Lassila Warfarin

Question 1

Which alleles for the CYP2C9 metabolite occur almost exclusively in persons of African descent?

Answer 1

*5 *6 *11

Question 2

How is dosing different for those with CYP2C9 *5, *6, and *11 alleles?

Answer 2

decreased Warfarin dose

Question 3

Which alleles for the CYP2C9 metabolite occur rarely for patients of African descent?

Answer 3

*2 and *3

Question 4

Why was there conflicting data between COAG Trial and EU-PACT trials?

Answer 4

1. EU- PACT a loading dose was used and in COAG there was no loading dose
2. COAG trial was more ethically diverse (~27% AA)

Question 5

What does decreased CYP2C9 metabolism lead to?

Answer 5

increased warfarin plasma exposure

Question 6

What does decreased CYP4F2 metabolism lead to?

Answer 6

elevated vit K levels –> higher warfarin doses needed