Therapeutic drug monitoring and pharmacogenetic tests as tools in pharmacovigilance

被引:0
作者
Sirot, Eveline Jaquenoud
van der Velden, Jan Willem
Rentsch, Katharina
Eap, Chin B.
Baumann, Pierre
机构
[1] Klin Konigsfelden, MediQ, Psychiat Dienste, Aargau AG, CH-5201 Brugg, Switzerland
[2] PharmaNet AG, Global Safety & Pharmacovigilance, Zumikon, Switzerland
[3] Univ Libre Bruxelles, Postgrad Programme Pharmaceut Med, Brussels, Belgium
[4] Univ Spital Zurich, Inst Klin Chem, Zurich, Switzerland
[5] Ctr Psychiat Neurosci, Dept Psychiat, Unite Biochim & Psychopharmacol, Prilly, Switzerland
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D O I
暂无
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Therapeutic drug monitoring (TDM) and pharmacogenetic tests play a major role in minimising adverse drug reactions and enhancing optimal therapeutic response. The response to medication varies greatly between individuals, according to genetic constitution, age, sex, co-morbidities, environmental factors including diet and lifestyle (e.g. smoking and alcohol intake), and drug-related factors such as pharmacokinetic or pharmacodynamic drug-drug interactions. Most adverse drug reactions are type A reactions, i.e. plasma-level dependent, and represent one of the major causes of hospitalisation, in some cases leading to death. However, they may be avoidable to some extent if pharmacokinetic and pharmacogenetic factors are taken into consideration. This article provides a review of the literature and describes how to apply and interpret TDM and certain pharmacogenetic tests and is illustrated by case reports. An algorithm on the use of TDM and pharmacogenetic tests to help characterise adverse drug reactions is also presented. Although, in the scientific community, differences in drug response are increasingly recognised, there is an urgent need to translate this knowledge into clinical recommendations. Databases on drug-drug interactions and the impact of pharmacogenetic polymorphisms and adverse drug reaction information systems will be helpful to guide clinicians in individualised treatment choices.
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页码:735 / 768
页数:34
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