Percent of doctors believe pharmacogenetics can improve health care
Percent of doctors have actually incorporated pharmacogenetics into their treatments
A Prescription for Prescriptions Nursing professor Jay Tan uses a simple test to help physicians customize their prescriptions to a patient’s genetic makeup.
BY MATT JACOB
t’s just past noon on a sweltering midweek day and assistant professor Jay Tan has wrapped up a four-hour lecture for one of his summer nursing courses. Sitting in his fourth-floor office of the Bigelow Health Sciences Building, he shares a story about a patient he helped as a nurse practitioner specializing in mental health.
The woman had tried multiple medications to relieve her psychosis symptoms, which included seeing and hearing things that weren’t real. Tan suggested using genetic testing to better understand how her body reacts to medication. A simple cheek swab soon led to a change in her prescriptions. Her symptoms gradually improved and within six months, Tan says, his patient had rejoined the workforce.
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“Suddenly during one of our visits, she became tearful,” he recalls. “She looked at me and said, ‘Dr. Tan, like you, my mom was a nurse practitioner, and like me, she had [mental health problems]. She committed suicide, and in her notes, she wrote, ‘Nothing works.’” Tan has focused his doctoral research on pharmacogenetics to help his patients find what will work before they give up. It’s the
science of how our genetic makeup affects the way in which our bodies absorb and react to different medications. “Over time, medication has come to be viewed as a solution for certain health problems,” he said. “But not all medications work the same way in all patients.” The typical approach to prescriptions involves trial and error — a method that can be expensive and exhausting if the medication doesn’t hit the bull’seye on the first, or second, or third try. Pharmacogenetics uses genetic testing to identify what medications are most likely to work and which to avoid. The tests also can help physicians refine a patient’s dosage more accurately than the standard practice of dosing by weight, seeing how patients respond, and then adjusting. “Take the anti-depressant Prozac,” Tan says. “The book says to start adults with 20 milligrams. But if we know, after looking at your genes, that you’re an ultra-rapid metabolizer, we’ll know that 20 milligrams isn’t enough — it won’t do anything for you — so I should probably start you at 40 milligrams. The opposite is also true: A poor metabolizer will hold
(R. MARSH STARKS)
Source: Clinical Pharmacology & Therapeutics
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