Why you need pharmacogenetic tests when taking Vancomycin

Vancomycin

Antibacterial obtained from Streptomyces orientalis. It is a glycopeptide related to ristocetin that inhibits bacterial cell wall assembly and is toxic to kidneys and the inner ear.

https://www.pharmgkb.org/drug/PA451850#tabview=tab1&subtab=31

Source: Drug Bank

Indication

For the treatment of serious or severe infections caused by susceptible strains of methicillin-resistant (beta-lactam-resistant) staphylococci.

CPIC Dosing Guideline for rasburicase and G6PD

Summary

Rasburicase is contraindicated in G6PD deficient patients with or without chronic non-spherocytic hemolytic anemia (CNSHA). In patients with a negative or inconclusive genetic test result an enzyme activity test is recommended prior to rasburicase treatment to determine whether a patient is G6PD deficient. The G6PD gene is X-linked and therefore males only have one copy, whereas females have two copies. See full guideline for disclaimers, further details and supporting evidence.

Annotation

Aug 2014

Accepted article preview online May 2014, advance online publication 11 June 2014

  • Guidelines regarding the use of pharmacogenomic tests in determining whether rasburicase treatment should be undertaken have been published in Clinical Pharmacology and Therapeutics by the Clinical Pharmacogenetics Implementation Consortium (CPIC).
  • Excerpt from the 2014 rasburicase guideline:
    • “As stated above, rasburicase is contraindicated by the FDA, the EMA, and PMDA in those with G6PD deficiency (32-34) (see Table 2). If, on the basis of genotyping, a deficient status can be unambiguously assigned to a patient, that would be a sufficient contraindication to the use of rasburicase. However, due to the limitations of genetic testing (discussed above), in most cases it is necessary to perform G6PD enzyme testing to assign G6PD status.”
  • These guidelines are applicable to
    • neonates
    • pediatrics
    • adults
  • ———–

Pharmacogenetic tests

  • We are working with doctors and medical sales reps, medxprime.com to prevent adverse drug reactions and promote patient safety. Contact Connie Dello Buono 408-854-1883 motherhealth@gmail.com if you want to add this service /test as added tool in your practice and  for medical sales reps (as we are hiring in all states in the USA).

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