AMS and PGx
The last 20 years have seen rapid developments in the use of genomic data to diagnose or classify disease, track infectious disease outbreaks, and increasingly to predict response, or adverse response, to medicines.
And over the next 20 years, pharmacy teams will be key in helping patients to get the most from their medicines using this new science.
Genomics and Infection Management
Dr Hayley Wickens
Consultant Pharmacist Genomic Medicine, Central and South Genomic Medicine Service Alliance
Download Dr Wickens' presentation on Genomics and Pharmacy and AMS
Possible applications in treatment of infection
Genomics has the potential to help us predict the risk of allergy to, or toxicity from, antimicrobials. For instance, it's possible to check for a variation in mitochondrial DNA that predisposes patients to ototoxicity with aminoglycosides, which is particularly important in those patients with long term conditions predisposing them to Gram negative infection, and who are therefore disproportionately likely to receive these antimicrobials in the medium to long term.
There are developments in pharmacogenomics that can predict the way in which individuals metabolise drugs, and whilst these tests are not in common clinical use yet, this could add to our understanding of antimicrobial pharmacokinetics and pharmacodynamics, which is particularly important in treatment of infection.
In addition, whole genome sequencing has been in use for some years now to predict antimicrobial susceptibility in tuberculosis, reducing the turnaround time from 4-6 weeks to less than a week, and enabling tailored therapy to be prescribed earlier for patients.
There are also exciting trials in rapid identification of pathogens using genomics, and it will be exciting to see how these develop for clinical use, particularly in sepsis.
Find out more about genomics
A section of our website is dedicated to pharmacogenomics at www.rpharms.com/pgx, which includes our position statement on PGx.
The PJ has two excellent articles on genomics:
The Genomics Education Programme (GEP) from Health Education England has a wide range of learning materials: from two-minute bite size sessions and podcasts, up to entire recorded lectures and interactive packages, and funding available for modules/PGCert/PGDip/MSc Genomic Medicine - find out more about these at www.genomicseducation.hee.nhs.uk/education
The GEP also provide GeNotes, ‘just in time’ educational resources for clinicians seeing patients with genomic diagnoses, and new material is under constant development (including for pharmacogenomics) at www.genomicseducation.hee.nhs.uk/genotes
The Centre for Pharmacy Postgraduate Education (CPPE) have a webpage dedicated to genomics at www.cppe.ac.uk/gateway/genomics
The UK Clinical Pharmacy Association (UKCPA) have a genomics practice interest group at ukclinicalpharmacy.org