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Pharmacogenetics in Geriatric Medicine: Challenges and Opportunities for Clinical Practice

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The genetics of drug metabolizing enzymes, drug transporters and drug receptors is a very active area of multidisciplinary research, overlapping the interest of medicine, biology, pharmacology and genetics. Indeed, these proteins are virtually responsible for the metabolism, disposition and efficacy of most of available drugs. Variations in the gene encoding these proteins may account for the interindividual differences observed in drug efficacy, including severe clinical consequences such as therapeutic failures and adverse drug reactions. It is well known that the prevalence of both therapeutic failures and adverse drug reactions strongly increased in older subjects, and this did not seem to be always related to the presence of multiple pharmacological treatments, a common status in subjects aged 65 years and over. The present article explored some basic concepts of human genetics that may have important implications in the pharmacogenetics of drug metabolizing enzymes, drug transporters and receptors. We also focus the current knowledge on the genetic basis of the efficacy and the adverse drug reactions of the most common drugs used in the geriatric patient. Thus we explore the status of what we know and what we need to know to forward the application of pharmacogenetics in clinical practice, in order to introduce a personalized treatment project for the older people.

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Keywords: Pharmacogenetics; adverse drug reaction; cytochrome P450; drug efficacy; elderly; genetics; human genome project; receptors; therapeutic failure (TF)

Document Type: Research Article

Publication date: September 1, 2011

More about this publication?
  • Current Drug Metabolism aims to cover all the latest and outstanding developments in drug metabolism and disposition. The journal serves as an international forum for the publication of timely reviews in drug metabolism. Current Drug Metabolism is an essential journal for academic, clinical, government and pharmaceutical scientists who wish to be kept informed and up-to-date with the latest and most important developments. The journal covers the following areas:

    In vitro systems including CYP-450; enzyme induction and inhibition; drug-drug interactions and enzyme kinetics; pharmacokinetics, toxicokinetics, species scaling and extrapolations; P-glycoprotein and transport carriers; target organ toxicity and interindividual variability; drug metabolism and disposition studies; extrahepatic metabolism; phase I and phase II metabolism; recent developments for the identification of drug metabolites and adducts.
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