title: Complexities of personalized medicine: how genes, drug-drug interactions, dosing schedules, and other factors can combine to produce clinically meaningful differences in a drug's effect.
abstract: Given increased knowledge from molecular biology and pharmacology, it is apparent that multiple factors can interact to produce clinically meaningful differences in a drug's effect in specific individuals (i.e., personalized medicine). This topic is discussed in this column using iloperidone as an example. The variables discussed include dose, dosing schedule, genes, drug-drug interactions, and other medical factors. How such variables can combine to alter a drug's effect is illustrated with a case example and the results of a thorough QTc study of iloperidone.
authors.forename: Sheldon H
authors.initials: SH
authors.lastname: Preskorn
mesh_terms: D000341:Affective Disorders, Psychotic / Q000188:drug therapy*; D000368:Aged; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004244:Dizziness / Q000139:chemically induced; D004347:Drug Interactions / Q000235:genetics; D000072237:ERG1 Potassium Channel; D051638:Ether-A-Go-Go Potassium Channels / Q000235:genetics; D006801:Humans; D007555:Isoxazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D008297:Male; D017374:Paroxetine / Q000627:therapeutic use; D010597:Pharmacogenetics; D010880:Piperidines / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D057285:Precision Medicine / Q000379:methods*
chemical_list: D014150:Antipsychotic Agents; D000072237:ERG1 Potassium Channel; D051638:Ether-A-Go-Go Potassium Channels; D007555:Isoxazoles; D010880:Piperidines; D017374:Paroxetine; C081732:iloperidone