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Understanding Pharmacogenomics and Its Implications for LTPAC Care

Topics: Clinical Consulting

dna.jpgHave you ever medicated a resident for pain, and an hour later they were still not getting relief? Have you ever had a patient with depression and after trying multiple medications, they were not feeling better than when first diagnosed? This has occurred in my career as a nurse more times than I can count. Each time I want so much to give that relief to my resident to no avail. Times have since changed and we now have a test that could change the way the meds are chosen for a resident forever.

My current position as a Clinical Consultant has given me the unique opportunity to read and research on healthcare related topics frequently. Most recently I came across the term pharmacogenomics. I was glued to my computer screen as I read all about this innovative new process. By the time I had finished reading the article, the thing that I kept repeating in my head was “This has the potential to help every single person who takes medication”. I know what you are probably thinking…”That seems a bit farfetched”. I assure you it is not! And here is why.

What is pharmacogenomics?

Pharmacology + Genomics = Pharmacogenomics

By definition, pharmacogenomics is the study of how genes affect a person's response to drugs. This relatively new field combines pharmacology (the science of drugs) and genomics (the study of genes and their functions) to develop effective, safe medications and doses that will be tailored to a person's genetic makeup.

Many drugs that are currently available are “one size fits all,” but they don't work the same way for everyone. It can be difficult to predict who will benefit from a medication, who will not respond at all, and who will experience negative side effects (otherwise known as an adverse drug reaction). Adverse drug reactions are a significant cause of hospitalizations and deaths in the US. With the knowledge gained from the Human Genome Project, researchers are learning how inherited differences in genes affect the body’s response to medications. These genetic differences will be used to predict whether a medication will be effective for a particular person and to help prevent adverse drug reactions.

The test for pharmacogenomics is performed with a simple buccal swab of the inner cheek. The results will include more than 200 prescription and over the counter medications including many of those for the following conditions: GERD, ADHD, anxiety, arthritis, asthma, DVT/PE, cancer, high cholesterol, depression, diabetes, HTN, and pain. We can now use this information to guide the medications we are choosing for our residents/ patients, instead of the usual trial and error.

The function of pharmacogenomics is to determine what medications are best suited for the resident/ patient. It does so by answering these questions:

  • Is the medication an effective treatment for you?
  • What is the optimal dose for you?
  • Could you have a serious reaction to the medication?

When the testing is completed caregivers and patients will have information from 4 categories with regard to the medication use:

  x.png   Increased caution with this medication and more frequent monitoring

   exclamation_point.png   Use caution with this medication

check-mark.pngUse medication as directed

   arrow.png   Medication dose recommendation


This type of testing is going to forever change the face how we treat our residents/patients with medication. We now have the technology to choose the right medication the first time, and in the process, avoid unwanted side effects. Truly personalized medicine.


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