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Lancet. 2019 Aug 10;394(10197):521-532. doi: 10.1016/S0140-6736(19)31276-0. Epub 2019 Aug 5.

Pharmacogenomics.

Author information

1
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address: dan.roden@vumc.org.
2
DeBartolo Family Personalized Medicine Institute, Moffitt Cancer Center, Tampa, FL, USA.
3
Pharmaceutical Department, St Jude Children's Research Hospital, Memphis, TN, USA.
4
Genomic Medicine Institute, Geisinger, Danville, PA, USA.
5
Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
6
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA.
7
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.

Abstract

Genomic medicine, which uses DNA variation to individualise and improve human health, is the subject of this Series of papers. The idea that genetic variation can be used to individualise drug therapy-the topic addressed here-is often viewed as within reach for genomic medicine. We have reviewed general mechanisms underlying variability in drug action, the role of genetic variation in mediating beneficial and adverse effects through variable drug concentrations (pharmacokinetics) and drug actions (pharmacodynamics), available data from clinical trials, and ongoing efforts to implement pharmacogenetics in clinical practice.

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