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INDIVIDUALIZATION OF DRUG THERAPY

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Definition

Individualized therapy is the practice of tailoring therapeutic intervention to a patient’s disease, demographic characteristics, genetics, environment, lifestyle and health status.

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Methods/Approaches to individualization

Selection of an antibiotic based on MEC and bacterial sensitivity
Population or sparse sample PK
Therapeutic drug monitoring
Pharmacogenomics

PK means pharmacokinetics.

A pharmacokinetic(PK) study of a new drug involves taking several blood samples over a period of time from study participants to determine how the body handles the substance.

This studies provide critical information about new drugs.

Sparse sampling means sparse samples are taken when a single sample or few samples can be taken from a subject on each study or study day.

In these studies,concentrations are pooled from different subjects into one pk profile which is used to generate pooled pk parameters.

Therapeutic drug monitoring.

Therapeutic drug monitoring is a branch of clinical chemistry and clinical pharmacology that specializes in the measurement of medication levels in blood. Its main focus is on drugs with a narrow therapeutic range. It is done to make sure the amount of medicine you are taking is both safe and effective.

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Pharmacogenetics

The study of inherited genetic differences in drug metabolic pathways which can affect individual responses to drugs, both in terms of therapeutic effect as well as adverse effects.

Pharmacogenomics

Investigates the role of acquired and inherited genetic differences in relation to drug response and drug behaviour through a systematic examination of genes, gene products, and inter- and intra- individual variation in gene expression and function.

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Framework for individualization

Pathogenesis of the disease
Mechanism of action of the drug
Exposure – response relationships

Goal of individualization

To optimize the efficacy of a drug
Minimize its toxicity.

Future strategies.

1.Pharmacogenomic technologies

2.Vaccines

3.Ex vivo gene therapy

4. Diseases-in-a-dish

Ex vivo gene therapy ………. Is a technique where genetic manipulation of cells is undertaken remotely and more safely since it is outside the body, is an emerging therapeutic strategy particularly well suited to targeting a specific organ rather than for treating a whole organism.

Stem cell

Stem cell is a cell with the unique ability to develop into specialized cell types in the body. In the future they may be used to replace cells and tissues that have been damaged or lost due to disease.

There are three types of stem cells: adult stem cells, embryonic or pluripotent stem cells and induced pluripotent stem cells.

Diseases in a dish

Is the contribution of patient-specific induced pluripotent stem cell technology to regenerative rehabilitation.

One of the most fascinating is through the creation of human diseases in a dish, which are giving scientists a better way to study disease biology and test new drugs.