title: Pharmacogenetics in the Community Pharmacy: Thienopyridine Selection Post-Coronary Artery Stent Placement.
abstract: BACKGROUND
  Although antiplatelet therapy is a mainstay of post-percutaneous coronary intervention therapy, pharmacogenetic (PGt) considerations of therapy are often ignored despite related Food and Drug Administration warnings. Pharmacists are well situated to provide PGt guidance, and the community pharmacy is one setting where PGt testing, interpretation, and recommendations can take place to ensure optimal therapeutic outcomes.
  
  
  METHODS
  A 65-year-old man who had a myocardial infarction that was treated with PCI and stent placement was determined by a community pharmacist to be a candidate for PGt testing to ensure optimal antiplatelet therapy. The patient was seen in the pharmacy as a part of a medication therapy management encounter and underwent genetic testing. Results of the genetic testing indicated the need for modification of therapy. The community pharmacist interpreted the results and made the appropriate recommendation to the cardiologist who in turn modified antiplatelet therapy appropriately.
  
  
  CONCLUSIONS
  This case describes the potential for collaboration between pharmacists and physicians to optimize antiplatelet therapy through PGt testing. Points of consideration for others looking to implement related PGt services are also discussed.
authors.affiliation: Raabe College of Pharmacy, Ohio Northern University, Ada, OH, USA d-kisor@onu.edu.
authors.forename: David F
authors.initials: DF
authors.lastname: Kisor
authors.affiliation: Raabe College of Pharmacy, Ohio Northern University, Ada, OH, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Bright
authors.affiliation: Kroger Pharmacy, Findlay, OH, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Conaway
authors.affiliation: Blanchard Valley Medical Associates, Findlay, OH, USA.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Bouts
authors.affiliation: Blanchard Valley Medical Associates, Findlay, OH, USA.
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Gerschutz
mesh_terms: D000368:Aged; D003157:Community Pharmacy Services / Q000458:organization & administration; D003299:Cooperative Behavior; D005820:Genetic Testing / Q000379:methods; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000628:therapy; D062645:Percutaneous Coronary Intervention / Q000379:methods; D010595:Pharmacists / Q000458:organization & administration*; D010597:Pharmacogenetics; D010820:Physicians / Q000458:organization & administration; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D024382:Professional Role; D015607:Stents; D058924:Thienopyridines / Q000008:administration & dosage*
chemical_list: D010975:Platelet Aggregation Inhibitors; D058924:Thienopyridines
keywords: medication therapy management; personalized medicine; pharmacogenetics; pharmacogenomics; thienopyridine