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Flashcards in Genomics Deck (33)
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1
Q

amitryptyline metabolism pathway

A

2C19 activates it

2D6 deactivates

2
Q

2D6 genotypes

A
  • normal = 1, 2

- non-functional = 3-8

3
Q

amitryptyline 2C19 recommendations

A
  • avoid in ultrarapid and poor metabolizers

- standard dose in extensive and intermediate

4
Q

amitryptyline 2D6 recommendations

A
  • avoid in ultrarapid and poor

- 25% reduction in intermediate

5
Q

simvastatin gene involved in metabolism

A

SLCO1B1

6
Q

simvastatin genotypes/phenotypes

A
  • TT = standard
  • TC = intermediate
  • CC = low function
7
Q

simvastatin dosing recommendations

A
  • TT = normal
  • TC = lower dose or alternative
  • CC = lower dose or alternative
8
Q

methotrexate metabolism by

A

SLC19A1

9
Q

methotrexate mutation

A

SNP at SLC19A1

10
Q

methotrexate recommendations

A

no definitive recommendations

-higher risk of toxicity has been seen

11
Q

clopidogrel metabolism

A

2C19

12
Q

clopidogrel phenotypes

A
  • Ultra = 17
  • extensive = 1/1
  • intermediate = 1 and 2-8 or 17 and 2-8
  • poor = 2-8
13
Q

clopidogrel recommendations

A

any loss of function allele should get alternative therapy

-still use in ultra rapid

14
Q

bupropion metabolised by

A

2B6

15
Q

bupropion moderately inhibits

A

2D6

16
Q

gene related to smoking cessation in bupropion

A

ANKK1

17
Q

bupropion recommendations

A
  • loss of 2B6 may need other treatment

- ANKK1 AA or AG may have decreased response

18
Q

codeine metabolism

A

2D6

19
Q

codeine recommendations

A

-alternative in ultra rapid and poor

20
Q

aripiprazole metabolism

A

3A4

2D6

21
Q

aripiprazole recommendations

A
  • poor 2D6 = reduce dose by half

- poor 2D6 + 3A4 inhib = reduce to 1/4

22
Q

drugs to do HLA-B*5701 test for

A

abacavir

carbamazepine

23
Q

patients to do HLA testing when using allopurinol

A

chinese

24
Q

warfarin metabolism

A

VKORC

2C9

25
Q

normal VKORC1 genotypes

A

G

C

26
Q

VKORC1 mutations

A

G > A

C > T

27
Q

2C9 genotypes

A

1 - normal

2,3 - reduced

28
Q

warfarin recommendations

A

no specific, maybe use table

29
Q

irinotecan mutation

A

UGT1A1*28

30
Q

irinotecan recommendations

A

if UGT1A1*28 is present reduce dose by 30%

31
Q

tamoxifen metabolism

A

mainly activated 2D6

some 2C9 and 3A4

32
Q

tamoxifen recommendations

A
  • avoid in poor
  • consider something else in intermediate
  • ultra rapid is fine
33
Q

gene of interest in cetuximab and panitumumab

A

KRAS

if its not present then they won’t work