4. "transcription tools are useless at picking up complex medical terms"
Think again!
SurveyMind is trusted by leading healthcare agencies due to our platform's unique ability to pick up complex medical terms or drug names.
For example, check out this video on Pharmacogemonics. It's littered with complicated terms, acronyms and more. We uploaded this video to SurveyMind and received the transcript in seconds.
Check out an 100% accurate transcript below!
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When it comes to medications, we know one size doesn't necessarily fit all. People can respond differently to the same drug due to differences in age, weight, liver and kidney function, other drugs they might be taking, or even their behavior. And for some drugs, genetic differences also play an important role. The study of how genetic differences affect drug response is called pharmacogenomics, also referred to as PGX. PGX testing is a kind of genetic testing that looks for specific DNA differences, or variants, that can impact some drug's effectiveness or the chance of experiencing side effects or even severe adverse reactions. Most PGX variants are inherited DNA differences that can impact pharmacokinetics, what the body does to the drug, or pharmacodynamics, what the drug does to the body. Pharmacokinetic effects include altering the absorption, distribution, metabolism, or elimination of a drug, also known as ADME, while pharmacodynamic effects may include altering the body's sensitivity to a drug or altering the drug target itself. Many PGX variants are found in genes that code for metabolizing enzymes, including the cytochrome P450 family, or SIPs, while other PGX variants can affect proteins that transport medications or play a role in the immune system. So, which drugs are impacted by pharmacogenomics, and what should you do if a patient has a PGx test result that indicates a change in therapy? It can be difficult to translate PGx results into actionable clinical practice on your own. However, resources such as FDA-approved drug labels, the Clinical Pharmacogenetics Implementation Consortium, or CPIC, and PharmGKB are important sources of actionable information. CPIC is a consortium of clinicians and researchers that evaluates available PGX evidence and publishes peer-reviewed, genotype-based dosing guidelines. PharmGKB is an online resource that annotates PGX evidence and disseminates dosing guidelines and drug label information. Let's look at a case study of a PGX test result and a corresponding CPIC recommendation. The CYP2C19 gene codes for the CYP2C19 enzyme, which helps the body metabolize several commonly used drugs. This person's test result shows that she has two copies of the loss-of-function STAR2 variant in the CYP2C19 gene. The clinical interpretation of this result is that she is predicted to be a CYP2C19 poor metabolizer, which means her body may process certain drugs slower than expected. She is about to be started on an antidepressant, but CYP2C19 poor metabolizers tend to have higher systemic drug concentrations of certain antidepressants called selective serotonin reuptake inhibitors, SSRIs, such as citalopram, escitalopram, and sertraline at standard doses. and are at an increased risk of experiencing side effects such as an irregular heartbeat. Therefore, CPIC guidelines recommend considering a 50% reduction in starting dose and titrate to response, or trying an alternative antidepressant not primarily metabolized by CYP2C19. This is just one example of a CPIC-guided recommendation. In addition to the guideline for SSRI antidepressants, there are currently more than 25 guidelines covering over 80 drugs, among them statins, clopidogrel, proton pump inhibitors, tricyclic antidepressants, opioids, nonsteroidal anti-inflammatory drugs, NSAIDs, and certain antibiotics and anesthetics. Please refer to the CPIC's website for the full list. For certain drugs, the potential impact of PGX variants is so strong that some FDA-authorized drug labels include warnings or dosing recommendations based on particular variants. On their website, the FDA has posted a helpful table that lists the drugs they deem significantly impacted by PGX variants. Please refer to the FDA's website for the full table. So when is pharmacogenomic testing most likely to be useful? Patients who are already on a stable dose of medication that is working well are less likely to benefit from therapy changes based on a PGX test. But if a patient is taking one of the drugs included in the CPIC guideline or the FDA table and it's not working as expected or is causing unexpected or intolerable side effects, then PGX testing may be informative. Preemptive PGX testing, testing before treatment has begun, is likely to be the most helpful for guiding drug and dosage decisions, especially if there's a family history of adverse reactions or non-response to the drug being considered. Certain PGX variants are much more common in specific populations. For example, CYP2C19 loss of function variants, like the STAR2 variant mentioned earlier, are present in over 50% of people with East Asian, South Asian, or Pacific Islander ancestry. If you want to order a PGx test, you can find testing labs on the Genetic Testing Registry hosted by the NIH. Some direct-to-consumer, or DTC, companies also offer PGx testing. Updated information about FDA oversight of DTC genetic tests can be found on the FDA's website. Along with CPIC, PharmGKB, and the FDA, pharmacists and genetic counselors are also valuable resources for deciding when to use PGX testing and for helping to interpret and act on the results.
