Abstract
Plasmatic levels of a drug may suffer variations due to a) medication-associated factors, such as problems in the disintegration or dissolution process, or differences in the release from the pharmaceutical form; b) pathophysiological changes, such as variation in the gastric or plasmatic pH which could modify the ionized fraction of the drug, or a decrease in the intestinal motility could affecting drug absorption; and c) interactions with food or with other medications, for example, fluoroquinolones as ciprofloxacin administered together with milk decreases the absorption of the antibiotic by chelation with calcium, or inhibition of P-glycoprotein by verapamil increases digoxin bioavailability and toxicity. Besides, genetic and epigenetic factors could generate inter-individual variations in the pharmacokinetics/pharmacodynamics processes affecting every one of ADME stages. A dysfunctional efflux pump in the enteric membrane could increase the toxicity of some drugs, alterations in protein binding sites could affect the distribution, a SNP, duplication or deletion in a gene that encodes a metabolizing enzyme could increase or decrease the plasmatic concentration of some drugs affecting their therapeutic effect, and an overexpression of a transporter in the apical membrane in the renal tubules can lead to enhance elimination, decreasing the drug half-life. In this chapter, we will review basic concepts of genetics, how changes in genes can affect pharmacokinetic processes and the influence of pharmacogenetics in clinical practice.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Amstutz U, Henricks LM, Offer SM et al (2018) Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for dihydropyrimidine dehydrogenase genotype and fluoropyrimidine dosing: 2017 update. Clin Pharmacol Ther 103:210–216
Annalora AJ, Marcus CB, Iversen PL (2017) Alternative splicing in the cytochrome P450 superfamily expands protein diversity to augment gene function and redirect human drug metabolism. Drug Metab Dispos 45:375–389
Bell GC, Caudle KE, Whirl-Carrillo M et al (2017) Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2D6 genotype and use of ondansetron and tropisetron. Clin Pharmacol Ther 102:213–218
Bensouda L, Jarry C, Jonville-Béra A et al (2002) Risk medications in case of glucose-6-phosphate dehydrogenase deficiency. Arch Pediat 9:316–319
Birdwell KA, Decker B, Barbarino JM et al (2015) Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for CYP3A5 genotype and tacrolimus dosing. Clin Pharmacol Ther 98:19–24
Bolleddula J, DeMent K, Driscoll JP et al (2014) Biotransformation and bioactivation reactions of alicyclic amines in drug molecules. Drug Metab Rev 46:379–419
Brookes AJ (1999) The essence of SNPs. Gene 234:177–186
Brunton L, Knollman B, Hilal-Dandan R (2017) Goodman and Gilman’s the pharmacological basis of therapeutics, 13th edn. McGraw Hill Professional, New York
Cappellini MD, Fiorelli G (2008) Glucose-6-phosphate dehydrogenase deficiency. Lancet 371:64–74
Caudle KE, Rettie AE, Whirl-Carrillo M et al (2014) Clinical Pharmacogenetics Implementation Consortium guidelines for CYP2C9 and HLA-B genotypes and phenytoin dosing. Clin Pharmacol Ther 96:542–548
Clancy J, Johnson S, Yee S et al (2014) Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for ivacaftor therapy in the context of CFTR genotype. Clin Pharmacol Ther 95:592–597
Colas C, Ung PM-U, Schlessinger A (2016) SLC transporters: structure, function, and drug discovery. Med Chem Comm 7:1069–1081
Crews KR, Gaedigk A, Dunnenberger HM et al (2014) Clinical Pharmacogenetics Implementation Consortium guidelines for cytochrome P450 2D6 genotype and codeine therapy: 2014 update. Clin Pharmacol Ther 95:376–382
Edwards IR, Aronson JK (2000) Adverse drug reactions: definitions, diagnosis, and management. Lancet 356:1255–1259
Evans WE, McLeod HL (2003) Pharmacogenomics—drug disposition, drug targets, and side effects. N Engl J Med 348:538–549
Ferrell PB, McLeod HL (2008) Carbamazepine, HLA-B* 1502 and risk of Stevens–Johnson syndrome and toxic epidermal necrolysis: US FDA recommendations. Pharmacogenomics 9(10):1543–1546
