### Introduction {: .ui .center .aligned .header}

Pharmacogenetics identifies the variations in genes that encode drug-metabolizing enzymes, drug
transporters, and drug targets, as well as other specific genes related to the action of drugs. Any
variations in the deoxyribonucleic acid (DNA) sequence can result in a change in the protein structure
which translates into major differences in how the protein functions. The study of these variations in
DNA sequence as related to drug response is referred to as pharmacogenomics, and its testing requires
genotyping to detect specific variants.

Pharmacogenomic test provides information about a person’s genetic makeup to help the physician
decide which medications and what doses might work best for him or her. It also helps to reduce the
cost and time associated with a trial-and-error approach to treatment. The results of this test should be
used as a supplement to the clinical decision making process and should not replace or override
appropriate clinical judgment.

This panel is based on relevant literature sources that may provide clinical insights to help inform the
physicians about a patient’s genetic changes to optimize treatments and outcomes. This panel can be
used to optimize therapy for nearly 200 commonly prescribed drugs in multiple treatment categories,
including statins, platelet aggregation inhibitors, biguanides, sulfonylureas, anticoagulants, beta-
blockers, antihypertensives, proton pump inhibitors, non-steroidal anti-inflammatory drug, and
antiarrhythmics. Based on the snp-drug interaction, drug metabolic status, and evidence levels.

Some interesting facts about genes and your medications:

+ **4th:** Adverse Drug Reactions (ADRs) are estimated to be between the 4th and 6th leading cause
of death in the US.
+ **75%** of patients have detectable changes in their DNA that impact drug metabolism
+ **400+** drugs carry product label FDA guidance on pharmacogenetic testing
+ **25%:** CYP2D6 gene alone is responsible for processinga quarter of all cytochrome metabolized
drugs in the body
+ Research on the benefits of pharmacogenomic recommendations in the long term care of patients
showed that nearly 50% of the patients had to change one to three drugs, with significant
estimated savings annually.
+ Codeine, a commonly used pain medication is poorly metabolized by CYP2D6 ultra-rapid
metabolizers. These individuals may experience symptoms of extreme sleepiness, shallow
breathing and even confusion and may not have sufficient relief from pain as they will be unable
to convert codeine into its active form.
+ In a recent review conducted by King’s College London, thirty-three economic evaluations (75%)
supported PGx-guided treatment while 11 studies (25%) found PGX cost-effective and 22 studies
(50%) showed that it was dominant and cost-saving
+ In a study conducted by the Medical University of Vienna, the fraction of patients with an
actionable genetic profile was 69% for warfarin, 28.5% for clopidogrel, 23% for tacrolimus, 25.7%
for simvastatin and 9.1% for thiopurines.

In this report, we profile gene variants that are associated with your metabolic responses to various drug
therapies.This report can help your physician prescribe for you:

The Right Medication at The Right Dose!
