title: Is personalized medicine achievable in obstetrics?
abstract: Personalized medicine seeks to identify the right dose of the right drug for the right patient at the right time. Typically, individualization of therapy is based on the pharmacogenomic makeup of the individual and environmental factors that alter drug disposition and response. In addition to these factors, during pregnancy, a woman's body undergoes many changes that can impact the therapeutic efficacy of medications. Yet, there is minimal research regarding personalized medicine in obstetrics. Adoption of pharmacogenetic testing into the obstetrical care is dependent on evidence of analytical validity, clinical validity, and clinical utility. Here, we briefly present information regarding the potential utility of personalized medicine for treating the obstetric patient for pain with narcotics, hypertension, and preterm labor, and discuss the impediments of bringing personalized medicine to the obstetrical clinic.
authors.affiliation: Department of Obstetrics and Gynecology and Department of Medicine, Indiana University School of Medicine, Indianapolis, IN. Electronic address: squinney@iupui.edu.
authors.forename: Sara K
authors.initials: SK
authors.lastname: Quinney
authors.affiliation: Department of Obstetrics and Gynecology and Department of Medicine, Indiana University School of Medicine, Indianapolis, IN.
authors.forename: Avinash S
authors.initials: AS
authors.lastname: Patil
authors.affiliation: Department of Medicine, Department of Medical Genetics, and Department of Pharmacology; Indiana Institute of Personalized Medicine, Indiana University School of Medicine, Indianapolis, IN.
authors.forename: David A
authors.initials: DA
authors.lastname: Flockhart
mesh_terms: D000959:Antihypertensive Agents / Q000378:metabolism / Q000627:therapeutic use; D065729:Cytochrome P-450 CYP2C9 / Q000235:genetics / Q000378:metabolism; D019389:Cytochrome P-450 CYP2D6 / Q000235:genetics / Q000378:metabolism; D051544:Cytochrome P-450 CYP3A / Q000235:genetics / Q000378:metabolism; D005260:Female; D014453:Glucuronosyltransferase / Q000235:genetics / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D009294:Narcotics / Q000378:metabolism / Q000627:therapeutic use; D007752:Obstetric Labor, Premature / Q000188:drug therapy; D009774:Obstetrics; D010146:Pain / Q000188:drug therapy; D010597:Pharmacogenetics; D057285:Precision Medicine; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy; D015149:Tocolytic Agents / Q000378:metabolism / Q000627:therapeutic use; D000099148:UGT1A1 Enzyme
chemical_list: D000959:Antihypertensive Agents; D065729:Cytochrome P-450 CYP2C9; D019389:Cytochrome P-450 CYP2D6; D051544:Cytochrome P-450 CYP3A; D014453:Glucuronosyltransferase; D009294:Narcotics; D015149:Tocolytic Agents; D000099148:UGT1A1 Enzyme
keywords: medications; obstetrics; personalized medicine; pharmacogenetics