Overview of the PRN

The Pharmacokinetics/Pharmacodynamics/Pharmacogenomics (PK/PD/PG) PRN was created for ACCP members to provide a mechanism for networking and collaboration, educational programming, and a high-quality forum where members with similar interests could discuss PK/PD/PG clinical practice and research. The PRN is designed to present and discuss a variety of current topics, including precision medicine, population PK/PD/PG analyses, innovative modeling, clinical research, clinical implementation, drug metabolism studies, and concentration-effect relationships. The PRN currently has more than 300 members, including over 100 members who identify as students or trainees.

Opportunities and Resources for Resident and Fellow Members of the PRN

• The PRN maintains a list of training opportunities in PK/PD/PG fields here. More than 35 postgraduate training opportunities are currently listed. These include PGY2 residencies, fellowships, and M.S. and Ph.D. training programs.
• Residents, fellows, and graduate students are encouraged to participate on PK/PD/PG PRN committees, including the Programming and Outreach committees. For more information, please contact PK/PD/PG PRN Chair Roseann Gammal, Pharm.D., BCPS ([email protected]), or Chair-Elect Jim Stevenson, Pharm.D., M.S., BCPP ([email protected]).
• The PRN provides networking opportunities at the PRN business meeting as part of the larger ACCP Annual Meeting. All PRN members, including trainees, are invited to attend the PRN business meeting. This is a great opportunity to meet experts in the PK/PD/PG community.
• The $1000 M. Kelli Jordan Travel Award provides an opportunity for a trainee (student, resident, or fellow) to present and promote his or her research efforts to the PK/PD/PG PRN. This award supports the awardee’s registration and travel expenses for the ACCP Annual Meeting.
  • More information can be obtained in the PK/PD/PG PRN Spring Newsletter or by e-mail to Secretary/Treasurer Max Smith, Pharm.D., BCPS ([email protected]).
• Follow the PRN on social media:
  • Twitter: @pkpdpg
  • LinkedIn: ACCP PK/PD/PG PRN

Current Clinical Issues

As pharmacists, we are used to incorporating patient-specific factors into therapeutic decision-making. The fields of pharmacokinetics (PK), pharmacodynamics (PD), and pharmacogenomics (PG) each approach precision medicine differently but ultimately work toward the same goal of improving patient outcomes. This is true across several specialty areas of pharmacy practice. Thus, the PK/PD/PG PRN recently led an opinion paper that describes perspectives on how pharmacists apply precision medicine across a variety of specialty areas of practice.¹

The Cardiology, Central Nervous System, Critical Care, Endocrine and Metabolism, GI/Liver/Nutrition, Hematology/Oncology, HIV, Immunology/Transplantation, Infectious Diseases, Nephrology, Pain and Palliative Care, and Perioperative Care PRNs all provided disease-specific perspectives on precision medicine. The PRNs commonly referred to patient-specific factors like weight, organ function, and age affecting the appropriate drug or dose selection. Discussions on pharmacogenomics included CYP2C19 genotyping for proton pump inhibitors, voriconazole, and antidepressants as well as CYP2D6 for opioids, antidepressants, and ondansetron.

Generalist and special population perspectives were provided by the Pediatrics, Pulmonary, Women’s Health, and Ambulatory Care PRNs. Therapeutic drug monitoring is a common practice, particularly in pediatric populations. Sex-related differences were discussed across PK, PD, and PG fields. This included the need for different dosing (e.g., zolpidem) and different levels of risk factors for adverse outcomes (e.g., drug-induced QT syndrome with antiarrhythmics, venous thromboembolism in factor V Leiden carriers prescribed contraceptives). Finally, the Pharmaceutical Industry and Health Outcomes PRNs weighed in. Discussions included new therapies (e.g., gene therapy) and expanded trial designs. Ultimately, clinical and economic values need to be demonstrated with precision medicine approaches.

Concepts from PK, PD, or PG can affect patients across the spectrum of pharmacy practice. Applying pharmacogenomic data will likely present unique barriers, particularly when incorporating genetic data into clinical care that optimizes pharmacotherapy. Finally, the paper issued a call for pharmacists to disseminate education to clinicians and to build scalable and sustainable models for the clinical implementation of precision medicine.

References

1. Caudle K.E., Gammal, R.S.; Karnes, J.H.; Afanasjeva, J.; Anderson, K.C.; Barreto, E.F.; Beavers, C.; Bhat, S.; Birrer, K.L.; Chahine, E.B.; Ensor, C.R.; Flowers, S.A.; Formea, C.M.; George, J.M.; Gosser, R.A.; Hebert, M.F.; Karaoui, L.R.; Kolpek, J.H.; Lee, J.C.; Leung, J.G.; Maldonado, A.Q.; Minze, M.G.; Pulk, R.A.; Shelton, C.M.; Sheridan, M.; Smith, M.A.; Soefje, S.; Tellez‐Corrales, E.; Walko, C.M.; Cavallari, L.H. PRN opinion paper: Application of precision medicine across pharmacy specialty areas. J Am Coll Clin Pharm 2019;2:288-302. doi:https://doi.org/10.1002/jac5.1107.