- To present various perspectives on pharmacogenomics, from the professional student to the practitioner, as well as a historical perspective on this rapidly developing field. A case describing a potential scenario for a pharmacist not adequately prepared for the integration of pharmacogenomics into patient care is provided.
- To briefly describe the origins and evolution of pharmacogenomics.
- To discuss the reasons why, after a decade of research, pharmacogenetics and individualized therapy have not yet emerged as an important part of patient care.
- To offer a glimpse of the future where increasingly complex technologies and more rapid advances in pharmacogenetic research will simplify the use of a patient's genetic variation for the selection of drug therapy and prediction of outcomes.
At first glance, it may not be obvious that the title of the introductory chapter for this textbook is a play on words. Perspectives are needed to properly understand how and when to apply knowledge. In this regard, as you become familiar with the concepts developed in the various chapters of this textbook and acquire specific knowledge and skills for the assessment of pharmacogenomic information, you will develop your own perspective so that you can apply these to the care of your patients. However, pharmacogenomics is still a rapidly emerging field, and so the vast amount of current research effort will provide new knowledge and information, perhaps previously unimagined, that will continue to shape current perspectives on how pharmacogenomics is to be utilized and the extent in which it should be applied. In other words, the perspectives of the practitioner will need to continuously change as the field of pharmacogenomics changes. Therefore, use of this textbook is just a starting point, a necessary first step to becoming an enlightened, modern-day practitioner who uses pharmacogenomic information along with other traditional sources of data to make informed pharmacotherapy recommendations.
A common perspective shared by many professional pharmacy students is that application of pharmacogenomic information to patient care is complicated and requires an understanding of the various scientific methods used to discover and establish associations between genetic polymorphisms and an important human trait, drug response. This perspective, often encountered during the decade in which I have coordinated an elective course entitled Introduction to Applied Pharmacogenomics, is one of needless trepidation and erroneous assumptions and stems, in part, from confusion created when basic scientists jumped to offer new pharmacogenomics courses and textbooks to interested professional students. These initial efforts focused almost exclusively on the science of pharmacogenomics, principally because there were so few examples of application. Today, many courses are still taught by basic scientists who are more comfortable discussing the pros and cons of various genotyping methods than they are with discussing the strengths and weaknesses of the design of clinical trials that aim at validating the clinical utility of a genetic association. Another source for such perspective stems from the way pharmacogenomics has been introduced in most curriculums. Given the ...