Flashcards in Pharm2 11 Pharmacogenetics Deck (14)
identify innovative drug targets; account for DNA sequence variation on drug effects, develop new agents
optimize drug efficacy, minimize drug toxicity via a genetic basis
The basis of pharmacogenetics revolve around the existence of:
Defined as genetic variations that occur in > 1% of population
Many involve cytochrome P450 isoenzyme
CYP2D6 drugs (5)
tricyclics, antidepressants, antiarrhythmics, β-receptor antagonists, codeine
CYP2C9 drugs (2)
CYP2C19 drugs (2)
Ethnic group (2)
Asians, African Americans
Ethnic groups CYP2C19
Ethnic groups CYP2A6
What may play a role in tobacco dependency in Asians?
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.
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.