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Drugs and genes

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by

Malak Abouayana

on 15 April 2016

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Transcript of Drugs and genes

Drugs
Genes
Pharmacogenomical approach

The

Right
Dose
of
The

Right
Drug
for
The

Right
Indication
for
The

Right
Patient
at
The

Right
Time.

Personalized

medicine

Why does this drug
work
for me but not for you?
Why do I have
side-effects
and you don’t?
Why does someone need
twice
the standard
dose
to be
effective
?
Why is
anecdotal information

irrelevant
to your own health and treatment?
Remember the

"
5 RIGHTs
"


1866
Mendels' rules
of heredity
1910
William Bateson's term
"
GENETICS
"
1950-60
Pharmaco
genetics
1980
-
2003
H
uman

G
enome

P
roject
2003/4
Pharmaco
genomics
Drug
disposition
Drug
metabolism
Drug
transport
Pharmaco
dynamic
?
--> Pharmaco
kinetics
Cytochrome
P450
57 Different active genes
17 Different families
metabolises the largest range of drugs of all the CYPs
CYP3A4
tricyclic antidepressants (imipramine),
opiate analgesics (codeine),
statins (lovastatin)
calcium channel blockers (verapamil)
antifungals (ketoconazole),
A
denosine triphosphate (ATP)–
B
inding
C
assette (
ABC
-family)
P-glycoprotein

encoded by
ABCB1

gene (also
MDR1
).
--> several anticancer drugs
--> HIV type 1 protease inhibitors
--> cardiac glycosides
promotes
ATP-dependant efflux
--> others
Drug targets (receptors) variability
β2-adrenoreceptor

coded by the

ADRB2

gene
Individual genetic variaion
S
ingle
N
ucleotide
P
olymorphism (
SNP
)
C
opy
N
umber
V
ariation (
CNV
)
Thiopurines:
6-mercaptopurine
6-methylmercaptopurine
Interferes with nucleic acid synthesis
treat lymphoblastic leukemia, autoimmune disease, inflammatory bowel disease
cytotoxic drug with a narrow therapeutic index
TPMT
life threatening
bone marrow suppression
Warfarin
Ranks
#1
in total mentions of deaths for drugs causing adverse events.
Ranks among the
top
drugs associated with hospital
emergency
room visits for
bleeding
Finding the
right dose
can be difficult, requiring serial measurement of
I
nternational
N
ormalized
R
atio (
INR
) levels over the course of days or weeks.
Are we,Egyptians,
ready
for pharmacogenomics?
A survey was conducted in Alexandria, Egypt (Mai, 2015)
50 random Egyptians have been questioned and 8 of which refused to participate.
--> Age: 15-75 --> Educated --> social status: variable
Objective: To measure the readiness of Egyptians to Pharmacogenomics.
84%
16%
Do you think that the study of genetic differences, as to relate such studies to individuals' response to medicines, is
Do you know that there´re medicines prescribed according to someone´s genes?
16%
30%
54%
Would you like to participate in a genetic research, if...
your participation in the research study would increase the possibility of developing a treatment to a certain disease in the future
you knew your test results, without your name or other identifying information, would be shared with other scientists nationwide to be used furthermore in genetic researches
60%
16%
20%
4%
76%
16%
2%
6%
it involved researchers reviewing your medical records, as well as, your genetic test results, in order to explore possible links between both
you knew the results would be anonymous, i.e. that nobody- even the researchers- would know which test came from which person
16%
66%
8%
10%
16 %
10%
14%
60%
Government
58%
16%
18%
8%
32%
34%
16%
18%
Universities and medical schools
50%
16%
18%
16%
Drug companies
54%
16%
28%
2%
Organizations
How much trust would you have in genetic research conducted by:
18%
16%
38%
28%
Do you think genetic studies and researches have a future in Egypt?
48%
16%
32%
4%
Could Egypt afford such studies and researches economically?
Presented by:

Malak Abouayana
Third year pharmacy student
Faculty of Pharmacy, Alexandria University
Questions
References:
http://www.pitt.edu/~super7/45011-46001/45961.ppt
http://www.nejm.org/doi/full/10.1056/NEJMra020526
https://cpmc.coriell.org/Sections/Medical/DrugsAndGenes_mp.aspx?PgId=216
https://www.pharmgkborg/
http://www.genome.gov/27530645

Weblinks
Books
Pharmacogenomics (social, ethical and clinical dimensions)
Pharmacogenomics in clinical therapeutics
Full transcript