Pharmaceutical sciences master of pharmacy

1. Categories of patients for
personalized medicine.
PRESENTED BY, FACILITATED TO,
RAJSHREE A. KABADE. DR. AVINASH HOSMANI SIR;
M PHARM. 1ST YEAR. HOD & PROFERSSOR OF
DEPT OF PHARMACEUTICS. DEPT OF PHARMACEUTICS.
GCOPK KARAD. GCOPK KARAD.

2. Categories of patients for personalized
medicine :
 Patients are mainly classified depending upon the :
 Genetic polymorphism.
 Epigenetics and other factors.
 Cytochrom p450 genetic.
 Different Families of enzyme polymorphsim.

3. 1. Genetic Polymorphsim :
 Genetic polymorphsim is a difference in DNA sequence among
individuals, groups or population.
 Variations in gene associated with pharmacokintics and
pharmacodyanamic of drug may result in toxic, altered ,or no response.
 These variants can be used for developing a biomarkers for diagnosis
and therapeutics categorization of a particular diseases.
 The genome-wide association studies (GWAS) have discovered many
genetics variants related to different lethal diseases.

4. 2. Epigenetic & other factors :
 Epigenetics factors such as age, sex, liver and kidney function ,lifestyle
previous diseases and adverse reaction are also decides therapeutic
response of drug .
 Old age patient have high risk of adverse reaction deu to the poor rate of
physiology and metabolism .
 Gender- specific physiological differnce such as a pregnancy and
breastfeeding also affect the outcome of treatment by a drug.
 A level of different hormones between a male and female has been
observed ,which may cause different response to a drug in male and
females.
 Environmental chemicals ,drugs, and natural compounds can alter the
efficacy of the drug by drug – drug interactions or drug-herb
interactions.

5. 3.Cytochrome p450 genetic
polymorphsim :
 This group of enzyms as indicated earlier, responsible for metabolizing
more than 30 types of enzyme.
 It can be determine how quickly and effectively these agents eliminated
from body.
 The CYP450 test can be used to determine dosing and effects of specific
antidepressant medications, anticoagulants such as warafarin, proton
pump inhibitors and number of other agents.

6. 4. Different families of enzyme
polymorphsim :
1.Thiopurine Methyltransferase :
 An enzyme called thiopurine Methyltransferase breakdowns a
chemotherapy drug called thiopurine.
 It is used to treat lukemias and autoimmune disorders.
 Some people have genetic variations that prevent them from producing
enzyme
 As a result, thiopurine levels can build up in body ,leading to severe
toxicity.
 Therefore blood test can be used to check this variations before
treatment begins.

7. 2.UGT1A1 enzyme :
 This enzyme determins how the body breaksdown irinotecan,a
chemotherapy drug for treating colorectal cancer.
 In patient with deficiency of this enzyme the medication can build up to
toxic levels, possibly causing suppression of the bone marrow, infection,
and even death.
 Doctors can test for this genetic variation before treatment
 starts and then customize the dosage to prevent a toxic buildup of the
drug.

8. 3.Dihydropyramidine dehydrogenase enzyme :
 The medication 5 – flurouracil along with its related compounds one of the
most commonly used chemotherapy agents
 Some people have a genetic variation that results in a decrease in the
Dihydropyramidine dehydrogenase enzyme, which is responsible for breaking
down 5-FU.
 As a result of this deficiency, some people may experience sever or even fatal
reaction to 5-FU.

9. Focusing on genomics ,we have identified
three categories :
1.Optimizing drug response : gene-durg interaction –
 A person‘s genetic constitution can be determined in order to address
gene-durg interaction. The aim is to optimize drug efficacy and to
minimize adverse events from drug treatment.
 Application inculde gene-based and genomic-based tests that commonly
target medicines that are the administrated to populations with a specific
variants.
 In gene –drug interactions, the focus is directed to either metabolism
gene or gene related to immune system.

10. 2. Gene- based drug targeting :
 Another area of individualization is the development of molecular
mechanism specific treatment,also called gene-based drug.
 Most research efforts are seen in the field of oncology and increasing
attention begin paid to genetically based disease such as cystic fibrosis.
 Apart from this many research efforts are undertaken in diseases areas in
which there is significant genetic association with the disease,in the case
with the VKORC1 gene with thrombosis patient.

11. 3. Predication and diagnosis :
 Lastly individualization efforts are undertaken to,
1. Dignose more accurately.
2. Predict risk of disease.
3.These efforts provide greater insight into a patients
constitution, contributing to better diagnosis.

12. Reference :
 Personalized medicine –NCBI-NIH.
 Science direct ; The faces of personalized medicine.
 Drug delivery system, edited by Kewal K. Jain. MD; Jain pharmabiotech,
Basel,switzerland.

13. Thank You….