PHARMACO- GENOMICS (PGX) TESTING IN YOUR … (PGX) TESTING IN YOUR PRACTICE If you have any...

PHARMACO-GENOMICS (PGX) TESTING IN YOUR PRACTICE

If you have any questions or require further information, please contact our Customer Service Center at 1 877 733 4522If you have any questions or require further information, please contact our Customer Service Center at 1 877 733 4522

PHARMACOGENOMICS (PGX) TESTING IN YOUR PRACTICE

he stan ar ose of a me ication is etermine so that the therapeutic a ent ill provi e the esire health ene ts to the majority of patients who take it. However, many factors, including heredity, type of diet, and concurrent health issues can influence how a person responds to medications. n many occasions, clinicians nd it dif cult to predict which patient will ene t from a particular kind of medication and which patient will e perience an adverse effect from the same medication.

Identifying Optimal Drugs and Dosages Based on GeneticsWith just a simple genetic test, clinicians have opened the door to improving patient care by understanding the most effective drugs for each patient.

What is Pharmacogenomics? harmacogenomic testing combines the science of how drugs work with a patient s genetic makeup to determine

a therapeutic response to particular drugs. Over the years, drugs have been marketed with the idea that each drug works the same for everyone. However, through genomic research, it has been discovered that the one si e ts all concept for drugs is untrue, thereby opening the door for a more personalized approach when it comes to drug therapy.

sing pharmacogenomics , a clinician identi es the most suitable drug for a patient with the likelihood of reducing an adverse therapeutic response from the drug. any healthcare professionals are incorporating testing into their patient care to routinely use the genetic information to choose those drugs and drug doses that offer the greatest chance of improving patient outcomes. Being able to routinely test patients for their response to a particular therapy helps provide ef cacy and safety insight prior to starting the patient on a new therapeutic regime.1

If you have any questions or require further information, please contact our Customer Service Center at 1 877 733 4522


testing provides the clinician and patient with the following

genetic information to assist in the development of an appropriate treatment plan and therapeutic decisions,

the likelihood of an adverse response to a medication,

improved adherence to medication and,

more ef cient, safe, and economical quality care.

dditionally, current studies have demonstrated that testing can reduce the costs of healthcare by potentially eliminating the costs of treatment for adverse drug reactions and delays in proper treatment, while at the same time, improve clinical results.

Testing Overview tests are performed to evaluate a person s potential

response to a drug therapy.

Indications for ordering the ccu eference edical ab ests

Clinicians who have spoken with their patients and have identi ed that the therapy has an associated test.

Clinicians who have spoken with their patients and have con-rmed that the therapy of interest has high adverse event rates.

Clinicians who have spoken with their patients and have con rmed that the therapy of interest has a narrow indica-tion range.

Doctors nd testing bene cial for patients that may be taking or will begin taking a drug. any clinicians utilize the information from testing to alter and develop therapeutic treatment plans. By combining test results with a patient s clinical history and prescription profile, the clinician can adopt a more personalized therapeutic approach into patient care by adjusting therapies and dosages.

Lab Code Test(s) Gene(s) Tested1

5088AccuCARDIAC Panel

CYP2C19, CYP2D6, CYP2C9, CYP3A4, CYP3A5,

5089 AccuPSYCH PanelCYP2C19, CYP2D6, , CYP2C9, CYP3A4, CYP3A5,

UGT2B15

5087 AccuPAIN PanelCYP2C19, CYP2D6, CYP2C9, CYP3A4, CYP3A5, CYP1A2, CYP2B6, OPRM1

5086AccuCOMPREHEN-

CYP2C19, CYP2D6, CYP2C9, CYP3A4, CYP3A5,

UGT2B15

5090

5092 CYP2D6 CYP2D6

5091 CYP2C19 CYP2C19

Lab Code Gene TestedY435 CYP2C9Y433 CYP3A4Y445 CYP3A5Y453 CYP1A2Y455 CYP2B6Y463Y469 APOEY467Y461 OPRM1Y475 COMTY493 HTR2AY495 HTR2CY499Y501 ITGB3Y503 UGT2B15Y465

Recommended?Pharmacogenomic testing typically takes place prior to begin-ning a new therapy, but may also be requested by clinicians during the initial or later stages of therapy use for the same gene pro les to identify any fluctuations. or additional patient pro le information, please Indications for Patient esting.


