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Iterative trial and error processes of pharmacotherapeutic management can be optimized by assessing and incorporating pharmacogenetics. For 82 PwCF, we reviewed 2\u2009years of medication use and response history and interrogated metabolizer status for common pharmacogenes, revealing 3336 medication exposure events (MEEs) to 286 unique medications. As expected, the more frequent MEEs were those commonly used to treat cystic fibrosis (CF), such as antibiotics and respiratory medications. Antibiotics also comprised 56.7% of the undesirable drug responses. The impact of gene variants on drug responses was assessed using Pharmacogenomics Knowledgebase (PharmGKB) and Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines. Thirty\u2010three (11.5%) medications have strong evidence of genetic influence on response as evidenced by gene\u2010based dosing guidelines. 110 (38.5%) unique medications had at least one association with a very important pharmacogene, whereas 143 (50%) were associated with at least one clinical or variant annotation. Over 97% of participants had at least one actionable genotype. Eleven (13.4%) patients with an actionable genotype, taking the impacted medication, had an undesirable drug response described in the CPIC guidelines that could potentially have been mitigated with a priori knowledge of the genotype. PwCF take many medications for disease management, with frequent dose changes to elicit a desired clinical effect. As CF care evolves, implementing pharmacogenetics testing can improve efficiency and safety of prescribing practices using precision selection and dosing at medication initiation.<\/jats:p>","DOI":"10.1111\/cts.13479","type":"journal-article","created":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T06:44:20Z","timestamp":1676011460000},"page":"662-672","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Pharmacogenetic actionability and medication prescribing in people with cystic fibrosis"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8894-3876","authenticated-orcid":false,"given":"Justin D.","family":"Anderson","sequence":"first","affiliation":[{"name":"Gregory Fleming James Cystic Fibrosis Research Center University of Alabama at Birmingham (UAB)  Birmingham Alabama USA"},{"name":"Division of Pulmonary and Sleep Medicine, Department of Pediatrics University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6717-2649","authenticated-orcid":false,"given":"Brittney H.","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gracie","family":"Giang","sequence":"additional","affiliation":[{"name":"McWhorter School of Pharmacy Samford University  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"April","family":"Jones","sequence":"additional","affiliation":[{"name":"McWhorter School of Pharmacy Samford University  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cameron R.","family":"Lee","sequence":"additional","affiliation":[{"name":"McWhorter School of Pharmacy Samford University  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kennedy","family":"Parker","sequence":"additional","affiliation":[{"name":"Gregory Fleming James Cystic Fibrosis Research Center University of Alabama at Birmingham (UAB)  Birmingham Alabama USA"},{"name":"Division of Pulmonary and Sleep Medicine, Department of Pediatrics University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Searcy","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Sleep Medicine, Department of Pediatrics University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim","family":"Benner","sequence":"additional","affiliation":[{"name":"McWhorter School of Pharmacy Samford University  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nita\u00a0A.","family":"Limdi","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer S.","family":"Guimbellot","sequence":"additional","affiliation":[{"name":"Gregory Fleming James Cystic Fibrosis Research Center University of Alabama at Birmingham (UAB)  Birmingham Alabama USA"},{"name":"Division of Pulmonary and Sleep Medicine, Department of Pediatrics University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,2,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2012.05.034"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2008.09.007"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1754.2006.00943.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25535"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201207-1160OE"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lpm.2017.05.011"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/GIM.0b013e318238b38c"},{"key":"e_1_2_10_9_1","unstructured":"Table of pharmacogenomic biomarkers in drug labeling.2022."},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.273"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25809"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.1651"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.2174\/1389200215666140130124910"},{"key":"e_1_2_10_14_1","first-page":"59935","article-title":"Investigational new drug safety reporting requirements for human drug and biological products and safety reporting requirements for bioavailability and bioequivalence studies in humans. 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