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Pharmacokinetics, Pharmacodynamics, and Toxicities: What Should We Know About Genetic Factors that Affect the Pharmacotherapy of Pulmonary Diseases?

Chapter
Part of the Respiratory Disease Series: Diagnostic Tools and Disease Managements book series (RDSDTDM)

Abstract

There have been significant recent advances in the pharmacotherapy of lung diseases, particularly, molecular targeted therapy of lung cancer and idiopathic pulmonary fibrosis. However, there are some limitations inherent to this type of next-generation pharmacotherapy such as adverse drug reactions and nonresponse to therapy. Several factors may underlie the variability in response to therapy, including inherited variants in drug-metabolizing enzymes, transporters, receptors, and the fact that different signaling proteins can elicit different biological responses. Therefore, understanding the genetic factors that affect pharmacodynamics would help physicians determine interindividual differences in the absorption, distribution, metabolism, and excretion of specific drugs. Here, we review representative drugs often prescribed by pulmonologists, with special focus on genetic factors relating to efficacy, toxicity, safety, and responsiveness. An understanding of the genetic variants underlying interindividual differences in drug pharmacokinetics and pharmacodynamics could move us toward personalized precision medicine in which cutting-edge pharmacogenomic analyses are used. In addition, advanced high-throughput technologies such as a multigene panel platform could encourage physicians to optimize therapy with more potent but less toxic drugs and to characterize individual genetic backgrounds.

Keywords

Genetic polymorphism Drug-metabolizing enzyme Pharmacokinetics Pharmacodynamics Pharmacogenomics 

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© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Department of PulmonologyYokohama City University Graduate School of MedicineYokohamaJapan

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