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Genome\u2010wide association and candidate gene finding studies suggest analgesic and sedatives tailored to an individual's genetic makeup, environmental adaptations, in addition to several other patient\u2010 and drug\u2010related factors, will maximize effectiveness and help mitigate harm. However, the number of pharmacogenetic studies in ICU patients remains small and no prospective studies have been published using pharmacogenomic data to optimize analgesic or sedative therapy in critically ill patients. Current recommendations for treating ICU pain and agitation are based on controlled studies having low external validity, including the failure to consider pharmacogenomic factors affecting response. Use of a precision medicine approach to individualize pharmacotherapy focused on optimizing ICU patient comfort and safety may improve the outcomes of critically ill adults. Additionally, benefits and risks of analgesic and\/or sedative therapy in an individual may be informed with large, standardized datasets. The purpose of this review was to describe a precision medicine approach focused on optimizing analgesic and sedative therapy in individual ICU patients to optimize clinical outcomes and reduce safety concerns.<\/jats:p>","DOI":"10.1002\/phar.2768","type":"journal-article","created":{"date-parts":[[2023,1,21]],"date-time":"2023-01-21T02:34:32Z","timestamp":1674268472000},"page":"1154-1165","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["A pharmacogenetic precision medicine approach to analgesia and sedation optimization in critically ill adults"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1527-6830","authenticated-orcid":false,"given":"Amy L.","family":"Dzierba","sequence":"first","affiliation":[{"name":"Department of Pharmacy New York\u2010Presbyterian Hospital  New York New York USA"},{"name":"Center for Acute Respiratory Failure Columbia University College of Physicians and Surgeons and New York\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna L.","family":"Stollings","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Services Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1751-9012","authenticated-orcid":false,"given":"John W.","family":"Devlin","sequence":"additional","affiliation":[{"name":"School of Pharmacy Northeastern University  Boston Massachusetts USA"},{"name":"Division of Pulmonary and Critical Care Medicine Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,3]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"National Institutes of Health.All of UsResearch Program [Internet]. 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