The primary motivation to apply pharmacogenomics to the prescription of medications is to:

Pharmacodynamics refers to:

One can determine immediately if a pharmacogenomic test is available and the evidence supporting the use of that test by reading the “pharmacogenomics” section in the package insert for a drug.

Which best describes the current state of evidence for the use of pharmacogenomics testing to guide the prescription of drugs?

A patient asks you if a pharmacogenomic test is covered by his/her insurance. Which is the most generally correct response?

The following series of questions uses the following scenario. Additionally, each question has no right/wrong answer(s), but must be completed in order to receive credit for the assessment.

---

Scenario: You’re a practicing psychiatrist and a respected colleague tells you about a test he’s been using, GeneSight Psychotropic (http://genesight.com/patients/genesight/psychotropic/) from AssureRx Health, Inc, for helping guide selective serotonin reuptake inhibitor (SSRI) treatment in his patients with major depression. This test is based on polymorphisms in the CYP2D6 gene that affect metabolism of the drug. He swears by this test and recommends you use it for your patients that are difficult to dose.

You consider using this test for one of your current patients, a 38 year old Caucasian male with major depression, before prescribing Prozac (fluoxetine). Is this patient a candidate for testing? If so, would testing be beneficial? Find the relevant information to make your decision. You may use any resources you would normally use in your medical practice and any of the new sources discussed in class.

---

What is your decision? Would you use either the AssureRx or similar test from another lab for CYP2D6 variants in order to dose your patient?

How long did it take you to come to your decision?

If you decided not to use the test, if this patient already had CYP2D6 information in his chart, would you use it?

How many different sources did you explore to find information to make your decision?

What source(s) of information did you use to derive your answer (check all that apply)?

Which sources were the most useful? (check all that apply)

What factor(s) made them more useful (check all that apply)?

Which sources were the least useful? (check all that apply)

What factor(s) made them less useful? (check all that apply)