Pharmacogenetics in critical care: atrial fibrillation as an exemplar.
Pharmacogenetic testing is currently not routine in critical care settings but recent changes in the warfarin label are likely to lead to critical care nurses encountering physician or nurse practitioner orders for such testing. Although the science for pharmacogenetics is complex, the components of patient teaching are not beyond that which nurses already provide about other laboratory, disease, and treatment-based information. It is reasonable to expect that as the science of pharmacogenetics and pharmacogenomics expands and discoveries are translated in clinical settings, the additional information from pharmacogenetic test results will help prescribers select or adjust medication doses to reduce the risk for adverse drug reactions and improve the chances of achieving therapeutic targets in a timely fashion.
Prows
Cynthia A
CA
Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA. cindy.prows@cchmc.org
Beery
Theresa A
TA
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001189:Aryl Hydrocarbon Hydroxylases / Q000187:drug effects / Q000235:genetics; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000235:genetics* / Q000451:nursing; D003422:Critical Care / Q000379:methods*; D065729:Cytochrome P-450 CYP2C9; D004347:Drug Interactions; D004348:Drug Labeling; D016903:Drug Monitoring / Q000379:methods* / Q000451:nursing; D005260:Female; D005820:Genetic Testing / Q000379:methods; D006801:Humans; D006899:Mixed Function Oxygenases / Q000187:drug effects / Q000235:genetics; D024802:Nurse's Role; D009730:Nursing Assessment; D010353:Patient Education as Topic; D018579:Patient Selection; D010597:Pharmacogenetics / Q000379:methods*; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D013041:Specialties, Nursing / Q000379:methods; D064417:Vitamin K Epoxide Reductases; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D014859:Warfarin; D006899:Mixed Function Oxygenases; C450260:CYP2C9 protein, human; D065729:Cytochrome P-450 CYP2C9; D001189:Aryl Hydrocarbon Hydroxylases; D064417:Vitamin K Epoxide Reductases