J Pharm Pract. 2012 Aug;25(4):417-27. doi: 10.1177/0897190012448309. Epub 2012 
      Jun 11.