Testing patients to allow tailored drug treatment

The application of pharmacogenetics in preventing adverse drug reactions as illustrated by Konstantopoulou et al1 is not new. In 510 bc Pythagoras observed that only some individuals—those with a deficiency of glucose-6-phosphate dehydrogenase (G6PD)—developed a potentially fatal reaction after ingesting fava beans. For nearly 50 years anaesthetists have been identifying patients who may have a deficiency of normal plasma cholinesterase (leading to prolonged suxamethonium neuromuscular blockade or “scoline apnoea”) by taking a simple patient history.2

Although the development of modern pharmacogenetic assays designed to reduce the incidence of adverse drug reactions is still its infancy, the case presented by Konstantopoulou et al …