Kruse: Intro to Biotransformation, Pharmacogenomics, and Clinical drug trials Flashcards

1
Q

What kind of metabolite does the phase 1 rxn make?

A

-usually, a more polar one

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2
Q

What CYP450 enzyme is responsible for most of the phase one rxns?

A

-CYP3A4

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3
Q

In the slow acetylator phenotype, what enzyme is mutated?

A
  • N acetyltransferase levels

- involved with isoniazid (TB tx)

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4
Q

What are the CYP inducers?

A

-Phenobarbital, chronic ethanol, aromatic hydrocarbons (smoking), rifampin, St. John’s wort

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5
Q

CYP inhibitors

A

-Grapefruit juice effect!

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6
Q

What do you give people for acetaminophen overdose?

A

-N acetyl cysteine

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7
Q

What is the most common disease producing enzyme defect of humans?

A
  • G6PD deficiency

- makes NADPH, which regenerates glutathione from its oxidized form

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8
Q

What is a Lead compund?

A

-a chemical compund that has pharmacological or biological activity and whose chemical structure is used as a starting point for chemical modifications in order to improve potency, selectivity, or pharmacokinetic parameters

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9
Q

What is no effect dose

A

-the maximum dose at which a specified toxic effect is not seen

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10
Q

What is minimum lethal dose(LDmin)

A

-the smallest dose that is observed to kill any experimental animal under a defined set of conditions

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11
Q

What is median lethal dose (LD50)?

A

-the dose that kills approximately 50% of the animals

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12
Q

What is Phase 0 of clinical trials

A
  • microdoseing of prospective drug candidates are administered to human volunteers
  • doesn’t cost much
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13
Q

Phase 1

A
  • determines whether humans and animals show significantly different responses
  • usually the first stage in humans
  • small number of healthy volunteers
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14
Q

Phase 2

A
  • larger group of pts that have the target disease
  • single blind
  • this is where drug failure typically occurs
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15
Q

Phase 3

A
  • further establishes drug safety and efficacy of a large groupt of pts
  • crossover double blind
  • intent is to gather additional info
  • most expensive phase
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16
Q

What happens after Phase 3 trials are good to go?

A

-NDA: new drug application

17
Q

What is Phase 4?

A
  • after approval to market a new drug
  • continues to monitor the safety of the new drug
  • no fixed duration
18
Q

complete phase 1 metabolism will yield what kind of product?

A
  • more polar products

- remember, phase 1, think CYP enzymes

19
Q

Is glucuronidation a phase 2 or phase 1 rxn?

A

-phase 2

20
Q

what does smoking do to CYP450 enzymes?

A
  • induces it

- so, smoking will increase clearance of some drugs

21
Q

What are we talking about when we are asking about pharmacodynamic things?

A

-the drug target

22
Q

Which CYP will do phase 1 for warfarin?

A

-CYP2C9

23
Q

what is the antidote for warfarin?

A

-vitamin K

24
Q

if someone has hemolytic anemia, what enzyme has a weird polymorphism?

A

-G6PD defect

25
Q

What enzyme takes care of succinylcholine?

A

-Butyrylcholinesterase

26
Q

Inhibitor of CYP3A4

A

-grapefruit juice

27
Q

if a person has hemolytic anemia, their hemolysis is most likely due to a reduction in which thing?

A
  • NADPH
  • G^PD uses NADP and G6P
  • makes 6PG and NADPH… that can then go on to make Hb and GSH
28
Q

What gets codeine?

A

-CYP2D6

29
Q

What gets clopidogrel?

A

-CYP2C19

30
Q

What gets isoniazid?

A

-N-acetyltransferase

31
Q

What gets succinylcholine?

A

-Butyrylcholinesterase

32
Q

What gets 6 mercaptopurine?

A

-Thiopurine S-Methyltransferase (TPMT)

33
Q

What gets Warfarin?

A
  • CYP2C9

- VKORC1

34
Q

is there any generally applicable relationship between age and overall elimination plasma half lives of drugs

A

-no, there is not because elimination half-life depends on the drug, not its class