Rx Note

Introduction Pharmacogenomics is the science which examines inherited variations in genes that determine a patient's response to a drug. Beyond tailoring a drug to an individual based on size, weight or age, the science of pharmacogenomics strives to tailor drug therapy to individual patients based on their own unique molecular characteristics (e.g. individual differences in drug-metabolizing enzymes, drug transporter activity, receptor sensitivity). Moreover, pharmacogenomic testing can help identify patients at higher risk of serious adverse drug reactions or therapeutic failure, and sometimes it can explain unexpected adverse effects or poor efficacy in patients already on drug therapy. Genetic Variation Major genetic variation is found in the cytochrome CYP450 group of isoenzymes. This can result in either inadequate responses to drugs or increased risk of ADRs . Clinically relevant genetic variation has been seen in CYP2D6, CYP2C9, CYP2C19 and CYP3A5. Examples Abacavir hyper...

Introduction Pain is 'an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage'. In other words, it is a subjective phenomenon . Hence, if a patient finds that he is in pain, then he is in pain. The function of acute pain is to alert the body to a potential threat , prevent the body from further damage (e.g. by moving away from the trigger), and learn to avoid similar harm in the future. NOTE: Older people are often reluctant to disclose pain for fear of being a burden or developing a drug dependence. Pain Assessment The most commonly used pain scales include Numerical rating scale : rates pain on a number scale, e.g. from 0 (no pain) to 10 (worst imaginable pain). Visual analogue scale : 10-cm-long lines labelled with an extreme at each end, usually "no pain at all" and "worst pain imaginable". Wong-Baker FACES Pain Rating Scale : uses pictures of faces with different expressions...