The AccuCARDIAC

The AccuPSYCH

The AccuPAIN

DRUG CATEGORY GENERIC AND BRAND NAME THERAPY EXAMPLESAngiotensin II Receptor Antagonists Irbesartan (AvaproAntianginal Agents Ranolazine (RanexaAntiarrhythmics Flecainide (Tambocor , (Mexitil , Propafenone (RythmolAnticoagulants (Eliquis , (Pradaxa , (Arixtra , (Xar-

elto , Warfarin (CoumadinAntiplatelets Clopidogrel (Plavix , Prasugrel (E ent , Ticagrelor (Brilinta , (ZontivityBeta Blockers Carvedilol (Coreg , (Normodyne, Trandate , Metoprolol (Lopressor , Nebivolol (By-

stolic , Propranolol (Inderal , Timolol (TimopticStatins Atorvastatin (Lipitor , Fluvastatin (Lescol , (Mevacor , Pitavastatin (Livalo , Pravas-

tatin (Pravachol , Rosuvastatin (Crestor , Simvastatin (Zocor

DRUG CATEGORY GENERIC AND BRAND NAME THERAPY EXAMPLESAntiadictives Bupropion (Wellbutrin, Zyban, Aplenzin, Contrave Vivitrol)Anti-ADHD Agents Amphetamine (Adderall Strattera Focalin

(Dexedrine Vyvanse), Methylphenidate (Ritalin)Anticonvulsants Carbamazepine (Tegretol, Carbatrol), Eslicarbazepine Acetate (Aptiom Zarontin), Ezogabine

(Potiga), Felbamate (Felbatol), Fosphenytoin (Cerebyx), Gabapentin (Neurontin Vimpat -rigine (Lamictal Keppra Trileptal), Perampanel (Fycompa), Phenobarbital (Luminal), Phenytoin (Dilantin), Pregabalin (Lyrica), Primidone (Mysoline Banzel), Tiagabine (Ga-bitril), Topiramate (Topamax Depakote, Depakene Sabril), Zonisamide (Zonegran)

Antidementia Agents Donepezil (Aricept), Galantamine (Razadyne), Memantine (Namenda)Antidepressants Amitriptyline (Elavil Amoxapine), Citalopram (Celexa), Clomipramine (Anafranil), Desipramine

(Norpramin Pristiq Silenor Cymbalta), Escitalopram (Lexapro), Prozac, Sarafem Luvox), Imipramine (Tofranil Fetzima),

Maprotiline (Ludiomil), Mirtazapine (Remeron), Nefazodone (Serzone), Nortriptyline (Pamelor(Paxil, Brisdelle), Protriptyline (Vivactil), Sertraline (Zoloft), Trimipramine (Surmontil Effexor),

Viibryd Brintellix)Antipsychotics Aripiprazole (Abilify), Asenapine (Saphris), Chlorpromazine (Thorazine), Clozapine (Clozaril), Fluphenazine

(Prolixin), Haloperidol (Haldol), Iloperidone (Fanapt Latuda), Olanzapine (Zyprexa), Palipe-ridone (Invega), Perphenazine (Trilafon), Pimozide (Orap), Quetiapine (Seroquel), Risperidone (Risperdal), Tetrabenazine (Xenazine), Thioridazine (Mellaril Navane), Trazodone (Oleptro), Trifluoperazine (Stelazine), Ziprasidone (Geodon)

Benzodiazepines Clobazam (On ), Clonazepam (Klonopin), Diazepam (Valium)

DRUG CATEGORY GENERIC AND BRAND NAME THERAPY EXAMPLESFibromyalgia Agents Milnacipran (Savella)

Carisoprodol (Soma), Cyclobenzaprine (Flexeril, Amrix Skelaxin), Methocarbamol (Robaxin), Tizanidine (Zanaflex)

NSAIDs Celebrex), Diclofenac (Voltaren), Flurbiprofen (Ansaid), Ibuprofen (Advil, Motrin), Indomethacin (Indocin Orudis Toradol Mobic), Nabumetone (Relafen(Aleve Feldene), Sulindac (Clinoril)

Opioids Alfentanil (Alfenta), Buprenorphine (Butrans, Buprenex), Codeine (Codeine; Fioricet with Codeine), Dihy-drocodeine (Synalgos-DC), Fentanyl (Actiq), Hydrocodone (Vicodin), Hydromorphone (Dilaudid, Exalgo),

Levo Dromoran), Meperidine (Demerol), Methadone (Dolophine), Morphine (MS Contin), Percocet, Oxycontin Opana, Numorphan), Sufentanil (Sufenta), Tapentadol

(Nucynta), Tramadol (Ultram)


-DIAC and AccuPSYCH Panels. The panel is also offered with an optional additional Risk Assessment.

DRUG CATEGORY GENERIC AND BRAND NAME THERAPY EXAMPLES5-Alpha Reductase Inhibitors for Benign Prostatic Hyperplasia

Dutasteride (Avodart), Finasteride (Proscar)

Alpha-Blockers for Benign Prostatic Hyperplasia

Alfuzosin (UroXatral Cardura), Silodosin (Rapaflo), Tamsulosin (Flomax), Tera-zosin (Hytrin)

Antiemetics Metoclopramide (Reglan), Ondansetron (Zofran)Antifungals Vfend)Antispasmodics for Overactive Bladder

Darifenacin (Enablex), Fesoterodine (Toviaz), Mirabegron (Myrbetriq Ditropan), Solifenacin (Vesicare), Tolterodine (Detrol), Trospium (Sanctura)

Immunosupressants Tacrolimus (Prograf)Phosphodiesterase Inhibitors for Erectile Dysfunction

Stendra Viagra Cialis Levitra)

Proton Pump Inhibitors Dexilant), Esomeprazole (Nexium Prevacid), Omeprazole (Prilosec), Pantoprazole (Protonix), Rabeprazole (Aciphex)

Sulfonylureas Glimepiride (Amaryl), Glipizide (Glucotrol), Glybu

CYP2D6 TESTThe CYP2D6 TEST is targeted for Amitriptyline (Elavil) and Nortriptyline (Pamelor).

