Can Pharmacogenomics Improve Drugs Safely Research Proposal

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Pharmacogenomics

The Opportunity for Health and Safety Improvement Through Pharmacogenomics

The currently dominant tendency in Western medicine is to appeal to methods of pharmacological treatment to attack ailments, diseases and the symptoms of conditions. The degree to which this strategy for treatment is successful may be subject to widespread debate. On one side, it is clear that pharmacy-based treatment may significantly reduce suffering pertaining to conditions in question; may help to fight the presence of afflicting foreign bodies; may be a significant factor in the healing strategy; or may simply contend with the peripheral symptoms of a condition. The other side of this argument, however, denotes the various dangers, inconsistencies and variances in outcome relating to the use of pharmaceuticals, providing this discussion with a basis to examine critical new frontiers in overcoming the limitations of the pharmaceutical approach. Such limitations may include the presence of unwanted side effects from a drug; the potential for the formulation of dependency on the part of the patient' the failure of the drug to hone in on the specific conditions or symptoms being addressed; or the tendency of a drug to impact different patients in different ways. This latter point is especially important to this discussion, pointing research toward the emergent field of Pharmacogenomics, which merges evolving knowledge and insight in the fields of pharmacy and genetics to create an increasingly individualized way of treating the needs of patients.

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Though this is a relatively new way of thinking about drug treatment programs and combinations, it does hold significant promise for improving the effectiveness, and in turn, the safety of pharmacy treatment programs. This is underscored by the basic impetus for the field, which "holds the promise that drugs might one day be tailor-made for individuals and adapted to each person's own genetic makeup. Environment, diet, age, lifestyle, and state of health all can influence a person's response to medicines, but understanding an individual's genetic makeup is thought to be the key to creating personalized drugs with greater efficacy and safety." (USDoE, 1)

Research Proposal on Can Pharmacogenomics Improve Drugs Safely Assignment

The field would be the outcome of two important contexts for medical treatment improvement. A more detailed comprehension of both chemical physiology and genetic makeup have offered remarkable new insights into ways to remove human beings from suffering, act to preventatively address conditions which have previously been seen as chronic and serve to lengthen and improve human life. Indeed, in just the space of a decade, science has made absolutely monumental strides in terms of identifying the building blocks of human life. From the mapping of the human genome, a project which was completed in 2003, to the day's top headlines on the subject of stem cell research in the political and philosophical arenas, the improvement of our grasp on human genetics has opened exciting new doors for medicine and science. (Rose, 3)

One door among these is that which is increasingly allowing practitioners to tailor specific treatment programs according to what is understood to be an almost infinite array of possible distinctions in treatment response. The growing understanding which we collectively possess about the way the human genome system works has revealed a direct connection between individual genetic makeup and treatment response. As the study by Evans & Relling (1999) denotes, "genetic polymorphisms in drug-metabolizing enzymes, transporters, receptors, and other drug targets have been linked to interindividual differences in the efficacy and toxicity of many medications." (Evans & Relling, 487) With the mapping of the human genome, it has become increasingly less necessary to endure such risks, given the increased capability to identify those phamaceutical risks and the degree of likely severity based on a consideration of genetic history and individual health scenarios. As a point of fact, this underscores the initial motive which has increasingly driven the field forward, with most major pharmaceutical companies not simply taking their own initiatives in order to achieve greater innovations but even further, actually collaborating on terms that promise to elevate the credibility, effectiveness and safety of their shared product. So is this illustrated by the actions described in the article by March (2000), which reports that "during the last months of the twentieth century, a remarkable collaboration was announced. Ten pharmaceutical companies, normally fierce competitors, came together with leading genome research institutions and the Wellcome Trust, to discover, map and place within the public domain 300-000 single nucleotide polymorphisms (SNPs) [6,13,25] across the human genome within 2 years." (March, 16) This is a demonstration of the shared gains which are perceived in all areas of pharmacy by achieving greater awareness of the correlation between single genes and certain drug dosages, combinations or compounds.

Prevailing evidence suggests that these developments address a very important area of health safety, with prospects for the improvement of treatment outcomes dependent upon or employing drug programs improving significantly. Likewise, evidence suggests that the effectiveness of such drug programs and their connection to negative health outcomes or treatment byproducts is likely to have a host of positive effects on individual patient safety and the safety which permeates the pharmaceutical field. The effort dedicated by pharmacists, geneticists and practitioners in identifying these prospects for advancement can be traced to indications that a need existed to respond to problematic treatment outcome variations as a broad pattern relating to drug treatment. As the article by Phillips et al. (2001) contributes to this account, "adverse drug reactions are a significant cause of morbidity and mortality. Although many adverse drug reactions are considered nonpreventable, recent developments suggest these reactions may be avoided through individualization of drug therapies based on genetic information." (Phillips et al., 2270)

The idea of individualization is now a prime motivator for the efforts which have been invested into and the successes which have been achieved in the area of pharmacogenomics. This would proceed from the understanding that the risk and safety variables considered here above are associated with the genetic differences distinguishing individual health scenarios. As the article by Evans & McLeod (2003) indicates,

"the existence of large population differences with small intrapatient variability is consistent with inheritance as a determinant of drug response; it is estimated that genetics can account for 20 to 95% of variability in drug disposition and effects." (Evans & McLeod, 538)

This reflects a distinct philosophical change in the pharmaceutical discourse, with research and development increasingly dedicated to drawing down dependency on uniform treatment programs. The historical tendency to simply employ drug allergies or the absence thereof as indicators relating to the appropriateness of certain drug treatment strategies is now less preferred to full genetic profiling and peripheral health factor screening. The information which is now intended to enter into drug treatment program decisions will significantly shape the combination and dosage decisions. This will also allow physicians and pharmacists to identify any potential negative reactions, any genetic factors which are likely to diminish the positive impact of certain combinations or the host of data that can help to direct otherwise obscured drug options. (Salerno, 25)

These incentives for the continued exploration of this specific area of pharmaceutical innovation are underscored by the reality that we are quite new at the process of using the genetic information before us to make competent medical decisions and treatments. However, we are in a period of great elucidation, with this relative frontier in genetic and drug science revealing exciting paths of exploration. This denotes that even as the benefits to human health and safety of pharmacogenomics become more wholly apparent, there remains a great deal of investigation left yet to be conducted, a great many prospects to be realized and, of course, a great deal of safety precaution yet to be fully evaluated. To this point, McCarthy and Hillfiker (2000) contend that "although great strides have been made in understanding the diversity of the human genome, such as the frequency, distribution, and type of genetic variation that exists, the feasibility of applying this information to uncover useful pharmacogenomic markers is uncertain." (McCarthy & Hillfiker, 505)

This is not to dismiss the opportunities present in improving health and safety but to demonstrate the difficulty or at least the relative newness of methods used to provide physicians and pharmacists with the bio-data necessary to conduct genetic profiling. Decisions in pharmacogenomic treatment will rest significantly on many areas of the individual health disposition previously ignored when prescribing treatment. The result is that in combination with the developments being made in the pharmaceutical field, physicians, biologists and anatomists are also working to improve our capacity to identify individualized genetic circumstances by which treatment decisions can be rendered. Thus, research points to a number of screening methods now being refined for this very purpose. To this end, Burczynski & Dorner (2006) identify a set of blood-screening methods with some proven effectiveness. They denote that "multiple approaches for identifying transcriptomes in peripheral blood cells exist and each method is associated with significant advantages and disadvantages. Nonetheless, a growing number of studies are rapidly identifying transcriptional biomarkers in peripheral blood cells that may function as… [END OF PREVIEW] . . . READ MORE

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