Pharmacogenomics: Aa clinician's primer on emerging technologies for improved patient care

Pharmacogenomics is a term recently coined to embody the concept of individ ualized and rational drug selection based on the genotype of a particular p atient, Customization of drug therapy offers the potential for optimal safe ty and efficacy in an individual patient. Such a process contrasts current prescribing practices, which use medications shown to be safe and effective in patient populations or based on anecdotal experiences. Within patient p opulations, medications vary in their efficacy among individual patients. M ore importantly; a medication that is safe and effective in one patient may be ineffective or even harmful in another. Underlying many of these phenot ypic differences are genotypic variants (polymorphisms) of key enzymes and proteins that affect the safety and efficacy of a drug in an individual pat ient. An understanding of these polymorphisms has the potential to enhance patient care by allowing physicians to customize the selection of medicatio n to meet individual patient needs. Pharmacogenomics may also lead to impro ved compliance and shorter time to optimal disease management, thereby redu cing morbidity and mortality, Significant cost savings could result from re ductions in polypharmacy as well as from fewer physician encounters and hos pitalizations for exacerbations of underlying illness and because of advers e drug reactions.