title: Navigating pleiotropy in precision medicine: pharmacogenes from trauma to behavioral health.
abstract: A strong emerging principle in the field of precision medicine is that variation in any one pharmacogene may impact clinical outcome for more than one drug. Variants tested in the acute care setting often have downstream implications for other drugs impacting chronic disease management. A flexible framework is needed as clinicians and scientists move toward deploying automated decision support for gene-based drug dosing in electronic medical records.
authors.affiliation: Department of Clinical Research, Sanford Healthcare-Fargo, 801 North Broadway, Fargo, ND 58102, USA.
authors.forename: Vicki
authors.initials: V
authors.lastname: Oberg
authors.affiliation: Department of Trauma and Surgical Critical Care, Sanford Healthcare-Fargo, 801 North Broadway, Fargo, ND 5810, USA.
authors.forename: Jerome
authors.initials: J
authors.lastname: Differding
authors.affiliation: Department of Medical Genetics, Sanford Healthcare-Fargo, 801 North Broadway, Fargo, ND 58102, USA.
authors.forename: Morgan
authors.initials: M
authors.lastname: Fisher
authors.affiliation: Department of Clinical Psychology, University of North Dakota, 700 South 1st Avenue, Fargo, ND 58103, USA.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Hines
authors.affiliation: Department of Internal Medicine, University of South Dakota Sanford School of Medicine, 1400 West 22nd Street, Sioux Falls, SD 57105, USA.
authors.forename: Russell A
authors.initials: RA
authors.lastname: Wilke
mesh_terms: D020000:Decision Support Systems, Clinical; D057286:Electronic Health Records; D058685:Genetic Pleiotropy; D005820:Genetic Testing; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy* / Q000235:genetics; D010597:Pharmacogenetics; D057285:Precision Medicine; D014947:Wounds and Injuries / Q000188:drug therapy* / Q000235:genetics
keywords: Best Practice Advisory; clinical decision support; drug metabolizing enzyme; electronic medical record; individualized medicine; personalized medicine; pharmacodynamics; pharmacogenes; pharmacogenetics; pharmacogenomics; pharmacokinetics; pleiotropy; precision medicine