Mastering Pharmacogenomics: A Nurse’s Handbook for Success by Dale Halsey Lea, Dennis J. Cheek, Daniel Brazeau, Gayle

By Dale Halsey Lea, Dennis J. Cheek, Daniel Brazeau, Gayle Brazeau

Pharmacogenomics, the research of the function of genetics in drug reaction, has constructed right into a serious new zone in scuffling with ailment and enhancing results. As our wisdom of the human genome grows, and with the arrival of next-generation sequencing applied sciences, the position of genetic learn is evolving to lead treatment and forestall many ailments and mitigate side-effects of present remedies. As a pivotal member of the healthcare workforce, nurses needs to gather competency in pharmacogenomics to bring optimum sufferer care within the twenty first century. learning Pharmacogenomics offers nursing execs with a foundational wisdom of human genetics and genomics that may be utilized in optimizing drug treatment and sufferer care supply. assurance comprises: crucial pharmacogenomics skills for registered nurses, genomics applied sciences and assets, serious homes of drug reaction and disposition, coated specialties comprise obstetrics and prenatal sufferers, pediatrics, older grownup sufferers, and oncology, ethics and sufferer care and destiny advancements in know-how and supply.

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Although genetic testing can provide additional, important information, it is not the only source of information the clinician will use to determine clinical efficacy and risk for adverse events from a drug. Nonetheless, the Clinical Pharmacogenetics Implementation Consortium (CPIC) has developed dosing guidelines based on pharmacogenomics in multiple drugs (Pharmacogenomics Knowledge Implementation, 2014). The CPIC provides freely available, peer-reviewed, updatable, and detailed gene-drug clinical practice guidelines.

The pharmacogenomic test is paid for through May’s insurer, Medicare (http://cms. gov), and includes the analysis of nine common cytochrome P450 (CYP) enzymes involved in drug metabolism. The pharmacogenomic test reveals that May is a slow CYP2C19 metabolizer. This result confirms the cardiologist’s clinical decision: namely, that clopidogrel—a prodrug—is unlikely to be effective in the prevention of thromboses for May. A prodrug is a medication that needs to be converted to an active form. Typically, conversion occurs through metabolism in the liver.

Improved chloride ion channel structure helps to thin the thick, sticky mucus in lungs common to cystic fibrosis. More than 400 mutations of the gene that codes for chloride ion channels result in a diagnosis of cystic fibrosis (National Human Genome Research Institute, 2014k). In terms of pharmacogenomics, patients need to be tested for the specific genetic mutations that respond to invacaftor before it is prescribed and used. Genes in Pedigrees An individual’s pedigree is a genetic representation of his or her family tree that illustrates the inheritance of a disease or trait through several generations.

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