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Dr. Monte’s research focuses on precision medicine and substance abuse. In the precision medicine arena, Dr. Monte aims to improve drug effectiveness and safety in acute care conditions. He links clinical outcomes, available through the electronic health record, to genomic and metabolomic variables in order to generate systems biology models of drug effects with plans to test these algorithms prospectively. As an emergency physician and medical toxicologist, Dr. Monte is well positioned to examine efficacy and safety of drugs and he has the capacity to pair these data with serial biologic samples. Dr. Monte is particularly interested in drug-drug and drug-gene interactions. Dr. Monte’s work in substance abuse examines the public health effects of cannabis liberalization, drug detection, and genomic variability in patient illicit drug responses.
Pharmacogenetics Of Analgesics
This talk will review the pertinent pharmacogenetics of 3 major drug classes, opioids, NSAIDs, and anesthetics. We will discuss major polymorphic genes such as CYP2D6, CYP2C9, and the opioid receptors and how variants affect common drug effectiveness/safety. We will review the evidence, resources for clinicians, and the holes in knowledge.
Pharmacists have long recognized that using unique patient characteristics to guide pharmacotherapy decision-making can improve drug response and mitigate drug-associated risks. Age, weight, and dietary habits were among the first patient-specific characteristics used to individualize pharmacotherapy. As technologies advanced, analytic tools that measure surrogate markers of liver and renal function, together with drug concentrations in biological fluids, were adopted to optimize therapeutic regimens. Cutting-edge genomic technologies are now being integrated into patient care for the selection of targeted therapies and identification of those at increased risk of poor pharmacotherapy outcomes. Precision Pharmacotherapy is combining genetic, environmental, lifestyle, and other unique patient or disease characteristics to guide drug selection and dosage. This session will introduce the concept and give many examples of how precision pharmacotherapy is used in specialties such as pediatrics, psychology, cardiology and oncology to guide prescribing.