Personalized Medicine in Clinical Pharmacology

Abstract

Clinical pharmacology includes the principles of personalized medicine as tailoring of medical treatment to the individual characteristics of each patient. In this chapter, three different areas of clinical pharmacology that are important in the individualization of the therapy (therapeutic drug monitoring, individualization in patients with renal and liver dysfunction, and pharmacogenetics/pharmacogenomics) have been presented. The main goal of therapeutic drug monitoring is to use drug concentrations to manage a patient’s medication regimen and optimize the outcome of the treatment. Proper dosage adjustment is of utmost importance in patients with liver or kidney dysfunction (main organs involved in the processes of metabolization and elimination of drugs). The recognition that a part of interindividual variability in drug response is inherited, and therefore predictable, created the field of pharmacogenetics/pharmacogenomics. Therefore, it is important to take into consideration all these specific fields, and the result will be adequate dosage for individual patients. This personalized therapy would maximize therapeutic efficacy, minimize drug toxicity, and can have an important economic impact on the health system. We presume, in the future, that personalized medicine will probably lose this adjective “personalized” since it is a unique medicine that uses all the tools we have at disposal in order to use drugs optimally for individual patients. In this approach, clinical pharmacologists certainly have a particularly important place.