Patients from around the globe differ broadly in their reaction to drugs. It is evaluated that hereditary variables can represent 20 to 95 percent of patient variability. Polymorphisms may impact a medication’s activity by changing its pharmacokinetics or its pharmacodynamics.
Pharmacokinetics, the investigation of the rate and extent of drug absorption, distribution, metabolism, and excretion (ADME), determine the fate of a drug in the body. A combination of metabolism and excretion facilitates drug elimination from the body, so these polymorphisms can effect drug transport. Genetic polymorphisms have been identified for many drug-metabolizing enzymes, including the cytochrome P450 (CYP450) enzymes, and have a ability to diminish the efficacy of these enzymes. This gives rise to a unique population of phenotypes from people who have metabolisms ranging from poor to ultra rapid.
Pharmacodynamics looks at the pharmacologic effect between the drug and the body. The relationship between the concentration of the drug and the observed pharmacologic response depends on the drug’s mode of activity. Polymorphisms can alter the pharmacologic response to a drug through a direct impact like altering binding to a specific receptor or drug target, or an indirect effect like inhibiting an enzyme in a protein synthesis pathway.

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