GBP11

Question 1

List four reasons why a patient might fail to respond to treatment

Answer 1

Metabolism
Interactions
Resistance
Pharmacogenetics

Question 2

What pharmacogenetic differences can cause failure to respond to treatment

Answer 2

difference in pharmacokinetics, dynamics or ethnicity

Question 3

What is the most common polymorphism

Answer 3

SNP single nucleotide polymorphism

Question 4

What is an example of a genetic polymorphism that changes metabolism of a drug

Answer 4

abnormal CYP2D6 makes people poor metabolises of debrisoquine

Question 5

What effect does variable metabolism have on Codeine

Answer 5

Codeine needs to be metabolised to be active so reduced response in poor metabolisers

Question 6

What is the significance of poor metabolism of tamoxifen

Answer 6

is not converted to active state meaning patients are less responsive to treatment for breast cancer

Question 7

Which drug does a polymorphism of CYP2G9 have an effect on

Answer 7

Warfarin, need to be careful as may have increased effects=increased bleeding

Question 8

What are dietary effects on warfarin

Answer 8

Vitamin K rich foods can reduce effectiveness (as vit.k antagonist)

Question 9

What is the problem with Aspirin and pharmcogenetics

Answer 9

quarter of patients are resistant to it