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Indian Journal of Pharmacy PracticeNOW IN
Review

Clinical Pharmacology and Genomic Prescription Pathways: Toward a Paradigm Shift in Individualized Drug Therapy-A Review

Muchukota Sushma1, Bharathi Bhogenahalli Venkatappa1★, Vanishree Sangatapalli Adinarayanareddy2, Shannumukha Sainath3, Marripalli Nagendra4★ Corresponding author

  1. 1Department of Pharmacy Practice, Aditya Bangalore Institute of Pharmacy Education and Research (ABIPER), Yelahanka, Bangalore, Karnataka, INDIA.
  2. 2Department of Medicine, Bachelor of Medicine, Bachelor of Surgery (MBBS), Intern, Hassan Institute of Medical Sciences, Hassan, Karnataka, INDIA.
  3. 3Department of Pharmacy Practice, Nirmala College of Pharmacy (Autonomous), Kadapa, Andhra Pradesh, INDIA.
  4. 4Department of Pharmacology, Trinayi College of Pharmacy, Rayachoti, Annamayya, Andhra Pradesh, INDIA.

CORRESPONDENCE

Bharathi Bhogenahalli Venkatappa

Department of Pharmacy Practice, Aditya Bangalore Institute of Pharmacy Education and Research (ABIPER), Yelahanka, Bangalore, Karnataka, INDIA.

bharathibv2002@gmail.com

Received: 14-07-2025; Revised: 29-09-2025; Accepted: 03-11-2025.

Volume 19, Issue 2 · pp. 186–192 · PUBLISHED · DOI: 10.5530/ijopp.20260563

View on IJPP original site ↗

ABSTRACT

Pharmacogenomics (PGx), a key pillar of precision medicine, enables drug therapy customization based on a patient’s genetic profile. Pharmacists, as experts in medication, are best placed to organize the use of PGx testing, interpretation, and decision-making about therapeutics in order to optimize therapeutic outcomes. This review identifies actionable gene-drug interactions in the form of CYP2C19-clopidogrel, DPYD-fluoropyridines, and TPMT/NUDT15-thiopurines, which have clinical implications for reducing adverse drug reactions and enhancing the effectiveness. It also explores the international situation of implementing PGx where high-income nations face fragmented data architecture, issues related to guideline harmonization, and lack of reimbursement, and low- and middle-income nations are characterized by poor infrastructure, high costs, and low genomic literacy. Some of the suggested solutions are the incorporation of decision-support tools into the electronic health record, pharmacy curriculum reformation, developing subsidized testing programs, and using AI/ML to support data interpretation. Pharmacists are becoming the primary contributors to precision medicine in the hospital, community and telehealth environment, and can become the solution to making PGx no longer a specialty service provided to a limited set of patients, but the default type of service in most places worldwide.

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    Sushma, M., Venkatappa, B. B., Adinarayanareddy, V. S., Sainath, S., & Nagendra, M. (). Clinical Pharmacology and Genomic Prescription Pathways: Toward a Paradigm Shift in Individualized Drug Therapy-A Review. Indian Journal of Pharmacy Practice, 19(2), 186–192. https://doi.org/10.5530/ijopp.20260563