The Relationship Between Pharmacogenomics and Pharmacokinetics and Its Impact on Drug Choice and Dosing Regimens in Pediatrics

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Book Chapter

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The concept of precision or personalized medicine in pediatrics is still in its infancy, and due to ethical and logistical constraints, it is difficult to conduct clinical studies in pediatric to obtain meaningful correlations between ontogeny and drug disposition. However, as a result of initiatives by the Food and Drug Administration (FDA) aimed toward incentivizing companies for conducting pediatric trials, knowledge on pediatric pharmacogenomics is slowly increasing. The information on pediatric pharmacogenomics is utilized to implement pharmacogenomic testing in pediatrics to allow clinicians to make an informed decision on selection and dosing of drugs in pediatrics. The ontogeny of drug-metabolizing enzymes (DMEs), transporters, and target proteins is the most crucial factor in pediatric pharmacogenomics. Based on in vitro and in vivo studies on the ontogeny of DMEs, various pharmacogenomic tests in pediatrics were evaluated concerning the pharmacokinetics of drugs utilized in pediatric pharmacotherapy. Needing to obtain clinically relevant advantages of incorporating pharmacogenomics in pediatric drug therapy, clinicians must be informed on pharmacogenomic terms by appropriate educational programs. Furthermore, a comprehensive database that can bank all pediatric pharmacogenomic information that can seamlessly collaborate with other international databases must be established.