Specialist Advice — 14 minutes
Pharmacogenetics for better targeted medication
February 10, 2022
In 2005, a young Toronto mother being treated with codeine following an episiotomy fatally poisoned her 11-day-old baby while breastfeeding. The investigation concluded that the woman had an ultra-fast metabolism, which means her body converted more codeine into morphine. She then unknowingly passed this potent painkiller to her child through her breast milk.[1]
“Pharmacogenetics can often reduce the period of trial and error and help reduce the delay in finding the right medication at the right dose. By testing a list of specific markers, we can then determine the rate of metabolism in individuals.”
Although this science, which belongs to the field of personalized medicine, is still relatively new, it is nevertheless of great interest to practitioners.
Pharmacogenetic studies are now underway across Canada on a variety of health problems potentially related to the use of medications. These studies cover topics such as the effect of medications on children with mental health problems. Unfortunately, up to 50% of these children are receiving treatments that are ineffective or cause harmful side effects. Dr. Chad Bousman, a professor of medical genetics at the University of Calgary who is leading the “PGx-SParK” project at his Psychiatric Pharmacogenomics (PsychPGx) Lab, believes a major part of the trial-and-error process could be avoided through pharmacogenetic testing.
In Europe, the possibility of integrating pharmacogenetics into public health systems is currently being explored. The “Ubiquitous Pharmacogenomics” project has been launched to assess the impact of pharmacogenetics on the efficacy, safety and cost of treatments. This landmark research project will provide numerous recommendations on the best way to include pharmacogenetics in the European health-care system. In particular, it will investigate the most effective way to integrate it into medical decision-making without disrupting routine clinical care.
If the project proves successful, the path it lays out will help health-care systems around the world follow this example.
Finally, it should be noted that after a few cases of acute respiratory problems, Health Canada has, since 2013, advised against administering codeine to children under 12 years of age, as some children metabolize it too quickly.[5]
