CLINICAL SCHOLARSHIP
Pharmacogenomics and Implications for Nursing Practice
Dennis J. Cheek, RN, PhD, FAHA1, Lisa Bashore, PhD, APRN, CPNP-PC, CPON2, & Dan Alan Brazeau, PhD3
1 Beta Alpha, Abell-Hanger Professor, Texas Christian University, Harris College of Nursing and Health Sciences & School of Nurse Anesthesia, Fort
Worth, TX, USA
2 Beta Alpha, Assistant Professor, Texas Christian University, Harris College of Nursing and Health Sciences, Fort Worth, TX, USA
3 Director of Genomics, Analytics and Proteomics, Research Associate Professor, College of Pharmacy, University of New England, Portland, ME, USA
Key words
Advanced practice nursing, genomics,
pharmacogenetic, pharmacogenomics, nursing
Correspondence
Dr. Dennis J. Cheek, Texas Christian University,
Harris College of Nursing and Health Sciences &
School of Nurse Anesthesia, TCU Box 298620,
Fort Worth, Texas 76129.
E-mail: d.cheek@tcu.edu
Accepted: August 11, 2015
doi: 10.1111/jnu.12168
Abstract
Purpose: This article aims to introduce the nurse to pharmacogenomics and
its implications for clinical practice with regard to drug therapy.
Organizing Constructs: Pharmacogenomics is discussed with regard to the
basic tenets, relationships to common health conditions, education and practice
resources, and implications for nursing practice.
Methods: Peer-reviewed literature, websites, and expert professional guidelines
were reviewed with relation to pharmacogenomics and nursing practice.
Findings: The genetic–genomic literature has grown significantly since the
completion of the Human Genome Project in 2003. This information is now
being translated into practice with regard to the patient’s genetic profile and
the impact on drug therapy, which is pharmacogenomics.
Conclusions: The utilization of the patient genetic–genomic profile is beginning
to have an impact on patient drug therapy in clinical practice.
Clinical Relevance: Nurses are in the position to make sure, with the increased
translation of pharmacogenomics into clinical practice, that adverse
drug reactions are avoided and doses are optimized.
Pharmacogenomics is one of the many “omics” fields
of study (transcriptomics, lipidomics, metabolomics, and
phenomics) that have risen as the result of the human
genome project and the growing understanding of the science
of genomics. Genomics, the study of the structure,
content, function, and evolution of genomes, has become
relevant to healthcare professionals largely due to the advances
in molecular technologies, particularly DNA sequencing
(Table 1). Genomics is changing the nature of
medicine and delivery of health care and the ability to
examine and ultimately comprehend the nature of disease
and drug action at the molecular level. Obtaining
this goal is the ultimate basis of “precision medicine”: to
characterize or individualize care for human disease (National
Institutes of Health, 2015). Precision medicine, a
recent term, includes not just the right drug for the right
individual (formerly called personalized medicine), but
also the right drug for the specific disease type afflicting
the specific individual. Precision medicine will allow for
much more specific and successful therapeutic interventions
than are now possible (Collins & Varmus, 2015).
Many of the differences observed in how individuals
respond to drugs are inherited and, therefore, are at least
in part due to the genetic makeup of the patient (Kalow,
2004). Pharmacogenetics was coined in 1959 by a
German geneticist (Vogel, 1959) and has been an active
area of research even before the genomic revolution.
While the terms pharmacogenetics and pharmacogenomics
are often used interchangeably, pharmacogenetics
is generally used to refer to the role of single genes
in drug response while pharmacogenomics is the broader
term that encompasses the role of the entire genome, including
gene–gene interactions in drug response. The selection
of studies and web resources for this review was
done using the authors’ expertise in the study and practice
in pharmacogenomics and pharmacogenetics. The resources
and references have been selected based on their
clear representation of the foci of this article.
496 Journal of Nursing Scholarship
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