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Abstract Category: Methods

Poster ID: M2

INTEGRATION OF PHARMACOGENOMICS INTO THE BASIC SCIENCE MEDICAL CURRICULUM. 

George A. Dunaway, Ph.D.*, Department of Pharmacology, Southern Illinois University School of Medicine, Springfield, IL 62794-9629, USA 

The availability of the human genome sequence and the ability to associate polymorphisms with drug responsiveness as well as treatment of disease symptoms will alter the practice of medicine and allow individualized treatment, as needed. Recognizing the importance and emergence of medical genomics, the AAMC proposed its inclusion into the medical curriculum and outlined core competencies. This creates the challenge of adding this information to an already packed medical curriculum, such that student knowledge in this area is enhanced and yet “classical” basic science concepts are adequately addressed. To appreciate medical genomics, familiarity with the basic concepts and terminology of normal, developmental, and abnormal human and molecular genetics is necessary. Further, knowledge of population genetics, genetic testing, and construction of pedigrees considering genetic mutations and disease sequella is needed. This poster will focus on basic strategies to introduce pharmacogenomics into a basic science medical course by offering guidance in development and use clinical vignette models to enhance relevance. The introduction of pharmacogenetics into a medical curriculum requires a basic knowledge of the mechanisms of drug disposition, i.e., distribution, metabolism, and elimination, and evaluation of drug efficacy and adverse effects. To appreciate the causes of unexpected influences of administered drugs, students should learn the basic causes of abnormal drug responses and, where possible, gain insight into predicting their occurrence from a knowledge of known polymorphisms. Unusual drug responsiveness can be related to such inherited defects as altered activity of the drug-sensitive receptor(s) and/or dysfunction of one or more of the parameters of drug disposition. Also, such effects can be acquired from systemic diseases, renal and/or hepatic dysfunction, diet, environmental stressors, drug-drug interactions, and/or age. These vignette models will be discussed as tools for discussing pharmacogenomics: (1) Defective receptors leading to altered responsiveness to a drug, (2) Altered metabolism of an administered agent imposing unexpected drug effects, (3) Multiple alterations, e.g.,  a defective receptor at the site of drug action and altered metabolism of an administered agent, which promotes reduced responsiveness and adverse effects, and (4) Altered renal or hepatic drug metabolism due to a disease or drug-drug interaction. Regardless of the basic or clinical science content of an educational unit, these vignettes could be modified to introduce the significance of pharmacogenetics by choosing a relevant agent for the unit. Also, if presented with normal drug action, these vignettes could minimize the impact of this information on curricular time.

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