对临床药学专业学生应加强精准用药教育

Reinforcement precision medication in clinical pharmacy education

精准用药是未来医疗工作的重要发展方向之一,本文旨在为临床药学专业学生的精准用药教育者提供参考。药物临床疗效的影响因素可分为遗传和非遗传因素两大类,遗传因素包括基因突变、表观遗传修饰、基因表达、miRNA等,非遗传因素可分为药物因素、生理因素、病理因素和其他因素。精准用药涉及的知识面较为广泛,包括遗传药理学、基因检测、生物信息分析、治疗药物监测、定理药理学等。以临床研究较为成熟的华法林为例,对每类具有影响的因素进行详细解读,还对精准用药常用的数据库进行归纳汇总。笔者认为掌握相关知识是实现精准用药的基础,临床用药中对具体的药物要具体分析,还应掌握精准用药常用的数据库,不断更新知识。

Precision medicine is one of the most important development in the future. In our study,the main contents of precision medication education were presented,and we aimed to provide a reference for clinical pharmacy educators. There are many factors affecting drug efficacy,and the factors could be divided into two categories of genetic and non-genetic factors. Genetic factors include genetic mutations, epigenetic modification,gene expression,miRNA etc. and non- genetic factors can be subdivided into drug- drug interaction,physiological factor,pathological factor,and other factors. Multiple knowledge was related to Precision medicine,such as pharmacogenetics,genetic testing,bioinformatics pharmacogenetics,therapeutic drug monitoring,pharmacometrics and so on. Take warfarin for example,we explained each factor effecting warfarin anticoagulant therapy. The commonly used databases for precise medication were also summarized. Related basic knowledge is the basis of precision medicine. In clinic, specific drug should be analyzed specifically. In order to constantly update knowledge,we should learn to use the common databases.