Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

I&I WC1 > Clinical Pharmacology I - Pharmacogenetics > Flashcards

Clinical Pharmacology I - Pharmacogenetics Flashcards

1
Q

Which factors influence the dose of a drug that a patient receives?

A
  • Absorption
  • Metabolism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is pharmacogenetics?

A

DNA analysis to explain/predict the response of a patient to drug therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which factors affect the blood concentration and therefore the effect of a drug? (2)

A
  • Receptors
  • Effectors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which path do drugs travel through the body?

A

Ingestion → intestine → blood → liver → blood → urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What determines the liver metabolizing capacity?

A

Cytochrome P450 enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How many percent of all hospitalizations are due to Adverse Drug Reactions?

A

5-7%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What defines the therapeutic window?

A

Range of doses at which the drug is effective in producing the desired therapeutic effect while minimizing adverse effects.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which CYP enzymes are mainly involved in metabolizing drugs? (4)

A
  • CYP3A4
  • CYP2D6
  • CYP2C9
  • CYP2C19
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What kind of drugs are metabolized by CYP3A4?

A
  • Oncology drugs
  • Psychiatric drugs
  • Cyclosporin, tacrolimus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What kind of drugs are metabolized by CYP2D6?

A
  • Anti-depressives
  • Antipsychotics
  • Beta-blockers
  • Tamoxifen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What kind of drugs are metabolized by CYP2C9?

A

Anti-coagulation drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What kind of drugs are metabolized by CYP2C19?

A
  • Anti-depressives
  • Clopidogrel
  • Proton pump inhibitors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which types of metabolizers exist? (4)

A
  • Ultrarapid metabolizer (UM)
  • Normal metabolizer (NM)
  • Intermediate metabolizer (IM)
  • Poor metabolizer (PM)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does an Ultra-Rapid metabolizer have genome-wise?

A

An extra copy of CYP2D6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which CYP2D6 variant alleles are most abundant in the African American population?

A
  • 2850C>T
  • 1023C>T
  • Gene duplication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which CYP2D6 variant alleles are most abundant in the Caucasian population?

A
  • 2850C>T
  • 1846G>A, 100C>T
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What could be a probable reason for the increase of CYP2D6 gene duplication when you travel further down the South (towards Africa)?

A

Diet changes, probably has detoxifying purposes

18
Q

You are seeing a patient that complains that the antidepressivum nortripyline you prescribed him 3 months ago, does not have any affect. What could be the possible causes of this? (2)

A
  • Non-compliance
  • CYP2D6 ultra rapid metabolism
19
Q

What could be the cause of (severe) side-effects?

A

Poor metabolizing

20
Q

What are the dosing guidelines for metoprolol?

A

UM: 250% of standard dose
IM: 50% of standard dose
PM: 25% of standard dose

21
Q

Which CYP enzyme metabolizes tramadol?

22
Q

Which CYP enzyme inactivates antidepressants such as imipramine and metoprolol?

23
Q

Name two immunosuppressants that play a role in pharmacogenetics

A
  • 6-Mercaptopurine
  • Azathioprine
24
Q

How many percent of the population is deficient in CYP2D6?

25
Which kind of therapies can benefit the most from CYP2D6 genotyping?
Antidepressant therapy
26
How many percent of the population is an intermediate metabolizer of TPMT?
11%
27
What is the dosing guideline for an intermediate metabolizer of TPMT?
50% of the standard dose
28
Which treatment can benefit form TMPT genotyping?
Azathioprine treatment
29
Which patients material can you obtain to perform a genetic analysis on?
- EDTA blood - Cheekswab
30
Name an anti-coagulation drug which is being metabolized by CYP2C19?
Clopidogrel
31
Which enzyme inactivates voriconazol?
CYP2C19
32
What are the most important inactive alleles of CYP2C19?
*2, *3
33
What is the most hyperactive allele of CYP2C19?
*17
34
How many percent of the caucasian population is an ultra-rapid metabolizer of CYP2C19 and which mutation is most common?
6%, *17*17
35
What can be said about the metabolism and trough concentrations of voriconazol in ultra-rapid and rapid metabolizers?
- Increased metabolism - Low trough concentrations
36
What can be said about the metabolism and trough concentrations of voriconazol in poor metabolizers?
- Reduced metabolism - High trough concentrations
37
True or False: "The risk of getting adverse side effects is highest when you are a poor metabolizer of voriconazole."
True. Caused by high trough concentrations
38
Which CYP enzymes metabolize tacrolimus?
CYP3A4 and CYP3A5
39
What can be said about the CYP3A5 expression between individuals?
It varies - Caucasians: 80% non-expresser - Africans: 30% non-expresser
40
How do you adjust the tacrolimus dose for CYP3A5 expressers?
Significantly increase it
41
Why do you have to increase the tacrolimus dose for CYP3A5 expressers?
- CYP3A5 inactivates tacrolimus - Most individuals (80%) are a CYP3A5 non-expresser
42

I&I WC1 (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions