Academic journal article American Journal of Pharmaceutical Education

Pharmacogenomics Training Using an Instructional Software System

Academic journal article American Journal of Pharmaceutical Education

Pharmacogenomics Training Using an Instructional Software System

Article excerpt

INTRODUCTION

The widespread application of genomic data to effectively influence health care outcomes is expected in the next decade as testing methods are improved and the public and health care professionals are educated about the potential benefits. The ability to identify single nucleotide polymorphisms (SNP) in drug metabolizing enzymes (eg, cytochrome P450) and targets represents an implementation model that can avoid some of the ethical issues previously associated with the identification of incurable genetic diseases. SNP identification has the potential to improve the cost-to-benefit ratio in the pharmacological management of patients with a wide variety of conditions. (1) A potential barrier to the use of genomic information is the ability of pharmacists to interpret and communicate about genetic data and their importance in health care. We describe an elective course in pharmacogenomics designed to teach pharmacy students about the fundamentals of pharmacogenomics and the manner in which pharmacogenomics will change the practice of pharmacy in the future.

The Accreditation Council for Pharmacy Education (ACPE) recognizes the importance of pharmacogenomics to the future of pharmacy practice and has made strides in increasing the exposure pharmacy students have to pharmacogenomics in the curriculum. (2) The elective course described in this paper has now been integrated into the core pharmacy curriculum and uses GeneScription, a software program that provides students with mock patient data to assist the student in making dosing decisions. (3)

GeneScription was developed by the authors under a grant from Microsoft Research specifically to provide hands-on instruction in applied personalized medicine and pharmacogenomics. GeneScription is designed to mimic the professional environment of the pharmacist, and therefore provides a practicum environment with a mock patient population, Food and Drug Administration (FDA) approved drugs, and algorithms that predict patient outcomes based on physiological parameters, genomic parameters, and drug and dose parameters. (A free online version of GeneScription is available at www. genescription.com).

This course was implemented to assist students in moving the basic science taught in the classroom to the actual practice site. In the near future, pharmacists will play a vital role in making personalized medicine a reality. To equip pharmacists to carry out this task, they need to be equipped with the fundamentals that will allow them to make clinical decisions based on pharmacogenomic data. Additionally, pharmacists will need to teach other healthcare professionals and patients about pharmacogenomics for personalized medicine to become a reality. This course was designed to prepare pharmacy students for this role.

Pharmacogenetics can be defined as inherited variations in drug effects as a result of single gene interactions with drugs. These single gene alterations or SNPs can alter drug disposition, safety, tolerability, and efficacy. Pharmacogenetic screening of drug metabolizing enzymes and pharmacologic targets can be used to improve patient outcomes. This course reviews the fundamentals of pharmacogenetics and genetic testing as a means to improve patient outcomes.

After completing this drug safety and pharmacogenomics course, pharmacy students should be able to:

(1) Compare and contrast pharmacogenetics and pharmacogenomics.

(2) Demonstrate an understanding of basic DNA terminology and genomic variations.

(3) Differentiate between the laboratory tests used in genetic testing for SNPs.

(4) Explain "personalized medicine" from the standpoint of drug metabolism, bioactivation, and pharmacologic target screening.

(5) Describe the limitations to implementing pharmacogenetic screening in health care.

(6) Apply knowledge of pharmacogenetics to the initiation of warfarin therapy. …

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