Answer 3 for DNP 810 How does the variability of responses result in tailoring pharmacologic agents to the care of these patients? 

Answer 3 for DNP 810 How does the variability of responses result in tailoring pharmacologic agents to the care of these patients? 

Healthcare continues to move away from a cookie-cutter approach or a one size fits all. With the advent of the human genome, therapies and treatments are targeted to meet the individual need of the patient. Using precision medicine, genetic information, environment, and lifestyle can be considered to target treatment and improve outcomes. When given the same medication, there can be unique and individual responses. Providers need to understand this potential complication and interaction with individual genetics. Medications with narrow therapeutic windows or side effects could cause life-threatening complications. As with other areas in healthcare, studies have not included minority races which contribute to social determinants of health and health inequities (Borrell et al., 2021). Including minority groups is imperative if precision medicine is truly going to target the uniqueness of each individual. Beyond the race or ethnicity of a person, which is socially ascribed, providers should consider genetic ancestry (Borrell et al., 2021). This represents the person’s genetic origin which is more specific and detailed to the exact but variable makeup of the individual. This more detailed information teases out some of the variations found in large race or ethnicity groups.

Certain medications impact individuals differently. For example, there are different classes of medications that are prescribed to address hypertension such as beta-blockers, calcium channel blockers, ace inhibitors, or diuretics. Hypertension can be a complex genetically acquired condition. However, genetics can impact the effectiveness of different classifications of anti-hypertensive medications. Targeting individual genotypes can produce a better response to antihypertensive medications. However, studies researching the effectiveness of the various classes of medications are inconclusive which may be due to interethnic differences (Rysz et al., 2020). Single nucleotide polymorphisms (SNPs) are considered to play a role in the inter-individual variation that can be seen with treatment response. Just as hypertension is complex and multi-causal, genetic traits are only a part of the explanation for treatment effectiveness. Treatment response for hypertension is multifaceted, just like the disease itself. With more research and understanding of the different alleles and SNPs involved in hypertension and the effects of the medication, treatments, especially in regard to pharmacogenetics, will be able to be targeted to the genetic picture of the patient.

References

Borrell, L. N., Elhawary, J. R., Fuentes-Afflick, E., Witonsky, J., Bhakta, N., Wu, A. H. B., Bibbins-Domingo, K., Rodríguez-Santana, J. R., Lenoir, M. A., Gavin, J. R., Kittles, R. A., Zaitlen, N. A., Wilkes, D. S., Powe, N. R., Ziv, E., & Burchard, E. G. (2021). Race and Genetic Ancestry in Medicine — A Time for Reckoning with Racism. N Engl J Med, 384(5), 474-480. 10.1056/NEJMms2029562