Mechanism based medicine in infancy: complex interplay between developmental pharmacology and pharmacogenetics
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Introduction of the available knowledge on pharmacogenetics very likely is one of the tools to close the gap between ‘population’ focused evidence based and ‘individual’ mechanism based medicine. However, besides pharmacogenetics, other covariates like age, renal function and/or co-medication should also be considered simultaneously when aiming for a ‘tailored’ pharmacotherapy. To illustrate this, we further extended the tramadol example used by Wilffert et al. to illustrate the complex interplay between developmental pharmacology and pharmacogenetics.
KeywordsCYP2D6 Developmental pharmacology Pharmacogenetics Tailored pharmacotherapy Tramadol
The clinical research of Karel Allegaert is supported by the Fund for Scientific Research, Flanders (Belgium) (F.W.O. Vlaanderen) by a Fundamental Clinical Investigatorship (1800209 N).
- 1.Wilffert B, Swen J, Mulder H, et al. From evidence based medicine to mechanism based medicine. Reviewing the role of pharmacogenetics. Pharm World Sci. 2010. doi: 10.1007s/s11096-010-9446-1.
- 3.Allegaert K, Rochette A, Veyckemans F. Developmental pharmacology of tramadol during infancy: ontogeny, pharmacogenetics and elimination clearance. Paediatr Anaesth 2011;21(3):266–73. doi: 10.1111/j.1460.9592.2010.03389.x.