Pharmacokinetic and Pharmacodynamic Challenges in Personalized Medicine: A Clinical Perspective

Abstract

Personalized medicine aims to tailor medical treatment to individual characteristics such as genetic makeup, environmental exposure, and lifestyle. Despite the promise of improved efficacy and reduced adverse drug reactions (ADRs), the clinical implementation of personalized medicine is hindered by pharmacokinetic (PK) and pharmacodynamic (PD) variability. PK refers to how the body affects a drug (absorption, distribution, metabolism, and excretion), while PD refers to how the drug affects the body. Variability in drug-metabolizing enzymes, transporters, and target receptors due to genetic polymorphisms, age, sex, comorbidities, and environmental influences significantly impact therapeutic outcomes. This paper provides a comprehensive clinical perspective on PK/PD-related challenges in personalized medicine, including issues in drug dosing, therapeutic drug monitoring (TDM), drug-drug interactions (DDIs), and biomarker-based dosing algorithms. The review also evaluates recent advancements in pharmacogenomics and modeling tools aimed at optimizing patient-specific therapy. Although progress has been made, integrating PK/PD data into clinical workflows remains a significant hurdle. Strategies such as clinical decision support systems (CDSS), standardized pharmacogenetic testing, and interdisciplinary collaboration are vital for the future of precision therapeutics.

DOI: 10.8612/37.3.2022.2