Pharmacogenetics

Question 1

What is the acronym used to define pharmacokinetics and what does it stand for?

Answer 1

ADME
Absorption
Distribution
Metabolism
Excretion

Question 2

What does pharmacodynamics refer to?

Answer 2

Relationship between concentration of a drug at its site of action and observed biological effects (i.e. toxicity, efficacy, no effect)

Question 3

What gene complex is responsible for the phase I metabolism of 90% of all drugs?

Answer 3

CYP450 complex

Question 4

What are the 3 main families and 6 main genes of the CYP450 complex?

Answer 4

Families:
CYP1
CYP2
CYP3
Genes: 
CYP1A1
CYP1A2
CYP2C9
CYP2C19
CYP2D6
CYP3A4

Question 5

What CYP gene is responsible for the metabolism of ~40% of all common drugs?

Answer 5

CYP3A4

has less genetic variation than other CYPs

Question 6

How do most CYPs function in drug metabolism?

Answer 6

Most CYPs function to inactivate drugs

• rarely needed to activate
  ex) CYP2D6: codeine->morphine

Question 7

What is the most commonly prescribed anticoagulant?

Answer 7

Warfarin

Question 8

Why is Warfarin difficult to calibrate to individual patients?

Answer 8

Individuals have a narrow therapeutic window
BUT
the population has a wide therapeutic range

Question 9

Why is it important to properly calibrate warfarin?

Answer 9

Under-dose = clot
Over-dose = bleed