Block 4 Flashcards
Pro/Con of Cost-consequence?
Good = Straightforward cost results
Bad = difficult to make value comparison between alternatives
Tricyclic antidepressants involve which CYP?
CYP2C19 + CYP2D6
Antipsychotics + Genotype?
Little evidence that shows efficacy is a factor regarding CYP2D6 or CYP2C19, other CYPs are used
Most info focus in drug-drug interactions
Poor metabolizers + Antidepressants?
Decrease dose by 50%
Pro/Con of Cost-utility?
Good = incorporates quality of life
Bad = can be difficult to interpret
Intermediate metabolizers + Antidepressants?
Decrease dose by 25% then evaluate response
Pro/Con of Cost-benefit?
Good = strong theoretical foundation
Bad = viewed with skepticism
Analytical Validity
Clinical Validity
Clinical Utility
How well does the diagnostic test differentiate responders vs non-responders or predict AE to a specific drug?
Clinical Validity
Pro/Con of Cost-effectiveness?
Good = relevant for clinicians/health care decision makers
Bad = cannot compare interventions between disease states
Gene prevalence vs penetrance?
Prevalence = how common
Penetrance = Variant and drug response
What drug transporters are involved in GI tract or BBB?
Pgp encoded by ABCB1
Pro/Con of Cost-minimization?
Good = simple
Bad = effectiveness of alternatives are equal
What’s up with SSRI used for depression?
Inhibitor of CYP2C19 + CYP2D6
Carbamazepine (antiepileptic) + Genotype?
HLA-B*1502 = black box warning of Asian ancestry
Can cause skin reactions, stevens-johnson syndrome
Phenytoin (antiepileptic) + Genotype?
HLA-B*1502 = Asian + European
Europeans are recommended for CYP2C9 testing and 25% lower dose in poor metabolizer status