Froehlich TK, Amstutz U, Aebi S et al (2015) Clinical importance of risk variants in the dihydropyrimidine dehydrogenase gene for the prediction of early-onset fluoropyrimidine toxicity. Int J Cancer 136:730–739
Fromm MF (2002) The influence of MDR1 polymorphisms on P-glycoprotein expression and function in humans. Adv Drug Deliv Rev 54:1295–1310
Fujikura K, Ingelman-Sundberg M, Lauschke VM (2015) Genetic variation in the human cytochrome P450 supergene family. Pharmacogenet Genomics 25:584–594
Gallagher EP, Gardner JL, Barber DS (2006) Several glutathione S-transferase isozymes that protect against oxidative injury are expressed in human liver mitochondria. Biochem Pharmacol 71:1619–1628
Gammal RS, Court MH, Haidar CE et al (2016) Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for UGT1A1 and atazanavir prescribing. Clin Pharmacol Ther 99:363–369
Group SC (2008) SLCO1B1 variants and statin-induced myopathy—a genomewide study. N Engl J Med 2008:789–799
Hayes JD, Strange RC (1995) Invited commentary potential contribution of the glutathione S-transferase supergene family to resistance to oxidative stress. Free Radic Res 22:193–207
Hershfield M, Callaghan J, Tassaneeyakul W et al (2013) Clinical Pharmacogenetics Implementation Consortium guidelines for human leukocyte antigen-B genotype and allopurinol dosing. Clin Pharmacol Ther 93:153–158
Hicks JK, Bishop JR, Sangkuhl K et al (2015) Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2D6 and CYP2C19 genotypes and dosing of selective serotonin reuptake inhibitors. Clin Pharmacol Ther 98:127–134
Hicks JK, Sangkuhl K, Swen JJ et al (2017) Clinical Pharmacogenetics Implementation Consortium guideline (CPIC) for CYP2D6 and CYP2C19 genotypes and dosing of tricyclic antidepressants: 2016 update. Clin Pharmacol Ther 102:37. https://doi.org/10.1002/cpt.597
Hoffmeyer S, Burk O, Von Richter O et al (2000) Functional polymorphisms of the human multidrug-resistance gene: multiple sequence variations and correlation of one allele with P-glycoprotein expression and activity in vivo. Proc Natl Acad Sci U S A 97:3473–3478
Hung SI, Chung WH, Liou LB et al (2005) HLA-B* 5801 allele as a genetic marker for severe cutaneous adverse reactions caused by allopurinol. Proc Natl Acad Sci U S A 102:4134–4139
Ikeda Y, Umemura K, Kondo K et al (2004) Pharmacokinetics of voriconazole and cytochrome P450 2C19 genetic status. Clin Pharmacol Ther 75:587–588
Ingelman-Sundberg M, Gomez A (2010) The past, present and future of pharmacoepigenomics. Pharmacogenomics 11:625–627
Jancova P, Anzenbacher P, Anzenbacherova E (2010) Phase II drug metabolizing enzymes. Biomed Pap 154:103–116
Johnson JA, Caudle KE, Gong L et al (2017) Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for pharmacogenetics-guided warfarin dosing: 2017 update. Clin Pharmacol Ther 102:397–404
Kameyama Y, Yamashita K, Kobayashi K et al (2005) Functional characterization of SLCO1B1 (OATP-C) variants, SLCO1B1* 5, SLCO1B1* 15 and SLCO1B1* 15+ C1007G, by using transient expression systems of HeLa and HEK293 cells. Pharmacogenet Genomics 15:513–522
Kalow W (1962) Pharmacogenetics, heredity and the response to drugs, 1st edn. W. B. Saunders Co, Philadelphia
Klaassen CD, Watkins J (2013) Casarett and Doull’s toxicology: the basic science of poisons, 8th edn. McGraw-Hill Education, New York
Leckband S, Kelsoe J, Dunnenberger H et al (2013) Clinical Pharmacogenetics Implementation Consortium guidelines for HLA-B genotype and carbamazepine dosing. Clin Pharmacol Ther 94:324–328
Lee AM, Shi Q, Pavey E et al (2014) DPYD variants as predictors of 5-fluorouracil toxicity in adjuvant colon cancer treatment (NCCTG N0147). J Natl Cancer Inst 106(12):1–2
Lee WK, Jung S-M, Kwak J-O et al (2006) Introduction of organic anion transporters (SLC22A) and a regulatory mechanism by caveolins. Electrolyte Blood Press 4:8–17
Li X, Yu C, Wang T et al (2016) Effect of cytochrome P450 2C19 polymorphisms on the clinical outcomes of voriconazole: a systematic review and meta-analysis. Eur J Clin Pharmacol 72:1185–1193
