Pharm2 11 Pharmacogenetics Flashcards Preview

Pharmacology > Pharm2 11 Pharmacogenetics > Flashcards

Flashcards in Pharm2 11 Pharmacogenetics Deck (14)
1

identify innovative drug targets; account for DNA sequence variation on drug effects, develop new agents

PharmacoGENOMICS

2

optimize drug efficacy, minimize drug toxicity via a genetic basis

PharmacoGENETICS

3

The basis of pharmacogenetics revolve around the existence of:

polymorphisms
Defined as genetic variations that occur in > 1% of population
Many involve cytochrome P450 isoenzyme

4

CYP2D6 drugs (5)

tricyclics, antidepressants, antiarrhythmics, β-receptor antagonists, codeine

5

CYP2C9 drugs (2)

warfarin, phenytoin

6

CYP2C19 drugs (2)

Omeprazole, clopidogrel

7

CYP2A6 drug

nicotine

8

Ethnic group (2)
CYP2D6

Asians, African Americans

9

Ethnic groups CYP2C19

Asians

10

Ethnic groups CYP2A6

Asians

11

What may play a role in tobacco dependency in Asians?

CYPA6 pathway

12

Pathway problem?:
A 27 yo Asian patient returns to your practice for f/u 48 hours after having some minor surgery done. You had prescribed Tylenol #3, two tabs po q4h prn pain.
He is complaining of continued pain (pain scale 7/10), and is complaining of nausea, vomiting and GI distress.

Probable poor metabolizer, CYP2D6 variant.

13

Pathway problem?
A patient in your practice is s/p recent diagnosis of DVT. She was seen in the ER, given heparin followed by warfarin.
After 4 days, you get an INR to see if therapeutic. You find that this patient has an INR >6.
You administer vitamin K to help reverse the INR, but are in a quandary as to what is happening.

CYP2C9

14

Pathway problem?
A patient with newly diagnosed seizure disorder is placed on phenytoin.
After a week, you get your first set of phenytoin levels. The patient’s level is 26.
What are your thoughts?

Three big issues:
Possible CYP2C9 variance
Narrow therapeutic index of phenytoin
Capacity-limited pharmacokinetics of phenytoin.
Decrease dose, recheck levels, monitor for adverse reactions
PCR-RFLP testing may be needed