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Advanced Pharmacology Exam 1 > Calculations, EBP & Pharmacogenomics > Flashcards

Calculations, EBP & Pharmacogenomics Flashcards

1
Q

1 inch

A

2.54 cm

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2
Q

1 tsp –> ml

A

5 ml

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3
Q

1000 mcg –> mg

A

1 mg

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4
Q

1:20

A

1 g of solute in 20 ml of solution

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5
Q

0.02%

A

0.02g in 100 ml

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6
Q

1 kg

A

2.2 lbs

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7
Q

1 lb –> oz

A

16 oz

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8
Q

1 tbsp –> tsp

A

3 tsp

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9
Q

1 oz –> ml

A

30 ml

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10
Q

3 principles of EBM

A

make decisions from the best available evidence

not all evidence is equal

evidence alone is never enough

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11
Q

3 components of EBP decision making

A

evidence
circumstances
values

within context

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12
Q

evidence-based approach to medication questions

A
  1. define the question (PICO)
  2. systematically search for relevant info
  3. critically evaluate the literature
  4. apply findings to patient/case/question
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13
Q

pharmacogenetics

A

study of how genetic differences in a SINGLE gene influence variability in drug response (ex efficacy and toxicity

ex. B1-adrenergic receptors on carvedilol

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14
Q

pharmacogenomics

A

study of how genetic differences in MULTIPLE genes influence variability in drug response (ex efficacy and toxicity)

ex B1 and B2 a2-adrenergic receptors and CYP2D6 on carvedilol

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15
Q

gene

A

series of codons that forms a protein

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16
Q

allele

A

sequence of nucleic acid bases at a given gene chromosomal locus

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17
Q

homozygous genotype

A

two identical alleles

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18
Q

heterozygous genotype

A

two different alleles

19
Q

phenotype

A

outward expression of genotype

20
Q

mutation

A

alteration in DNA code occuring <1% of time in the population

21
Q

polymorphisms

A

alterations in the DNA code occuring >1% of the time in the population

22
Q

single-nucleotide polymorphism (SNP)

A

single base pair difference in DNA occurring on every chromosome

23
Q

what phase of metabolism is CYP 450?

A

phase I

24
Q

examples of drugs metabolized by CYP2D6

A

codeine
nortriptyline
tamoxifen

25
Q

codeine w CYP2D6 metabolism

A

codeine is a prodrug!

poor metabolism - no pain relief but AEs

ultrarapid metabolism - pain control with AEs

26
Q

nortriptylene w CYP2D6 metabolism

A

nortriptylene is an active drug!

poor metabolism - depression relief w/ adverse effects

ultrarapid - no depression relief, no AEs

27
Q

tamoxifen w CYP2D6 metabolism

A

poor metabolism - deceased efficacy, increased risk of cancer recurrence

28
Q

CYP2D6 inhibitors

A

SSRIs prozac, paxil, zoloft - these should all be avoided w tamoxifen due to risk of recurrence!!!

29
Q

examples of drugs metabolized by CPY2D19

A

omeprazole - & all PPIs

clopidogrel

30
Q

omeprazole w CPY2C19 metabolism

A

rapid and intermediate metabolizers have decreased ulcer cure rates

31
Q

clopidogrel w CYP2C19 metabolism

A

clopidogrel is a prodrug!

poor or intermediate metabolizers have poor efficacy –> recommend other platelet inhibitors (ticagrelor or prasugrel)

32
Q

CYP2C19 inhibitors

A

proton pump inhibitors

decreased efficacy of clopidogrel -> not converted to active drug -> risk for clotting

avoid omeprazole and clopidogrel! prefer H2 antagonists/antacids (famotidine)

33
Q

examples of drugs metabolized by DPD

A

5-FU
cepecitabine
tegafur

(chemotherapy drugs)

34
Q

DPD deficiency results in

A

decreased efficacy of chemotherapy agents & risk for toxicities

severe AEs! ex. myelosuppression, mucositis, neurotoxicity, hand-and-foot syndrome, diarrhea

35
Q

example of drug metabolized by UGT 1A1

A

ironetecan - tx for colon cancer

36
Q

AEs with irenotecan UGT1A1 metabolism

A

diarrhea

neutropenia

37
Q

examples of drugs metabolized by thiopurine S-Methyltransferase (TPMT)

A

azathioprine
6-MP
6- thioguanine

anticancer/immunologics

38
Q

G6PD deficiency causes

A

excessive hemolysis of RBCs

39
Q

example of drugs metabolized by G6PD

A

carbamazepine

ribavirin

40
Q

carbamazepine w G6PD deficiency

A

risk of stevens johnsons syndrome and TEN

41
Q

why do we need to be cautious with warfarin?

A

narrow therapeutic range due to CYP2C9 and VKORC1

42
Q

what resource provides authoritative info regarding drugs for breastfeeding?

A

lactmed

43
Q

what resource provides comprehensive information regarding drug use during pregnancy and lactation?

A

Brigg’s

44
Q

what is an authoritative reference for antibiotic prescribing and dosing?

A

john hopkins abx guide

Advanced Pharmacology Exam 1 (4 decks)

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