基因组医学时代的临床药学发展契机

Opportunities for the development of clinical pharmacy in the era of genome medicine

药物反应性个体差异普遍存在,患者的遗传特征是导致药物反应性个体差异的决定性因素。药物基因组学从药物代谢和效应基因变异角度阐明药物反应性个体差异的机制,并基于此指导临床根据患者的基因型信息选择药物的种类和最佳剂量,以实现更安全、更有效地用药。药物基因组学理论指导下的个体化药物治疗或个体化医学已成功地转化为临床实践,极大地推动了疾病防治中医学模式的革新。尽管个体化药物治疗临床实践仍面临多种挑战,但其在改善疾病预后、提升用药安全性方面的优势依然凸显。临床药学通过参与制定和优化药物治疗方案,进行药物不良反应监测和治疗药物监测等方式参与临床治疗与决策,从而促进临床合理用药。药物基因组学为临床药学服务提供了一个全新的“抓手”,是联系临床药理学服务和临床药学服务的纽带,同时也为临床药学学科高质量发展注入了新的活力并指明方向。临床药师已经成为临床多学科团队中不可或缺的力量,越来越多的临床药师参与了临床药物基因组学实践,成为临床一线最早接受、掌握和传播药物基因组学知识的人才队伍,共同致力于精准临床药学的发展。药物基因组和个体化医学的推广和服务将给临床药学服务带来前所未有的机遇。

Individual differences in drug reactions are generally present,and the genetic characteristics of patients are the major factors leading to individual differences in drug reactions.Pharmacogenomics elucidates the mechanism of individual differences in drug reactivity from the perspective of drug metabolism and effector gene variation,and based on this,it guides the doctor to select the type and optimal dose of drugs according to the patient's genotype information,so as to achieve safer and more effective drug use.Individualized drug therapy or individualized medicine under the guidance of pharmacogenomics theory has been successfully transformed into clinical practice,which has greatly promoted the innovation of the medical model of disease prevention and treatment.Although the clinical practice of individualized drug therapy still faces many challenges,its advantages in improving disease prognosis and drug safety are still prominent.Clinical pharmacy participates in clinical treatment and decision making by participating in the formulation and optimization of drug treatment plan,adverse drug reaction monitoring and therapeutic drug monitoring,so as to promote rational clinical drug use.Pharmacogenomics provides a brand-new"handle"for clinical pharmacy services.It is the link between clinical pharmacology services and clinical pharmacy services.It also brings new vitality and points out the direction for the high-quality development of clinical pharmacy discipline.Clinical pharmacists have become an indispensable force in the clinical multidisciplinary team.More and more clinical pharmacists have participated in the practice of clinical pharmacogenomics,becoming the first talent team to accept,master and disseminate pharmacogenomics knowledge in the clinical front line,and jointly commit to the development of precision clinical drugs.The promotion and service of pharmacogenomics and individualized medicine will bring unprecedented opportunities to clinical pharmaceutical service.