Chapter 6 deck 2

Question 1

Among the many reasons for genetic variations, an interesting one that specifically apply for CYP to D6 is

Answer 1

Gene duplication. The name suggests, some necessities, duplication of the illegal coding for 2D six result in increased protein expression or for ultra-rapid metabolism and markedly reduced activity some drugs. The percentage of populations that shows June duplication the CYP to D6 across different countries shown below

Question 2

CYP2D6 and Tamoxifen

Answer 2

Recently, the normative effects in variable is a forms of CYP 226 have on metabolism and therapeutic efficacy of tamoxifin in some patients have received much attention. With referenct to tamoxifen, the rol of CYP2D6 is not so much the metabolism of this durg as it is to activate it by conversion to endoxifen inside the cell. Parmacogentic vation of CYP2D6 has been shown in clincal trials conduced in the UK an dgermany to lead to veraiabl hearputic otcums in strogen sensitive cnacers

Question 3

CYP2D6 and opiod analgesics

Answer 3

Opioid analgesics such as coding rely on sips like this one to convert them to their active form, morphine. Genetic polymorphisms of CYP to the six enzyme can greatly alter the effect that coding has on patients who are for metabolize visual Ultram tranquilizers. Ultra metabolize or types we not experience analgesic effect of the drug and normal doses or metabolizes may not be able to convert coatings with active metabolite morphine, thus experience and little or no clinical benefit. Other narcotics that are active when administered to patients they produce effects of asset access road and even lower end of therapeutic dosing

Question 4

In August 2012 the Food and Drug Administration acknowledged that it was considering the legal codes of coding and some pediatric patients and estimated that

Answer 4

Number of ultra-rapid metabolizes is generally 1 to 7 per 100 people, may be as high as 2100 and some ethnic groups. Consequently in April 2017, the FDA at the black box warning to the drug levels of coding containing cough syrup and pain medications Tina Conine should not be used in children younger than 12 years including a warning for codices and children aged 12 to 18 years obese, have obstructive sleep apnea, severe lung diseases

Question 5

CYP 2C9 is the primary route of metabolism for

Answer 5

About 100 different drugs in humans. All sums CIP to see nine substances are the most common drugs, such as glipizide, losartan, and celecoxib. Other drug substrates include those of have a narrow therapeutic index, such as phenotoin in the entity regular divisions

Question 6

Warfarin acts by inhibiting the enzyme

Answer 6

Vitamin K epoxide reductase, which prevents the formation of functional vitamin K. This action in turn inhibits the activation of clotting factors in the letter, causing the anticoagulant effect.

Question 7

Warfarin is available as a racemic mixture, of which the S-enantiomer, which is the more bioactive form, metabolized by

Answer 7

CYP to C9.

Question 8

The presence of CYP to see nine mutations associated with a reduction in the metabolism of

Answer 8

S-warfarin

Question 9

Work remains dosing requirements are lower in patients with

Answer 9

CYP2c9*2

CYP2c9*3

Question 10

CYP2c9* 2 variant evinces a ___ and a the cyp2c9*3 varriant a ___ reduction in warfarna cleaance resulting in adjusted dose requirements in these patients compared to noncarriers

Answer 10

30%

90%

Question 11

CYP3A4

Answer 11

Group of Iceland and is responsible for 50% of the metabolism. As I stand in his response (Williams 1:5 the family is in primary care samples of the classes included -azole antifunglas, calcium channel blockers, antihistamines, anticonvulsants, microbials, words.

Question 12

P glycoprotein

Answer 12

The membrane-bound, ATP dependent transport system responsible for the reflux of a variety of venal bionics from cells the extracellular fluid. This included the ejection of drugs from cells, usually cancer concentration gradients. PGP, also known as multidrug resistance protein is a product of ABCB1 and ABCB4 genes and is a member of the adenosine triphosphate fighting Family Court.

Question 13

Differential expression of PGP explain

Answer 13

Tissue specific and temporal variations in East looks efficacy in different cells. In fact, chemoresistance than cancer therapeutics is strongly linked with PGP expression, more PGP protein expressed by the so the greater the floats potential of Zeno bionics such as anticancer drugs.

Question 14

PGP at the site of the GI tract

Answer 14

effluxes hydrophilic drugs out of the cells and inhibts drug absorption throug ht GI tract. As drugs passively diffuse through the GI tract, Pgp pumpms move drugs from the cytoplasmic areas to extracellualr fluid.

Question 15

PGP affects

Answer 15

the level of digoxin available for absorption and elmination.

Question 16

If a pgp is administered then blood levels of substrates will

Answer 16

rise as seen when quinidine is administered with digoxin

Question 17

Drugs can be categorized as

Answer 17

Reversible suicidal inhibitors were PGP. For example calcium channel blockers and high dose steroids are considered as reversible inhibitors of both PGP’s and CYP 450.

Question 18

Grapefruit and ritonavir are

Answer 18

Suicidal agents for both PGP and CYP 450, meaning the effect of grapefruit juice will be prolonged, perhaps of the 24 hours

Question 19

The CYP 450 enzyme and families 1 to 3 mediate

Answer 19

78% to 80% of all phase I dependent metabolism of clinical use drugs

Question 20

The polymorphic forms of CYP 450s are responsible for

Answer 20

The development of a video syncretic ADRs.

Question 21

56% of all drug cited in AR studies are metabolized by

Answer 21

Polymorphic phase I enzymes which 86% are P 450s

Question 22

VKORC1

Answer 22

An encoding subunit of the vitamin K at the Zide reductase complex, was found to cause a rare syndrome of warfarin resistance. Subsequently the variance have been found to account for much greater fraction variability in warfarin response up to 21%

Question 23

2007 the FDA in the black box warning to carbamazepine recommending testing

Answer 23

HLA-B*1502 allele in patients with Asian ancestry for initiating therapy because these patients are at high risk for developing Stevens-Johnson syndrome or toxic epidermal necrolysis.