Pharmacogenomics is an essential means to achieve personalized medicine. Multi-gene and multi-loci panel testing is an inevitable trend in its development, comprehensively analyzing the impact of genes on medications from the perspective of drug metabolism, efficacy, and adverse reactions, thereby formulating individualized regimen plans. Based on the requirements for detection throughput, nucleic acid mass spectrometry with medium throughput has become a suitable platform for pharmacogenomic testing. In this review, we examine the application of this technology in clinical pharmacogenomics, discuss its current challenges, and put forward suggestions for advancing its clinical application and precision medicine.

Background: Precision medication emphasizes tailored treatment approaches based on individual patient characteristics, yet the limitations in current drug target identification hinder therapeutic advancements.

Objective: s This review aims to explore innovative strategies for identifying druggable targets (a biological target that is known to or is predicted to bind with high affinity to a drug) and enhancing their therapeutic potential within the framework of precision medication.

Methods: We examine various methodologies employed to assess the targets’ abilities in forming drugs, including computational modeling, network analysis, and multi-omics integration. Recent technological advancements in machine learning facilitate the extraction of relevant features from large datasets, improving target prioritization.

Results: Despite existing challenges in the landscape of targeted therapies—such as limited targets and high clinical failure rates—emerging data-driven approaches show promise in refining the drug discovery process. Enhanced validation frameworks are essential to mitigate risks associated with inadequate target assessment during early discovery phases.

Conclusions: The identification of viable druggable targets is critical for advancing personalized treatment options. By integrating diverse biological datasets and employing cutting-edge predictive tools, researchers can streamline drug development pathways, ultimately leading to more effective therapeutic interventions tailored to specific patient populations. This review highlights the need for innovative strategies in drug target discovery to unlock the full potential of precision medicine.

Precision medicine relies on individuals’ genetic information, omics characteristics, and environmental factors to achieve personalized disease prevention, diagnosis, and treatment. With the successful mapping of the entire human genome and the rise of various cutting-edge omics technologies, precision medicine has ushered in an era of accelerated development. However, there are still many challenges in the implementation of precision medicine, such as insufficient accumulation of clinical evidence, the complexity of data interpretation, and there is a long road ahead before it can be widely available. Close cooperation among multiple disciplines is necessary. Policy support, technological and methodological innovation in academia and industry, and competent precision medicine teams are important factors in the advancement and implementation of precision medicine. Precision prevention, diagnosis, and treatment of diseases require guidance from various levels of data, underscoring the value of big data in the era of precision medicine. It also imposes higher demands on physicians and pharmacists to be capable of prescribing the right drug to the right patient at the right time and at the right dose. The era of precision medicine will be a new era for them to demonstrate greater professional value.

Precision emergency medicine (EM) represents a transformative approach to healthcare, integrating advanced technologies and human-centric data to tailor treatments to individual patient needs. This commentary explores the integration of pharmacy practice into the precision EM framework, highlighting the crucial role of pharmacists in improving treatment efficacy and optimizing patient outcomes. We discuss the drivers of precision EM, including the utilization of digital health tools, artificial intelligence (AI), and machine learning to refine pharmacogenetic recommendations, as well as the challenges and solutions related to implementing these advanced practices in emergency departments. The importance of collaborative multidisciplinary efforts, enhanced training in health data literacy, and policy advocacy for supporting genomic research and education reform is highlighted. This commentary also reflects on the growing necessity for pharmacists to adapt and evolve with the emerging technologies and protocols that define precision EM. The integration of pharmacogenetics, predictive analytics, and collaborative healthcare strategies promises to refine the effectiveness of emergency medicine and establish new standards in patient care, emphasizing precision, efficacy, and safety.

With the ongoing societal development and changes in lifestyle, the incidence of cardiovascular diseases continues to rise. Although the most effective means of preventing atherosclerotic cardiovascular disease, heart failure, and atrial fibrillation is the lifelong promotion of a healthy lifestyle, pharmacological treatment plays a critical role in the comprehensive management of cardiovascular diseases, with an increasing demand for effective drug management. Effective medication management aids in controlling disease progression, reducing the occurrence of complications, and improving patients' quality of life. Therefore, understanding and mastering the importance of drug toxicity and prescription review in the management of cardiovascular diseases is crucial. Moreover, outpatient time plays a pivotal role in the treatment and recovery of patients. Through appropriate medication management and outpatient practices, better patient management and personalized medical services can be achieved. This paper will focus on discussing the significance of drug toxicity and prescription review in the context of cardiovascular disease management.

