Personalized forensic toxicology: the promises of pharmacogenomics in the interpretation of drug poisonings

Objectives: Pharmacogenomics involves the assement of personalized contributions in response to drugs, adverse drug reactions and also drug poisoning. Pharmacogenomics is a useful area in the prediction of responses to drugs and poisons in different subjects. Some aspects of forensic toxicology importance of pharmacogenomics are the interpretation of forensic toxicology analysis results in alive and postmortem cases and their role in inducing life threatening outcomes and even death.Methods: To perform the present study many databases such as PubMed, Google scholar, … were searched to find the role of personalized and interindividual variations in drug induced poisoning.Results: Results showed that genetic and environmental factors cause interindividual differences in response to drugs and poisons. For example fluoxetine induces death in poor CYP2D6 metabolizer genotype subjects due to the accumulation of parent drug. There is a high prevalence in CYP family variation. Decedents intoxicated with methadone and oxycodone had shown decreased CYP2D6 enzyme activity. Warfarin has a narrow therapeutic index with a large interindividual variation. Overconversion of codeine in ultrarapid metabolizers with greater CYP2D6 activity results in high morphine amount and therefore toxicity and death.Conclusion: Pharmacogenomics might aid in dose adjustment of drugs in different individuals. Also pharmacogenomics helps the interpretation of the side effects of many drugs in different populations and drug poisoning related deaths.

کلیدواژه ها:

personalized medicine ، drug metabolism ، interindividual variation ، drug toxicity ، forensic toxicology