1. Pharmacogenetics/Pharmocogenomics - Campbell

Question 1

What is the difference between pharmacogenetics and pharmacogenomics?

Answer 1

Pharmacogenetics consider a single gene.

Pharmacogenomics considers the genomics (the idea to cover a lot more of the genome, so hundreds and thousands of genes, rather than one single gene). In addition, pharmacogenomics is used in deciding gene therapy (ex. warfarin).

Question 2

What drugs is the most dose-adjusted drug? For what drug is there notably precise dosing information given genetic and environmental information? (Hint-same answer)

Answer 2

Warfarin.

Question 3

What is special about Warfarin (aka. Coumadin)?

Answer 3

Most dose adjusted drug. Because it needs a very specific dose.

Question 4

What enzyme converts VKORC1 into gamma-glutamyl carboxylate? What does this affect?

Answer 4

Vitamin K epoxide reductase-1 converts VKORC1 into GGCX, which affects clotting and affects anticoagulation

Question 5

What does Warfarin relationship to VKORC1?

Answer 5

Warfarin inhibits VKORC1.

Question 6

What five genes have polymorphisms that are included in the algorithm by which the predicted maintenance dose is obtained? What is the physiological relevance of each gene’s protein to the dosing of the drug?

Answer 6

VKORC1: drug target for warfarin
GGCX: part of vitamin K recycling (reverses the action of VKORC1)
Calumenin: regulates both of the activation of VKORC1 and GGCX.
CYP2C9: degrades warfarin.
CYP4F2: oxidizes Vitamin K (therefore needing more wafarin)

Question 7

If CYP2C9 levels are high, what do you need to do to warfarin dosage?

Answer 7

Increase warfarin dosage to overcome degrading activity of CYP2C9

Question 8

What is wafarin’s action on vitamin K?

Answer 8

Warfarin inhibits Vitamin K, therefore affecting clotting.

Question 9

What is the definition of biopharmaceutical?

Answer 9

A drug made by a cell that is not normally made by that cell. The first drug of this was insulin.

Question 10

What gene has an important role in Rheumatoid and Arthritic diseases? Why? What are inhibitors of this drug?

Answer 10

TNF-alpha.
There is too much TNF-alpha being made/read.

Inhibitors:
Enbrol
Remicade
Humira
(By Bill)