Genetic predisposition to adverse drug reactions in the intensive care unit.

摘要: Adverse drug reactions are a significant public health problem that leads to mortality, hospital admissions, an increased length of stay, increasing healthcare costs, and withdrawal drugs from market. Intensive care unit patients particularly vulnerable at elevated risk. Critical practitioners, regulatory agencies, the pharmaceutical industry aggressively seek biomarkers mitigate patient The rapidly expanding field pharmacogenomics focuses on genetic contributions variability in response. Polymorphisms may explain why some groups have expected response pharmacotherapy whereas others experience adverse reactions. Historically, association studies focused characterizing effects variation metabolizing enzymes pharmacokinetics. Recent work has investigated transporters variants genes encoding targets, both intended unintended, comprise pharmacodynamics. This led appreciation role genetics plays either predictable extensions drug's known therapeutic effect or idiosyncratic.This review presents evidence for predisposition reactions, focusing gene producing alterations pharmacokinetics pharmacodynamics intensive patients. Genetic with strongest associations reaction risk presented along medications involved. Variant genotypes phenotypes, allelic frequencies different populations, clinical discussed. article also current recommendations pharmacogenetic testing practice explores drug, patient, research study design, regulatory, practical issues presently limit more widespread implementation.