Stanford Hospital's Sean David, MD, on Personalized Medicine



personalized medicine is the notion that by using a combination of biological information and cultural and social information we can individually tailor treatment for you so that it's not simply one medication and the same dose for everybody it's the way that we can really make a major advance a quanta paradigm shift in how we treat patients pharmacogenetics is the study of how genes that affect drug metabolism and drug efficacy responsiveness how common variants in those genes can affect drug response and pharmacogenomics is looking at the entire genome not only at one gene at a time but looking for clues as to new new molecular targets for new medications but the actual practice of that with patients is something different that's taking what we know about how genes and drugs interact but then starting over and saying to a new patient this is your genotype that's personalized medicine using pharmacogenetics the question of whether or not the new genomics personalized medicine will affect certain groups more than others is a very important one there is some concern that that the people who will benefit the most and the soonest will be those of European ancestry the reason for that is that a lot of the data that we have on how certain genes affect certain drug responses is from clinical trials where eighty ninety percent of the people who were enrolled are white so we're really eager to have large data sets of african-americans and Latinos and Asian Americans I think it's an exciting time because we can focus as much on the biological causes for why there are inequities in health and adjust our medication our treatment accordingly ten years from now I would like it to be a standard of care considered best practice model to genetically test before giving any medication ultimately what will happen is it will be inexpensive to do a person's entire genome and sequence it and and that only has to be done once in a lifetime and once it's in the computer then every time the doctor goes to that computer and orders a medication there will be a flag saying well you might want to reduce the dose of this medication or red flag saying don't give it it causes liver necrosis liver death or there's a green light go forward but don't use too high a dose and that's the kind of level of information that electronic health systems can provide they already do that with drug interactions for drug allergies automatically substitute genetics for that and that could be done today

1 comment

  1. Best place to start is family medical history then based on your familial risk one can get further testing if needed. Dr. David shared that current data does not support non-whites. We have developed a simple and easy to use platform – ZibdyHealth which will help patient manage their health and wellness and help create a virtual pharmacogenetics for user and their family. Please try zibdy.com

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