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You may be one of the patients who do not respond to treatments that are effective in 80 percent of the cases. This may be due to problems at the receptors (where the drug is supposed to act) or drug metabolism. After absorption in the small intestine, the drugs travel to the liver where they are broken down into more water soluble products that can be eliminated by the urine. A fraction of the parent-drug escapes this breakdown, reaches the blood stream and is distributed to all the cells in the body; and where ever there is a receptor to which the drug can chemically bond, the drug will exert its action, i.e., will activate or inhibit this receptor.


The drug deactivating process is carried out by liver enzymes. Most people have the right amount of these enzymes, but you (for genetic reason) may have too little or too much. In the first instance, you will not tolerate that drug(s) even when taken at a dose lower than the average and will present bad side effects, which prevents increasing the dose to a therapeutic level.
On the other hand, the therapeutic level may not be reached because you may have too much liver enzyme activity, which almost completely destroys the drug and thus only a small fraction reaches the blood and ultimately the receptors.


When you have too much or too little liver enzyme, the result will be the same — inadequate blood concentration and consequently lack of response to that drug(s). In the current clinical practice, the right drug/dose to you has been a blind and lengthy trial and error process, which imposes further burden to your well-being, academic, personal, professional and family life.


Dr Dorgival Caetano’s pharmacogenetics expertise, with the aid of a simple blood test, can sort your genetic liver enzymes make up and find the right drug/dose for you, overcome your ‘treatment-resistance’ and provide you with a more personalised treatment.