Abstract
Implementing pharmacogenetics in daily clinical practice has the potential to improve patient care. The translation of results of pharmacogenetic studies into practical pharmacotherapeutic recommendations is essential. These recommendations are preferably available at the time of drug prescribing and drug dispensing. This chapter describes a process of developing evidence based drug dosing and pharmacotherapeutic guidelines per genotype by the Dutch Pharmacogenetics Working Group. It is aimed to provide recommendations in case drugs are prescribed to a patient whose genotype is known. Furthermore, several examples are given. Many drugs are metabolized by the Cytochrome P450 CYP2D6 enzyme. Carriage of genetic variants of the CYP2D6 gene can result in a predicted phenotype of poor, intermediate or ultrarapid metabolizer. Dose adjustments, pharmacotherapeutic and monitoring recommendations are described for several CYP2D6 substrates, when initiated in patients with the above mentioned phenotypes.
The Pharmacogenetics Working Group is part of the Pharmacogenetics Project of the Royal Dutch Association for the Advancement of Pharmacy
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References
Sachse C et al (1997) Cytochrome P450 2D6 variants in a Caucasian population: allele frequencies and phenotypic consequences. Am J Human Genet 60:284
Kirchheiner J et al (2003) Effects of polymorphisms in CYP2D6, CYP2C9, and CYP2C19 on trimipramine pharmacokinetics. J Clin Psychopharmacol 23:459
Brockmöller J et al (2002) The impact of the CYP2D6 polymorphism on haloperidol pharmacokinetics and on the outcome of haloperidol treatment. Clin Pharmacol Ther 72:438
Swen J et al (2008) Pharmacogenetics: from bench to byte. Clin Pharmacol Ther 83:781
Kirchheiner J et al (2004) Pharmacogenetics of antidepressants and antipsychotics: the contribution of allelic variations to the phenotype of drug response. Mol Psychiatry 9:442
Swen J et al (2011) Pharmacogenetics: from bench to byte—an update of guidelines. Clin Pharmacol Ther 89:662
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Deneer, V.H.M., van Schaik, R.H.N. (2013). Evidence Based Drug Dosing and Pharmacotherapeutic Recommendations per Genotype. In: Innocenti, F., van Schaik, R. (eds) Pharmacogenomics. Methods in Molecular Biology, vol 1015. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-435-7_23
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DOI: https://doi.org/10.1007/978-1-62703-435-7_23
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Publisher Name: Humana Press, Totowa, NJ
Print ISBN: 978-1-62703-434-0
Online ISBN: 978-1-62703-435-7
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