Lin JH, Lu AY (2001) Interindividual variability in inhibition and induction of cytochrome P450 enzymes. Annu Rev Pharmacol Toxicol 41:535–567
Lin L, Yee SW, Kim RB et al (2015) SLC transporters as therapeutic targets: emerging opportunities. Nat Rev Drug Discov 14:543–560
Mallal S, Phillips E, Carosi G et al (2008) HLA-B* 5701 screening for hypersensitivity to abacavir. N Engl J Med 358:568–579
Martin M, Klein T, Dong B et al (2012) Clinical Pharmacogenetics Implementation Consortium guidelines for HLA-B genotype and abacavir dosing. Clin Pharmacol Ther 91:734–738
Martin M, Hoffman J, Freimuth R et al (2014) Clinical Pharmacogenetics Implementation Consortium guidelines for HLA-B genotype and abacavir dosing: 2014 update. Clin Pharmacol Ther 95:499–500
Mason PJ, Bautista JM, Gilsanz F (2007) G6PD deficiency: the genotype-phenotype association. Blood Rev 21:267–283
Meulendijks D, Henricks LM, Sonke GS et al (2015) Clinical relevance of DPYD variants c. 1679T> G, c. 1236G> A/HapB3, and c. 1601G> A as predictors of severe fluoropyrimidine-associated toxicity: a systematic review and meta-analysis of individual patient data. Lancet Oncol 16:1639–1650
Meyer UA (2004) Pharmacogenetics–five decades of therapeutic lessons from genetic diversity. Nat Rev Genet 5:669–676
Meyer UA (2000) Pharmacogenetics and adverse drug reactions. Lancet 356:1667–1671
Miranda C (2016) Estudio de la asociación entre polimorfismos genéticos y la respuesta clínica a Tamoxifeno en pacientes con Cáncer de Mama. Universidad de Chile, Santiago/Chile
Moriyama B, Obeng AO, Barbarino J et al (2017) Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for CYP2C19 and voriconazole therapy. Clin Pharmacol Ther 102:45. https://doi.org/10.1002/cpt.583
Muir A, Gong L, Johnson S et al (2014) Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for IFNL3 (IL28B) genotype and PEG interferon-α–based regimens. Clin Pharmacol Ther 95:141–146
Munro AW, McLean KJ, Grant JL, Makris TM (2018) Structure and function of the cytochrome P450 peroxygenase enzymes. Biochem Soc Trans 46:183–196
Nelson DR (2009) The cytochrome P450 homepage. Hum Genomics 4:59–65
Neven P, Jongen L, Lintermans A et al (2018) Tamoxifen metabolism and efficacy in breast cancer: a prospective multicenter trial. Clin Cancer Res 24:2312–2318
Nguyen AP, Ness GL (2014) Hemolytic anemia following rasburicase administration: a review of published reports. J Pediatr Pharmacol Ther 19:310–316
Niemi M, Schaeffeler E, Lang T et al (2004) High plasma pravastatin concentrations are associated with single nucleotide polymorphisms and haplotypes of organic anion transporting polypeptide-C (OATP-C, SLCO1B1). Pharmacogenet Genomics 14:429–440
Nkhoma ET, Poole C, Vannappagari V et al (2009) The global prevalence of glucose-6-phosphate dehydrogenase deficiency: a systematic review and meta-analysis. Blood Cells Mol Dis 42:267–278
Orellana M, Guajardo V (2004) Cytochrome P450 activity and its alteration in different diseases. Rev Med Chil 132:85–94
Pasanen M, Fredrikson H, Neuvonen P et al (2007) Different effects of SLCO1B1 polymorphism on the pharmacokinetics of atorvastatin and rosuvastatin. Clin Pharmacol Ther 82:726–733
Peedicayil J (2008) Pharmacoepigenetics and pharmacoepigenomics. Pharmacogenomics 9:1785–1786
Pirmohamed M (2001) Pharmacogenetics and pharmacogenomics. Br J Clin Pharmacol 52:345–347
Preissner SC, Hoffmann MF, Preissner R et al (2013) Polymorphic cytochrome P450 enzymes (CYPs) and their role in personalized therapy. PLoS One 8:e82562
Quiñones L (2017) Pharmacogenomics in Latin America: challenges and opportunities, 1st edn. Nova Science, New York
Quiñones L, Rosero M, Roco Á et al (2008) Papel de las enzimas citocromo p450 en el metabolismo de fármacos antineoplásicos: Situación actual y perspectivas terapéuticas. Rev Med Chil 136:1327–1335
Ramsey LB, Johnson SG, Caudle KE et al (2014) The Clinical Pharmacogenetics Implementation Consortium guideline for SLCO1B1 and simvastatin-induced myopathy: 2014 update. Clin Pharmacol Ther 96:423–428
Relling MV, McDonagh EM, Chang T et al (2014) Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for rasburicase therapy in the context of G6PD deficiency genotype. Clin Pharmacol Ther 96:169–174
