Drug Safety

, Volume 29, Issue 9, pp 735–768

Therapeutic Drug Monitoring and Pharmacogenetic Tests as Tools in Pharmacovigilance

  • Eveline Jaquenoud Sirot
  • Jan Willem van der Velden
  • Katharina Rentsch
  • Chin B. Eap
  • Pierre Baumann
Leading Article

Abstract

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.

Copyright information

© Adis Data Information BV 2006

Authors and Affiliations

  • Eveline Jaquenoud Sirot
    • 1
  • Jan Willem van der Velden
    • 2
    • 3
  • Katharina Rentsch
    • 4
  • Chin B. Eap
    • 5
  • Pierre Baumann
    • 5
  1. 1.Psychiatrische Dienste Aargau AG, MediQ, Klinik KönigsfeldenBruggSwitzerland
  2. 2.Global Safety and Pharmacovigilance, PharmaNet AGZumikonSwitzerland
  3. 3.Postgraduate Programme in Pharmaceutical MedicineUniversité Libre de BruxellesBrusselsBelgium
  4. 4.Institut für Klinische ChemieUniversitätsspital ZürichZurichSwitzerland
  5. 5.Unité de Biochimie et Psychopharmacologie, Department of Psychiatry, Center for Psychiatric NeurosciencePrilly-LausanneSwitzerland

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