Drug reaction testing
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Drug reaction testing uses a
genetic test Genetic testing, also known as DNA testing, is used to identify changes in DNA sequence or chromosome structure. Genetic testing can also include measuring the results of genetic changes, such as RNA analysis as an output of gene expression, ...
to predict how a particular person will respond to various prescription and non-prescription
medication A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy ( pharmacotherapy) is an important part of the medical field and ...
s. It checks for genes that code for specific
liver The liver is a major organ only found in vertebrates which performs many essential biological functions such as detoxification of the organism, and the synthesis of proteins and biochemicals necessary for digestion and growth. In humans, it i ...
enzyme Enzymes () are proteins that act as biological catalysts by accelerating chemical reactions. The molecules upon which enzymes may act are called substrates, and the enzyme converts the substrates into different molecules known as products ...
s which activate, deactivate, or are influenced by various drugs. There are currently four
genetic marker A genetic marker is a gene or DNA sequence with a known location on a chromosome that can be used to identify individuals or species. It can be described as a variation (which may arise due to mutation or alteration in the genomic loci) that can be ...
s commonly tested for: 2D6, 2C9, 2C19, and
1A2 The 1A2 Key Telephone System is a business telephone system developed and distributed by the Western Electric, Western Electric Company for the Bell System. The 1A2 Key Telephone System is a modular system that provided flexible solutions for a ...
. This testing has been done for some time by drug companies working on new drugs, but is relatively newly available to the general public. Strattera is the first drug to mention the test in the official documentation, although it doesn't specifically recommend that patients get the test before taking the medication. There are four possible categories for each marker:
poor metabolizer Pharmacogenomics is the study of the role of the genome in drug response. Its name ('' pharmaco-'' + ''genomics'') reflects its combining of pharmacology and genomics. Pharmacogenomics analyzes how the genetic makeup of an individual affects the ...
, intermediate metabolizer,
extensive metabolizer Pharmacogenomics is the study of the role of the genome in drug response. Its name ('' pharmaco-'' + ''genomics'') reflects its combining of pharmacology and genomics. Pharmacogenomics analyzes how the genetic makeup of an individual affects the ...
, or ultra-extensive metabolizer. Different testing companies may call these by different names. Extensive metabolizers (that is, people who are extensive metabolizers of a given type) are the most common, and are the type of people for which drugs are designed. Up to 7% of Caucasians are poor metabolizers of drugs metabolized by the
CYP2D6 Cytochrome P450 2D6 (CYP2D6) is an enzyme that in humans is encoded by the ''CYP2D6'' gene. ''CYP2D6'' is primarily expressed in the liver. It is also highly expressed in areas of the central nervous system, including the substantia nigra. CYP2D ...
enzyme. Saturday, 16 February 2019 People who cannot metabolize a drug will require a much lower dose than is recommended by the manufacturer, and those who metabolize it quickly may require a higher dose. Some drugs, such as
codeine Codeine is an opiate and prodrug of morphine mainly used to treat pain, coughing, and diarrhea. It is also commonly used as a recreational drug. It is found naturally in the sap of the opium poppy, ''Papaver somniferum''. It is typically ...
, will not be effective in people without the requisite enzymes to activate them. People who are poor metabolizers of a drug may overdose while taking less than the recommended dose.


See also

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Medical prescription A prescription, often abbreviated or Rx, is a formal communication from a physician or other registered health-care professional to a pharmacist, authorizing them to dispense a specific prescription drug for a specific patient. Historicall ...
*
Contraindication In medicine, a contraindication is a condition that serves as a reason not to take a certain medical treatment due to the harm that it would cause the patient. Contraindication is the opposite of indication, which is a reason to use a certain tre ...
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Cytochrome P450 Cytochromes P450 (CYPs) are a superfamily of enzymes containing heme as a cofactor that functions as monooxygenases. In mammals, these proteins oxidize steroids, fatty acids, and xenobiotics, and are important for the clearance of various co ...
* Drug metabolism


References and end notes

{{Reflist Pharmacy Clinical pharmacology