Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2020.61.147
Use of pharmacogenomics in elderly patients treated for cardiovascular diseases
Nada Božina
orcid.org/0000-0001-6016-1699
; Department of Pharmacology, University of Zagreb School of Medicine
Majda Vrkić Kirhmajer
; Department of Cardiovascular Diseases, University Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
Livija Šimičević
orcid.org/0000-0002-2491-1920
; Division of Pharmacogenomics and Therapy Individualization, Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia
Lana Ganoci
; Division of Pharmacogenomics and Therapy Individualization, Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia
Nikica Mirošević Skvrce
; Croatian Agency for Medicinal Products and Medical Devices, Zagreb, Croatia
Iva Klarica Domjanović
; Croatian Agency for Medicinal Products and Medical Devices, Zagreb, Croatia
Iveta Merćep
; Department of Internal Medicine, University Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
Sažetak
Older people are increasingly susceptible to adverse drug
reactions (ADRs) or therapeutic failure. This could be medi-
ated by considerable polypharmacy, which increases the
possibility of drug-drug and drug-gene interactions. Pre-
cision medicine, based on individual genetic variations,
enables the screening of patients at risk for ADRs and the
implementation of personalized treatment regimens. It
combines genetic and genomic data with environmental
and clinical factors in order to tailor prevention and dis-
ease-management strategies, including pharmacothera-
py. The identification of genetic factors that influence drug
absorption, distribution, metabolism, excretion, and action
at the drug target level allows individualized therapy. Pos-
itive pharmacogenomic findings have been reported for
the majority of cardiovascular drugs (CVD), suggesting that
pre-emptive testing can improve efficacy and minimize
the toxicity risk. Gene variants related to drug metabolism
and transport variability or pharmacodynamics of major
CVD have been translated into dosing recommendations.
Pharmacogenetics consortia have issued guidelines for
oral anticoagulants, antiplatelet agents, statins, and some
beta-blockers. Since the majority of pharmacogenetics
recommendations are based on the assessment of single
drug-gene interactions, it is imperative to develop tools for
the prediction of multiple drug-drug-gene interactions,
which are common in the elderly with comorbidity. The
availability of genomic testing has grown, but its clinical
application is still insufficient.
Ključne riječi
Hrčak ID:
253163
URI
Datum izdavanja:
14.6.2020.
Posjeta: 749 *