When I was in nursing school, I learned about genetics in biology class, but never heard the terms genomics or pharmacogenomics. Today, these are three terms that we really need to consider when we assess our patients and develop their plans of care.
The study of genomics helps explain why some people can exercise 30 minutes every day, follow a heart-healthy diet and strict medical regimen, and still die of an acute myocardial infarction at the age of 50; but others smoke, eat whatever they want, never go to a healthcare provider, and live to be over 100 years old. Nine of the 10 leading causes of death, including cancer, cerebrovascular disease, diabetes, and heart disease, are believed to be influenced by genomics.1,2 Understanding genetic and family history can help clinicians and researchers develop screening tools and interventions that can improve health and may even prevent some diseases. As genetic and genomic tests and technology become more widespread, understanding these concepts will be an important part of providing good nursing care.
The study of pharmacogenomics helps to explain why some drugs work for some patients, but aren't effective or cause adverse reactions in other patients. We know that adverse drug reactions are a significant cause of hospitalization, increased length of stay, and even death. Pharmacogenomics can help us to do an even better job individualizing drug therapy related to drug choice and dose. As we move into the future, I believe that pharmacogenomics will play a bigger role in individual treatment plans for some disease processes.
In this issue, authors Elizabeth L. Pestka, MS, RN, PMHCNS-BC, APNG, and Margaret F. Dretsch, BSN, RN, explore these topics in "Using genetics and genomics in critical care nursing." And because, as Elizabeth says, basically all of the disorders treated in the critical care setting have genetic and genomic underpinnings, we've invited Elizabeth and Margaret to contribute a regular column on genetics and genomics and their implications for critical care nursing practice. In future issues, this new column will be exploring topics such as the pharmacogenomics of warfarin metabolism and the genomic implications of alcoholism. I'm confident that these articles will influence all of our practices.
I encourage all of you to learn more about genetics, genomics, and pharmacogenomics, and to incorporate these concepts into your everyday critical care practices.
Until the next time: be healthy, be happy, and be great advocates for your patients!!
AnneMarie Palatnik, MSN, RN, APN-BC
Director of Clinical Learning Center for Learning Virtua Health Mount Laurel, N.J. [email protected]
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