In the context of rapid development of clinical pharmacy in China, therapeutic drug monitoring (TDM) has become a vital tool for rational medication and is widely concerned. TDM combines the knowledge of pharmacokinetic and pharmacodynamic to optimize individualized drug therapy, which can ensure drug efficacy, avoid excessive accumulation of drug, and reduce drug-drug interaction. Drug therapy in elderly patients is often accompanied by age-related changes in the processes of drug absorption, distribution, metabolism and elimination. The pharmacokinetic and pharmacodynamic behaviors of elderly patients differ significantly from those of normal adult population, which may lead to treatment failure or drug toxicity. TDM allows clinician to optimize dose and provides the most viable approach to individualize therapy. By researching the published literature, it is found that little data are available with respect to the special effect of TDM in elderly patients. Herein, focusing on elderly patients, we summarize types of commonly monitored drugs, therapeutic windows, and track the tends and opportunities of TDM. The purpose of this paper is to call for more attention to TDM in elderly patients. TDM should be implemented for the elderly to overcome age-related differences between dose and plasma concentration, to monitor possible drug-drug interaction, and to guide dose adjustment.

The greater the complementarity between pharmacists’ knowledge and doctors’ knowledge, the more significant the role pharmacists can play in clinical practice. Physicians extensively use drugs for disease management and are well-versed in the medications related to their specialties. Conversely, surgeons often prioritize surgical procedures over medication, which can lead to more frequent irrational drug uses in surgical departments compared to internal medicine department. Given this, pharmacists could play a pivotal role in surgical departments. In 2018, the Guangdong Province Pharmaceutical Association (GDPA) in China advocated for the establishment of surgical pharmacist in hospitals. Surgical pharmacists are tasked with overseeing all aspects of medication management during the perioperative period and beyond and serve as a bridge between surgeons and physicians. The GDPA has established "surgical pharmacy" as a distinct knowledge system for surgical pharmacists, which is defined as a specialty that studies the characteristics of surgical medication, seeks the most suitable medication therapy and addresses medication-related problems for surgical patients to improve clinical outcomes. Focus on perioperative medications, such as anti-infection, anti-thrombosis, analgesia, nutrition, blood sugar, blood pressure, fluid, nausea and vomiting management, and glucocorticoid use. In Guangdong province, many major hospitals have now established surgical pharmacist positions, accepted by surgeons and physicians. Unlike pharmacists in surgical settings outside of China, those endorsed by the GDPA engage directly in patient care through collaborative drug therapy management (CDTM), positioning them as integral members of the surgical team alongside surgeons and anesthetists rather than members of the multidisciplinary team, having their own specialty - "surgical pharmacy". Thereby surgeons concentrate on surgical procedures and anesthetists on anesthesia, while pharmacists focus on medication therapy. This delineation enhances the efficiency and effectiveness of patient care in surgical departments.

Drug-induced liver injury is a significant contributor to cases of acute liver failure and the primary reason for drug withdrawal due to safety concerns. Acetaminophen (N-acetyl-para-aminophenol, APAP) is a widely used antipyretic and analgesic drug worldwide. It has been reported that APAP-induced hepatotoxicity accounts for approximately 50 % of acute liver failure cases in Europe and the United States. Currently, N-acetylcysteine is still the only drug approved for the treatment of APAP-induced hepatotoxicity. Nevertheless, its restricted therapeutic window constrains its clinical utility. There is an urgent need to find new drugs for the prevention and treatment of APAP-induced liver failure. Mitochondria are the main toxic targets of APAP, playing important roles in the injury, progression, and recovery stages of its hepatotoxicity. Excessive poisonous metabolites of APAP, such as N-acetyl-benzoquinone imine (NAPQI), can bind to mitochondrial proteins, inducing mitochondrial oxidative stress and changes in membrane permeability, leading to the release of pro-apoptotic factors into the nucleus and causing hepatocyte death. Mitochondrial fusion and fission, autophagy, and biogenesis collectively constitute the mitochondrial quality control system, which plays an important role in maintaining mitochondrial homeostasis and resisting APAP hepatotoxicity. Traditional Chinese medicine (TCM) is a treasure of the Chinese nation, with many herbal medicines used clinically for liver protection. Previous reviews summarized that TCM exerted its protective effects by reducing oxidative stress, combating inflammation and anti-apoptotic pathways. However, few reviews highlighted the regulating effects of TCM on mitochondrial function. This review focuses on elucidating the effects of TCM on regulating mitochondrial oxidative stress and mitochondrial quality control system and preventing APAP-induced liver failure, providing a theoretical basis for developing preventive and therapeutic drugs for APAP-induced liver failure from TCM in the future.