[Individualization of drug therapy and pharmacogenetics].
This brief review discusses the relationship between genetic polymorphism of drug metabolizing enzyme and drug's safety and efficacy. When elimination occurs via a single metabolic pathway, individual differences in metabolic rates can lead to large differences in drug and metabolite concentrations in the blood. Genetic polymorphism leads to subpopulation of patients with decreased, absent or even increased activities of certain reactions (e.g., CYP2C19, CYP2D6, CYP2C9, N-acetyltransferase, thiopurine methyltransferase polymorphism). The consequences of a genetic polymorphism include not only altered kinetics of specific drug substrate but idiosyncratic adverse drug reactions. Having these information will aid in determining dosage of certain medications to the patients with an inherited abnormality of drug metabolizing enzyme. Pharmacogenetics already has influenced therapeutics.
Yamamoto
I
I
Department of Clinical Evaluation of Medicines and Therapeutics, Faculty of Pharmaceutical Sciences, Osaka University.
Azuma
J
J
D000925:Anticoagulants / Q000493:pharmacokinetics; D001189:Aryl Hydrocarbon Hydroxylases; D001191:Arylamine N-Acetyltransferase / Q000235:genetics*; D001379:Azathioprine / Q000009:adverse effects / Q000493:pharmacokinetics; D065731:Cytochrome P-450 CYP2C19; D065729:Cytochrome P-450 CYP2C9; D019389:Cytochrome P-450 CYP2D6 / Q000235:genetics / Q000502:physiology; D065607:Cytochrome P-450 Enzyme Inhibitors; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics* / Q000502:physiology; D014644:Genetic Variation; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000493:pharmacokinetics; D008780:Methyltransferases / Q000235:genetics*; D006899:Mixed Function Oxygenases / Q000037:antagonists & inhibitors / Q000235:genetics* / Q000502:physiology; D009154:Mutation; D009853:Omeprazole / Q000494:pharmacology; D011110:Polymorphism, Genetic; D039181:Steroid 16-alpha-Hydroxylase; D013250:Steroid Hydroxylases / Q000235:genetics / Q000502:physiology; D014859:Warfarin / Q000493:pharmacokinetics
D000925:Anticoagulants; D065607:Cytochrome P-450 Enzyme Inhibitors; D007166:Immunosuppressive Agents; D014859:Warfarin; D003577:Cytochrome P-450 Enzyme System; D006899:Mixed Function Oxygenases; D013250:Steroid Hydroxylases; C450260:CYP2C9 protein, human; D065729:Cytochrome P-450 CYP2C9; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D019389:Cytochrome P-450 CYP2D6; D039181:Steroid 16-alpha-Hydroxylase; D008780:Methyltransferases; C022745:thiopurine methyltransferase; D001191:Arylamine N-Acetyltransferase; D009853:Omeprazole; D001379:Azathioprine