Associate Professor of Pharmacy & Director, New Mexico Medicaid Retrospective Drug Utilization Review Program, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
Pharmacogenomics is a field that describes the genetic basis of inter-individual variation in drug efficacy and toxicity. The burgeoning of pharmacogenomics has the poten-tial to drastically change the way pharmacists'' practice.
The objectives of this presentation are to:
1) provide a brief overview of the potential impact of pharmacogenomics on drug efficacy and adverse drug reactions (ADRs),
2) describe how pharmagenomic information will change the practice of pharmacy in the future, and
3) provide suggestions for how pharmacy education might respond to the increased knowledge base that would be required by pharmacists to deliver pharmaceutical care in the pharmacogenomics era.
Two common examples of the impact of pharmacogenomics on adverse drug reactions are the slow acetylation of isoniazid possibly leading to peripheral neuropathy, and the slow metabolization of warfarin by polymorphism of hepatic microsomal enzyme CYP2C9 leading to serious bleeding events.
As testing for genetic polymorphism becomes more widespread pharmacists will need to work collaboratively with physicians to develop treatment algorithms incorporating these genetic variables. This approach has the potential for improving selection and dosing of drugs.
On the other hand, pharmacists will need to develop effective patient counseling strategies that incorporate pharmacogenomic considerations to ensure that patients use their drugs appropriately. An interactive counseling technique used by the United States Public Health Service - Indian Health Service might prove valuable in the pharmacogenomics era.
This patient counseling technique will be presented. Several curricular changes in the education of pharmacists, as well as faculty development needs will have to be addressed in the pharmacogenomics era.
Some changes recommended by the American Association of Colleges of Pharmacy will be presented. Finally, an open discussion will be conducted to determine how the three objectives of this presentation will affect pharmacy in India.