Pharmacogenics2

Why Pharmacogenetics?

Patient’s Choice Laboratories™ (PCL) is proud to offer the following Pharmacogenetic testing panels to help you to better serve your patients. Pharmacogenetic testing provided by PCL will allow you to deliver personalized medicine to your patients that is custom-tailored to their specific needs and conditions such as pain management, mental health, and cardiovascular risk. These tests have been extensively validated in-house by highly trained scientists under strict conditions that satisfy CLIA and CAP requirements.

Testing genes involved in metabolism of pharmaceuticals can provide important genetic information to help you identify the ideal drug for your patients, offering the opportunity to maximize the therapeutic effect while reducing adverse drug reactions (ADRs).

Results will be reported in standard nomenclature such as “Poor Metabolizer”, “Intermediate Metabolizer”, “Normal Metabolizer”, and “Rapid Metabolizer”, with specific recommendations based on clinical research for the medications your patients are taking that can be listed on the requisition form.

Click here to download a printable PDF of our PGX Gene Monographs.

Poor Metabolizer (PM): Presence of mutations, usually on both chromosomes or in multiple locations on the gene, which significantly decrease or completely inhibit expression of the mutated gene. This generally results in a decreased dosage recommendation or change in medication to something more easily metabolized by the patient.

Intermediate Metabolizer (IM): Presence of mutations on only one chromosome, or multiple mutations only partially effecting expression of the mutated gene.

 

Rapid Metabolizer (RM): Presence of mutations, usually on both chromosomes or in multiple locations on a gene, which significantly increase expression of the mutated gene. This generally results in an increased dosage recommendation.

Normal Metabolizer (NM): No detected mutations (wild type).

PHARMACOGENETIC PANELS AVAILABLE FROM PATIENT’S CHOICE LABORATORIES:


Comprehensive Panel

CYP2D6, CYP2C9, CYP2C19, CYP1A2, CYP3A4, CYP3A5, CYP2B6, VKORC1, SLCO1B1, APOE, OPRM1, COMT, GRIK4, ANKK1, Factor II (F2), Factor V (F5) Leiden, MTHFR


The Comprehensive Panel includes the full battery of Pharmacogenetic testing available from PCL, which encompasses applications such as pain management, thrombotic risk, cardiovascular medications, general drug metabolism, and psychiatric care.


Core Drug Metabolism Panel

CYP2D6, CYP2C9, CYP2C19, CYP3A4, CYP3A5, OPRM1, COMT, GRIK4, ANKK1, MTHFR


The Core Drug Metabolism Panel includes genes that have been determined to be most relevant in metabolism of pharmaceuticals, many of them in the CYP450 family. The CYP450 gene products are a family of isoenzymes found in the liver that are essential for metabolism of many pharmaceuticals. Knowing a patient’s genotype for these genes can provide information to help personalize their medicine profile by potentially increasing therapeutic effect by optimizing drug choice and dosage while at the same time reducing adverse drug reactions (ADRs).

 


Cardiovascular Panel

CYP2D6, CYP2C9, CYP2C19, CYP1A2, CYP3A4, CYP3A5, VKORC1, SLCO1B1, APOE, Factor II (F2), Factor V (F5) Leiden, MTHFR


The Cardiovascular Panel includes genes involved in metabolism of pharmaceuticals such as Warfarin, Clopidogrel, and beta blockers as well as screening for thrombosis risk factors. Incorrect administration of cardiovascular medications can be a cause of morbidity or even mortality in patients. Pharmacogenetic testing for these genes can help you, as a health care provider, determine the most appropriate medication and dosage of that medication, and reduce the time it takes to determine the therapeutic index for your patients.


Cardiovascular Risk Panel

APOE, Factor II (F2), Factor V (F5) Leiden, MTHFR


The Thrombotic Risk Panel addresses venous thromboembolism (VTE), a condition that includes deep vein thrombosis (DVT) and pulmonary embolism (PE). VTE is one of the top three most common cardiovascular diseases along with myocardial infarction (heart attack) and stroke, and is estimated to occur in about 1 in every 1000 individuals. The presence of multiple mutations in the genes on this panel may increase a patient’s susceptibility to VTE.


Mental Health Panel

CYP2D6, CYP2C9, CYP2C19, CYP1A2, CYP3A4, CYP3A5, CYP2B6, COMT, GRIK4, ANKK1


A substantial percentage of antipsychotic and antidepressant medications (including SSRIs) are metabolized by enzymes coded for by the CYP450 gene family, and can present adverse drug reactions (ADRs) at dosages minimally higher than necessary dosages to provide psychiatric therapy. Obtaining genotypes for the CYP450 genes involved in metabolism of psychiatric drugs can help to determine the ideal therapeutic dosage more efficiently than traditional methods, as well as the most appropriate medication for the specific metabolism of the patient.


Pain Panel

CYP2D6, CYP2C19, CYP1A2, CYP3A4, CYP3A5, OPRM1, COMT


Mutations in the specific CYP450 genes on PCL’s Pain Panel can have a significant effect on metabolism of a large number of medications, including drugs for managing chronic and acute pain. Opioids are the most widely prescribed medications for pain relief, and their narrow therapeutic index can create issues ranging from insufficient pain relief to adverse drug reactions (ADRs) including decreased respiratory function, nausea, and excessive sedation on the other end of the spectrum.

Some narcotic analgesics are categorized as prodrugs (such as codeine), and must be metabolized by enzymes into a therapeutic compound. Mutations in the genes on this panel can interrupt this conversion, reducing or even eliminating any pain relief the patient would experience with wild type alleles, and also increasing ADRs such as toxicity.

A Novel Collection Kit for Genetic Testing:
Click to open a full explanation of Patient Choice Laboratories’ COPAN eNAT with FLOQSwabs Testing

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