The right drug … at the right dose … at the right time. Those goals drive pharmacogenomics — how genetics influence a person's response to medications.
Chemotherapy drugs are more effective when treating certain types of cancers. Codeine offers no pain relief in some patients and in others causes life-threatening reactions, such as respiratory depression. Other individuals experience harmful side effects from statin drugs designed to lower cholesterol levels. Finding the right dose of blood-thinning agents, such as warfarin, can involve a long process of trial and error.
Some Food and Drug Administration-approved drug labels contain warnings or information about potential adverse event risks, variable responses, drug-action mechanisms or genotype-based drug dosing. Recommendations are based on genomic information about the drug.
Pharmacogenomics drives greater drug effectiveness, with increased safety and reduced side effects. At Mayo Clinic, drug-gene alerts are part of the electronic medical record system, assisting providers in delivering safer, more effective care.
Each day, research uncovers new gene variants or novel drug-gene interactions that influence whether a patient may be harmed or helped by a medication. Keeping up to date with complex, new genomic information is a challenging task for clinicians, but decision-support tools and online education helps.
For the Record
The Center for Individualized Medicine at Mayo Clinic is adding drug-gene interactions to the patient electronic medical record to alert physicians and pharmacists at the point of care as part of the clinical decision-support system.
If genomic information exists for a drug-gene interaction, alerts are triggered in the patient's electronic medical record to guide the clinician regarding prescription choices and dosing recommendations.
A team of physicians, pharmacists, genetic counselors and medical educators provides just-in-time education linked to these pop-up alerts. Online resources provide information about:
- Appropriate genetic testing
- Patients at increased risk of adverse side effects
- Suggested dosing recommendations
Ongoing discovery and validation of new drug-gene pairs at Mayo Clinic and elsewhere will result in additional alerts being added to the electronic medical record.