There is a rapidly growing body of evidence linking genetic polymorphisms with functional changes in proteins that are responsible for the metabolism and disposition of many medications. Likewise, polymorphisms in genes encoding the targets of medications (e.g. receptors) can alter the pharmacodynamics of the drug response by changing receptor sensitivity. As a result, the inherited basis of drug effects is often polygenic in nature, and thus more challenging to define. However, technological advances, coupled with new insights into the molecular pharmacology of medications and the functional consequences of polymorphisms in the human genome, are providing the tools needed to elucidate genetic determinants of drug response, and translate functional genomics into personalized medicine.