For years, we’ve talked about how our genetic differences impact our health.
It is not uncommon to hear people utter such phrases as, “I get my high blood pressure from my father’s side of the family.” Or, “I have my mom to thank for my good eyesight.”
The more we learn about genetics, the more we realize that there is a lot of truth to those age-old beliefs. Our genetics have a profound impact on our health and understanding our genetic differences will play an even larger role in how we treat disease in the years ahead.
From their pharmacist, patients will be hearing more about the emerging role of pharmacogenetics or, as it is sometimes called, personalized medicine. Just as your parents provided you with the genes that indicate your eye and hair color, your genetic code has a profound impact on how the medicines you take are broken down by or act on your body.
You may know friends and family remembers who cannot take certain medicines or require a difference dose of a drug than you take. In many of those cases, those differences are based upon a person’s individual genetic makeup.
Recent studies have indicated that in some cases upwards of 30 percent of the population breaks down the same medication at very different rates. For example, about 1 in 10 people are unable to convert codeine into its active form, morphine, and thus do not receive any relief from pain.
In another example, approximately 1 in 100 individuals is deficient in the ability to break down the blood thinner warfarin (Coumadin) and thus require approximately one-fifth the dose of the typical patient. If this dose is not adjusted properly and in a reasonable period of time the patient could experience a severe bleeding episode.
This is not new information. For years, pharmacists have known that different patients require different doses of the same drug. But the only tool we had to discover the correct dose was through trial and error. We gave patients the same amount of a prescribed medication and checked back with them after some time to see how effectively it was working – or not working. From there, we adjusted the dose. Now, with the advent more accessible genetic testing related to drug therapy we are learning some of the reasons for these differences among patients.
As science advances, we can do better. Pharmacists practicing personalized medicine will develop individual drug therapies based on a patient’s genetic code. This is being aided by advances in conducting genetic testing of individuals in a rapid and relatively inexpensive manner.
You won’t be seeing as much of the “one dose fits all” brand of medicine that was practiced for generations. Instead, your pharmacist – using information culled from your genetic code – will develop a personalized drug therapy program for you.
Providing the right dose to the right patient at the right time is the future of pharmacy. Frankly, it is the future of health care. And as we work toward developing a health care continuum that puts the patient and their health first, pharmacists will be prepared to help lead the way.
Timothy S. Tracy is dean of the University of Kentucky College of Pharmacy.