Fausto Zaruma-Torres
Mexico
Title: Establishment and optimization of medicine and personalized pharmacotherapy units (MPPU) in Mexico
Biography
Biography: Fausto Zaruma-Torres
Abstract
Introduction:The role of pharmacokinetics (PK), pharmacogenetics (PG) and clinical and therapeutic drug monitoring (TDM), are essential for improving the efficacy and safety of medicines. In the last years, in Mexico the individualization of medicine and therapeutics has become a priority for chronic and oncologic patients, and it demanded the establishment of pilot programs for MPPU. Objective:To show the experiences, mission and vision of MPPU as a resource to improve the individualization of treatment in chronic or/and critical patients. Methods: We have twonewintra-hospital UMPPin the states ofDurangoandBajaCalifornia underagreementacademia, government andprivate institutions.The service offerspharmacogenetictests (FG) such asqPCR, RFLP's, gene expressionand identificationof nucleotidevariationsbyautomated sequencing, that identifygenetic polymorphismsencodingdrugmetabolizing enzymessuch asCYP450, TPMT, MTHFR, FPGS, XO; drug transportersandreceptors(SLC19A1, ABCB1, ABCC5, OCT), etc. In addition we give aserviceclinicalPKandtherapeutic drug monitoring(TDM) fordose adjustmentfor cancerandchronic patients. Results:Based onthePGprofile, monitoring of drug concentrationsand /orthe population pharmacokineticstudy (PopPK), trainedpersonnelin analysisand interpretation are able toevaluate the therapeuticschemeestablished, design a new personalized treatment regimenin orderto reduce therisk of adverseeventsand maintaining optimal drug concentrationswithin the therapeutic range. Conclusion: Expertise gained in the first Clinical Pharmacokinetics Laboratory of the National Institute of Pediatrics and the implementation of a program for Optimizing Drug Therapy in Pediatrics, it led to creating the Laboratory of Pharmacogenomics and Molecular Biomedicine at the National Polytechnic Institute, CIIDIR-Unit Durango , Mexico to study FG in indigenous, mestizos and Caucasian populations of northern and northwestern Mexico, which has improved the differential diagnosis and personalized treatment in critical and/or chronic patients