Genetic Polymorphisms And Response To Drugs

It is now commonly accepted that individual drug response is determined by both genetic and nongenetic factors. Polymorphisms may influence drug response in three ways, through (i) pharmacokinetic interactions (e.g., caused by the polymorphisms in the CYP450 system), (ii) pharmacodynamic gene-drug interactions (e.g., that involve gene products expressed as receptors, which are relevant to the pharmacodynamics of drugs such as ^-adrenergic receptor antagonists), and (iii) genes that are in the causal pathway of disease and are able to modify the effect of drugs, such as APOE (147). Therefore, identifying genetic variants that discriminate between responders and nonresponders and using these to ascertain which patients are likely to be susceptible to adverse drug reactions promises to revolutionalize drug therapy. In the following section, we discuss some polymorphisms that influence individual responses to various cardiovascular drugs.

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