LEXINGTON, Ky. (June 29, 2011) — The following column appeared in the Lexington Herald-Leader on Sunday, June 26.
Individualized medicine the future of pharmacy
By Timothy S. Tracy
For years, we’ve talked about how our genetic differences affect our health.
It is not uncommon to hear people say, “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.
Patients will hear more about the emerging role of pharmacogenetics — sometimes called personalized medicine — from their pharmacists. Just as your parents provided you with the genes that give you your eye and hair color, your genetic code affects how the medicines you take are broken down by your system or act on your body.
You might know friends or relatives who cannot take certain medicines or who require a differen t dose of a drug than you take. In many of those cases, those differences are based on a person’s genetic makeup.
Recent studies have indicated that in some cases, more than 30 percent of the population breaks down the same medicine 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 person in 100 is deficient in the ability to break down the blood thinner warfarin (Coumadin) and thus requires approximately one-fifth the dose of the typical patient. If this dose is not adjusted properly and in a reasonable time, the patient could experience severe bleeding.
This is not new information. For years, pharmacists have known that various 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 medicine and checked back after some time to see how effectively it was working or not working. From there, we adjusted the dose. Now, with the advent of more accessible genetic testing, 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 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 drug-therapy program specifically 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 patients 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.