Rafał Paweł Prost

Potential application of pharmacogenetics into treatment – drug discussion

2025-09-12

Pharmacogenetics is a field of clinical pharmacy devoted to research on the influence of an individual’s genotype on drug activity. The genes encoding liver enzymes, particularly cytochrome P450 enzymes (CYP), are of special importance in this field. Various mutations of the same enzyme cause changes in the pharmacokinetics of drugs; hence, the division of patients considering the speed of drug metabolism is pivotal. With respect to CYP, the patients are divided into ultraextensive metabolisers, extensive metabolisers, intermediate metabolisers, and poor metabolisers. The divisions differ between enzymes; e.g., with respect to N-acetyltransferase 2, they are divided into rapid, intermediate, and slow acetylators. This paper presents the influence of genotypes on drug activity, taking into consideration psychiatric (selective serotonin reuptake inhibitors), infectious disease (remdesivir, isoniazid), oncological (tyrosine kinase inhibitors, tamoxifen), anticoagulant (warfarin), and anti-gout (allopurinol) treatments. It also addresses challenges in implementing pharmacogenetics in hospital practice, including inadequate medical professionals’ education, bioethical issues concerning genetic material storage and personal data protection, fear of ineffective teamwork and cooperation between departments, deficiencies in information causing absence of data on some polymorphisms in guidelines, time constraints, and the need for computerization of the processes and data. It also presents a tangible benefit from pharmacogenetics’ application in the form of a 30% drop in adverse effects. This paper also displays proposed acts of international consortiums and committees, with special regard to the Ubiquitous Pharmacogenomics Consortium, active in Europe. What is more, it draws attention to the differences in activity of liver enzymes in populations from various geographical locations, making it necessary to collect large-scale data, which, in turn, can be achieved through fulfilling projects in cooperation with the Organization for Economic Co-operation and Development. Pharmacogenetics is undoubtedly a promising direction in the development of not only pharmacy but also the entire public health sector.

Keywords: genotype, personalized medicine, pharmacogenetics, CYP, cytochrome P450 isoenzymes, pharmacokinetics.

© Farm Pol, 2025, 81(1): 25–29