Relling M, Gardner E, Sandborn W et al (2011) Clinical Pharmacogenetics Implementation Consortium guidelines for thiopurine methyltransferase genotype and thiopurine dosing. Clin Pharmacol Ther 89:387–391
Roses AD (2000) Pharmacogenetics and the practice of medicine. Nature 405:857–865
Roth M, Obaidat A, Hagenbuch B (2012) OATPs, OATs and OCTs: the organic anion and cation transporters of the SLCO and SLC22A gene superfamilies. Br J Pharmacol 165:1260–1287
Saito Y, Stamp LK, Caudle KE et al (2016) Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for human leukocyte antigen B (HLA-B) genotype and allopurinol dosing: 2015 update. Clin Pharmacol Ther 99:36–37
Sansone S, Rottensteiner J, Stocker J et al (2010) Ciprofloxacin-induced acute haemolytic anaemia in a patient with glucose-6-phosphate dehydrogenase Mediterranean deficiency: a case report. Ann Hematol 89:935–937
Sear J (2004) In: Evers AS, Maze M (eds) Anesthetic pharmacology: physiologic principles and clinical practice. Oxford University Press, Churchill Livingstone, Philadelphia
Scott SA, Sangkuhl K, Stein C et al (2013) Clinical Pharmacogenetics Implementation Consortium guidelines for CYP2C19 genotype and clopidogrel therapy: 2013 update. Clin Pharmacol Ther 94:317–323
Shalan H, Kato M, Cheruzel L (2019) Keeping the spotlight on cytochrome P450. Biochim Biophys Acta 1866:80–87
Sim SC, Risinger C, Dahl ML et al (2006) A common novel CYP2C19 gene variant causes ultrarapid drug metabolism relevant for the drug response to proton pump inhibitors and antidepressants. Clin Pharmacol The 79:103–113
Skaar TC, Desta Z (2018) CYP2D6 and endoxifen in tamoxifen therapy: a tribute to David A. Flockhart. Clin Pharmacol Ther 103:755–757
Strange RC, Spiteri MA, Ramachandran S et al (2001) Glutathione-S-transferase family of enzymes. Mutation Res 482:21–26
Tirona RG, Leake BF, Merino G et al (2001) Polymorphisms in OATP-C identification of multiple allelic variants associated with altered transport activity among European-and African-Americans. J Biol Chem 276:35669–35675
Vasiliou V, Vasiliou K, Nebert DW (2009) Human ATP-binding cassette (ABC) transporter family. Hum Genomics 3:281–290
Vogel F (1959) Moderne probleme der humangenetik. In: Ergebnisse der inneren medizin und kinderheilkunde. Springer, Berlin, pp 52–125
Walsh JS, Miwa GT (2011) Bioactivation of drugs: risk and drug design. Annu Rev Pharmacol Toxicol 51:145–167
Wijnen P, Op Den Buijsch R, Drent M et al (2007) The prevalence and clinical relevance of cytochrome P450 polymorphisms. Aliment Pharmacol Ther 26:211–219
Wilkinson GR (2005) Drug metabolism and variability among patients in drug response. N Engl J Med 352:2211–2221
World Health Organization (2002) The world health report 2002: reducing risks, promoting healthy life. World Health Organization, Geneva
Xie H-G, Frueh FW (2005) Pharmacogenomics steps toward personalized medicine. Pers Med 2:325–337
Yee SW, Nguyen AN, Brown C et al (2013) Reduced renal clearance of cefotaxime in asians with a low-frequency polymorphism of OAT3 (SLC22A8). J Pharm Sci 102:3451
Zhou S-F, Ming Di Y, Chan E et al (2008) Clinical pharmacogenetics and potential application in personalized medicine. Curr Drug Metab 9:738–784
Zhou S-F, Liu J-P, Chowbay B (2009) Polymorphism of human cytochrome P450 enzymes and its clinical impact. Drug Metab Rev 41:89–295
Zhu Y, Shennan M, Reynolds KK et al (2007) Estimation of warfarin maintenance dose based on VKORC1 (− 1639 G> A) and CYP2C9 genotypes. Clin Chem 53:1199–1205
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Martínez, M.F., Quiñones, L.A. (2018). Relationship Between Pharmacokinetics and Pharmacogenomics and Its Impact on Drug Choice and Dose Regimens. In: Talevi, A., Quiroga, P. (eds) ADME Processes in Pharmaceutical Sciences. Springer, Cham. https://doi.org/10.1007/978-3-319-99593-9_8
Download citation
DOI: https://doi.org/10.1007/978-3-319-99593-9_8
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-99592-2
Online ISBN: 978-3-319-99593-9
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)