Pharmacogenomics (PGx) – finding the right dose of the right medicine for your child
Staff in the PGx program are the Kid Experts® supporting your healthcare team in finding the right dose of the right medicine to help your child now and in the future. We assist families and healthcare providers who may be struggling to find medicines that are both effective and free from side effects.
We pride ourselves on delivering precision medication selection and dosing based on your child’s unique diagnosis, symptoms, development and genetics. Children’s Minnesota has over 2000 patients with PGx results that are used in their medical care.
PGx research has made significant advances in some conditions, like anxiety and depression, while it is still in the early stages for others. In some cases, more research is needed, and PGx testing may not yet be helpful for your child’s medications. When this happens, we may recommend waiting to get tested until further research is completed.
Specialty areas where pharmacogenomic testing may improve medicine selection and dosing for different conditions
PGx and mental & behavioral health
Since 2003, anxiety and depression in children and adolescents has increased from 5.4% to 8.4%. (www.cdc.gov). We know that there are lasting effects from the COVID-19 pandemic combined with ongoing stress from school and social media that are increasing mental health issues for children and adolescents.
Only 40% – 50% of us may respond to the first medication for depression and anxiety. Unfortunately, it can also take 4 – 6 weeks to fully evaluate whether a medicine will work. This trial-and-error approach can take a long time for kids with anxiety or depression to find medicines that work best for them, leading to frustration and distrust for both patients and families. Pharmacogenomic testing may decrease the time it takes to find a medication and dose that is more likely to be effective by identifying individuals who are more likely to have medicine levels that are too high (leading to side effects) or too low (leading to lack of benefit) when standard doses of antidepressant and antianxiety medicines are used.
Many kids are also struggling to find the right medicines for attention deficit hyperactivity disorder (ADHD). While this is a very active area of research, currently PGx testing provides limited information for most ADHD medicines.
PGx and cancer & blood disorders
Being a child or young adult with cancer or a blood disorder is scary. Cancer treatment can make kids feel sick to their stomach and weaken their immune system, making them more likely to get infections. Sometimes, this can lead to extra days of sickness and even a hospital stay.
- Standard doses of some chemotherapy medicines can cause unnecessary immune suppression and infections
- Sometimes the medications we give to treat nausea and vomiting associated with chemotherapy do not work
- The normal dose of a medicine we give to prevent or treat a fungal infection can have levels in the body that are too low to be effective or too high causing side effects making the child feel worse
PGx testing can help your doctor or nurse practitioner:
- Pick a better dose of chemotherapy so it does not lower the immune system too much.
- Select an anti-nausea medication better suited to your child.
- Choose a medicine to prevent and treat fungal infections that is tailored to your child
Genetic tests at Children’s Minnesota are helping the Cancer and Blood Disorders team identify specific genetic changes in a child’s tumor that allow selection of new targeted medicines that may help treat the cancer more effectively. The collaboration between oncology specialists and pharmacogenomics experts is advancing precision medicine for children and young adults with cancer and blood disorders, offering tailored treatment approaches for this vulnerable population.
PGx and pain medication
No parent wants to see their child in pain. Getting pain medications right the first time is extremely important whether your child is having their tonsils removed or has fallen off their bike and broken their arm. Because of genetic differences in how medicines like codeine, tramadol, and ibuprofen are metabolized, some children may get pain relief while others may get too much and experience side effects. PGx testing can help us sort this out ahead of time to ensure that your child gets the right dose of pain medicine from the beginning.
Our pharmacogenomic program services
Extra safety for your child
We have built a system of alerts and flags in our electronic health record to let your Children’s Minnesota prescriber know when your child may need a different dose or medication when they are placing the order. At Children’s Minnesota, your prescriber does not even need to know that your child has had PGx testing! We use this tool to decrease the risk to your child from experiencing side effects if a wrong dose is used.
Here are some other services provided by the pharmacogenomics program:
- Comprehensive Medication Management: A thorough review of all the medicines your child is taking.
- Personalized PGx report: A report that looks at PGx results for any current or potential medicines for your child.
- Inpatient consultations: For patients having bad side effects or not responding well to their medicines.
- Meet with a genetic counselor: To get information and education about other health issues that might come up from PGx test results.
- Education for prescribers: Teaching doctors about this new healthcare technology.
- Consultations with outside providers: For healthcare providers who are not part of Children’s Minnesota and have questions about PGx testing.
- Research: To learn more about PGx in children and teens.
