Drug metabolism

Question 1

Drug induced lupus is associated with which gene serotype + phenotype?

Answer 1

HLA DR4
+
slow acetylator phenotype

Question 2

Which 3 clinical features of drug induced lupus?

Answer 2

1. arthralgia
2. butterfly rash
3. pleurisy

Question 3

slow acetylation is associated with which two specific adverse effects?

Answer 3

Drug induced lupus

Isoniazid induced peripheral nephropathy

Question 4

Name 7 drugs causing a lupus erythematous like sydrome
(PCP HIPS)

Answer 4

1. Phenytion
2. Chlopromazine
3. procainamide
4. hydralazine
5. isoniazide
6. penicillamine
7. sulfasalazine
   * methlydopa

Question 5

Drug concentrations will be low if patient is a slow acetyltor..

Which drugs are most affected:

Answer 5

(PD HIPS)

Phenelzine (MAOI)
Dapsone
Hydralazine
Isoniazid
Procainamide

Question 6

Name the 6 drugs affected by induction of Cytochrome P450

Answer 6

PC BRAS
1. Phenytoin
2. Carbemazepine
3. Barbituates
4. Rifampicin
5. Alcohol (chronic)
6. Sulhonylureas

Question 7

Induction of Cyto P450 leads to treatment failure with which common agents?

Answer 7

hydrocortisone
OCP
phenytoin
warfarin

Question 8

Name the 9 drugs affected by inhibition of Cytochrome P450

Answer 8

AO DEVICES
1. Allopurinol
2. Omeprazole
3. Diusulfiram
4. Erythromycin
5. Valproate
6. Isoniazid
7. Cimetidine / ciproflox
8. Ethanol intoxication
9. Sulphonamides

Question 9

Enzyme inhibition reduced the rate of metabolism and thus increases side effects / potentiates the effects of which drugs..

Answer 9

carbemazepine
cyclosporin
phenytoin
warfarin