Genomic Medicine in Primary Care Christine Kessler MN, CNS, ANP-BC, BC-ADM, CDTC, FAANP B2 Genomic Medicine in Primary Care Newsinhealth.gov Christine Kessler MN, CNS, ANP-BC, BC-ADM, CDTC, FAANP Metabolic Medicine Associates Co-chair Metabolic & Endocrine Summit (MEDS)
[email protected] Objectives Have you been using genetic (“-omic”) testing in your facility for the following? Have you wondered why….? Or WHY? • Do so many people receive no benefit or greater side effects from Is caffeinated coffee highly beneficial for some (like me) but deadly for prescribed medications? others? • Do some people have more severe symptoms and morbidities with COVID-19? • Do some people develop greater CV risk eating a Mediterranean diet than reduced risk? Or “therapeutic” diets don’t work for everyone? • Do some people have severe hypertension & DM but NO kidney issues? • Do some people have prolonged sequela from TBI than others with same injury? • Do some people gain weight eating the same calories than a skinnier person eats regardless of exercise? Giphy.com 1 Genomic Medicine in Primary Care Christine Kessler MN, CNS, ANP-BC, BC-ADM, CDTC, FAANP B2 Unless you Healthgrades.com nih.gov are an It is illogical to assume all people have equal RISKS to health or RESPONSE to drugs, foods or food components!! identical twin ….but are we really? Hopewellva.gov directorsblog.nih.gov Pinterest.com A case to ponder • PT: 9 y/o boy • Hx: ADHD, OCD, Tourette disorder • Rx: methylphenidate, clonidine and fluoxetine • Symptoms: vague c/o of nausea, occasional vomiting and mild HA developing slowly first weeks/months of Rx • What next: Genes-environment-biology • Reported to PCP but missed consideration of drug-source • Progressed to overt metabolic toxicity symptoms with severe GI distress, low grade fever, incoordination, disorientation and – finally generalized seizures….coma…death • Adoptive parents under investigation Which drug(s) were the problem & why? Goals of Precision Medicine 1.