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A loading dose is an essential pharmacological strategy to rapidly achieve the target plasma drug concentration necessary for an immediate therapeutic effect. This approach is especially critical for drugs characterized by slow absorption or extended half-lives, where delaying therapeutic plasma levels could compromise treatment outcomes. By administering a loading dose, clinicians ensure a prompt onset of drug action, even for agents with complex pharmacokinetic profiles.Achieving steady-state...
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Gene-Based Dose Optimization in Children.

Laura B Ramsey1,2, Jacob T Brown3, Susan I Vear4

  • 1Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267, USA.

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|July 9, 2019
PubMed
Summary
This summary is machine-generated.

Pharmacogenetics, the study of genetic variation in drug response, offers personalized medicine for children. Gene-based dosing guidelines exist for several drugs, enabling precision treatment in pediatric patients.

Keywords:
immunologyinfectious diseaseoncologypediatricspharmacogenomicspsychiatry

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Area of Science:

  • Pharmacology
  • Genetics
  • Pediatrics

Background:

  • Pharmacogenetics is crucial for precision medicine, as genetic variations affect drug metabolism, leading to variable drug exposure, inefficacy, or toxicity.
  • While adult data is extensive, pediatric pharmacogenetic evidence is growing, revealing significant drug-gene interactions in children across various therapeutic areas.

Purpose of the Study:

  • To highlight the clinical implementation opportunities of pharmacogenetics in pediatric medicine.
  • To identify drugs with established pediatric pharmacogenetic guidelines and those requiring further research.

Main Methods:

  • Review of existing pediatric pharmacogenetic data and clinical guidelines.
  • Identification of specific drugs with robust evidence for gene-based dose optimization in children.

Main Results:

  • Guidelines for gene-based dose optimization are available for codeine, thiopurine drugs, selective serotonin reuptake inhibitors, atomoxetine, tacrolimus, and voriconazole.
  • These drugs represent opportunities for precision medicine in pediatric care when genetic information is available.

Conclusions:

  • Clinical implementation of pharmacogenetics in pediatrics is feasible for several key drugs.
  • Further research is needed to establish genetic factors influencing dosing for many other commonly used pediatric medications.