DRUG CATEGORY GENERIC AND BRAND NAME THERAPY EXAMPLESAntidepressants Amitriptyline (Elavil), Nortriptyline (Pamelor)

CYP2C19 TESTThe CYP2C19 TEST is targeted for patients with acute coronary syndromes un-dergoing percutaneous coronary intervention who are beginning treatment with

DRUG CATEGORY GENERIC AND BRAND NAME THERAPY EXAMPLESAntiplatelets Clopidogrel (Plavix)

CYP2C9+VKORC1 TEST

DRUG CATEGORY GENERIC AND BRAND NAME THERAPY EXAMPLESAnticoagulants Warfarin (Coumadin)


How to Order a Test

1. Sample Collectiontesting.

2. Sample Transportation-

port specimens in a cold bag, providing a constant 4ºC.

3. Turnaround timeSamples shall be processed within one week

4. Testing Overviewa drug therapy.

5. Indications for ordering our P Tests

that the therapy of interest has high adverse event rates.

that the therapy of interest has a narrow indication range.

. or uestions If there are any questions, clinicians can contact Accu Reference

Anjali Seth at [email protected]

Why Accu Reference

Accu Reference is a state-of-the-art medical testing laboratory service that provides a complete range of tests for diagnosis, screening or evaluation of diseases and health conditions. We are

and operate in compliance with all governmental regulations. We use the latest diagnostic technology. As new medical tests become available, we update our list of services.

Our laboratory technicians are well trained and have many years

results. We provide easy-to-interpret results and can provide test results the way you need them, whether you prefer a pa-per-based system, completely electronic or some combination

RI. Our centers are staffed by trained phlebotomists, who provide the safest and most professional specimen collection services available.

We are available to you around-the-clock, with a Client Services Department which is available to take your call 24 hours a day 7 days a week. If you have questions or comments, call Accu Reference at (877) 733-4522

References1. Pharmacogenomic tests. merican ssociation for Clinical Chemistry. Website https labtestsonline.org understanding analytespharmacogenetic-tests . pdated pril 3, 2 14. ccessed October 11, 2 15.

2. Pharmacogenetics fact sheet. ational Institute of eneral edical Sciences. Website http www.nigms.nih.gov education Pagesfactsheet-pharmacogenomics.asp . pdated October 1, 2 15. ccessed October 11, 2 15.

3. enetic testing for personalized psychiatric drug therapy. I Biotech. http www.aibiotech.com sites default les les IB- 53- 213-Psychiatric uadfold.pdf. Published ebruary 2 13. ccessed October 11, 2 15.

4. Gervasini G et al. Pharmacogenomic testing and therapeutic drug monitoring are complementary tools for optimal individualization of drug therapy. ur Clin Pharmacol. 2 1 755-774.

5. S B Haga and N M A LaPointe.The Potential Impact of Pharmacogenomic Testing on Medication Adherence. The Pharmacogenomics ournal (2 13 13, 481 483. http www.nature.com tpj journal v13 n full tpj2 1333a.html. published online 3 September 2 13.


Chronic Pain Syndrome

Other Chronic Pain

Acute Pain Due To Trauma

Other Acute Pain

Other Symptoms Referable To Back

Generalized Pain

Cervicalgia

Pain In Thoracic Spine

Atherosclerosis of Aorta

Occlusion And Stenosis of Carotid Artery Without Cerebral Infarction

Posttraumatic Stress Disorder

Dysthymic Disorder

Depressive Disorder Not Elsewhere

Major Depressive Affective Disorder Recurrent Episode

Medicinal and Biological Substance

Morbid Obesity

Diabeted Mellitus Without Mention of Complica-

Cerebral Aneurysm Nonruptured

Malignant Neoplasm of Colon

Bile Ducts

G89.4

G89.29

G89.11

R52

M54.08

R52

M54.5

M54.2

M54.6

M25.50

I10

I20.8-I20.9

I42.7

I25.10

I70.0

I73.9

I50.9

I21.3

I65.29

F41.1

F43.10-F43.12

F34.1

E32.9

F33.9

T50.905A

E66.01

Z79.899

E11.9

I67.1

M19.90

B20

C17-C17.9

C22-C22.9

C34-C34.92

Z21

Z79.01

Z79-Z79.890

Z79.891

Z79.899

PAIN CARDIAC

PSYCHIATRIC

ICD-10

ICD-10

ICD-10

ICD-10

Description

Description

Description

Description


call 877-733-4522

*sample report for illustration purpose only

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