Day 15, Lecture 3 (Sept 13): Pharmacogenomics: Cornerstone for Precision Medicine

Question 1

What is Pharmacogenomics

Answer 1

• Using patient’s genotype to optimize drug therpy and minimize toxicity
• Reverse Genetics
  
  • Using human genetics to improve existing treatments and develop new therapies

Question 2

Pharmacokinetics

Answer 2

• What the body does to a drug
  
  • absorption, distribution, metabolism, and elimination

Question 3

Pharmacodynamics

Answer 3

• Physiological effects of drug
  
  • Drug targets, pathways

Question 4

What Factors Determine Drug Response?

Answer 4

Question 5

What is the first priority of Pharmacogenomic research

Answer 5

Prediciting serious Adverse reactions (ADRs)

Question 6

Adverse drug reactions are the ___ leading cuase of death in the US

Answer 6

4th

Question 7

______ patients in the US die annually due to ADRs of prescription drugs

Answer 7

>106,000

Question 8

Cost of ADRs is ____ billions annually

Answer 8

$136 billion annually

Question 9

Why Drugs Fail?

Answer 9

Question 10

___ % of patients have poor or no response to beta blockers

Answer 10

15-35%

Question 11

Up to ___% of patients have poor or no response to ACE inhibitors (angiotensin converting enzyme)

Answer 11

28%

Question 12

____% of patients respond poorly to anti-depressants and other psychiatric drugs

Answer 12

20-50%

Question 13

__% of patients do not respond to statins

Answer 13

30%

Question 14

Answer 14

Question 15

Question 16

Answer 16

Question 17

Question 18

there are only ____ actionable PGX genes

Answer 18

20

Question 19

Importance of Single Nucleotide Polymorphisms (SNPs) in pharmacogenomics

Answer 19

• Ability to predict drug effectiveness
• Potential to predict adverse effects
• Discover new targets for drug development and diagnosis

Question 20

pharmacogenomics of Abacavir: Antiretroviral agent for HIV

Answer 20

• Allele frequency across ethnic groups
  
  • HLA-B (immune system gene)
    
    • Caucasians: 10%
    • African: 3%
    • East Asians: 3%
    • Asian Indians: 20%
  • About 50% of HLA-B allele carriers develop life threatening hypersensitivity
  • Abacavir screening for HLA-B variant is standard of care

Question 21

Therapeutic window

Answer 21

Question 22

Question 23

Answer 23

Question 24

Answer 24

Question 25

Answer 25

Question 26

Answer 26

Question 27