Exam 1- Lectures 3 & 4 Flashcards
1 cause of monogenic hypercholesterolemia
familial hypercholesterolemia (FH)
FH is
autosomeal co-dominant
FH class 1
no LDL receptors made
treatment for FH
HMG-CoA reductase inhibitors (statins)
what class can you not treat with HMG-CoA reductase inhibitors (statins) and why?
class 1- bc it requires at least some working receptors.
what kind of enzyme is NAT2?
phase II enzyme
NAT2 is
autosomal dominant
all NAT2 mutations are
SNPs
what is the function of NAT2?
detoxification/inactivation of xenobiotics by acetylation
slow acetylations due to NAT2 mutation increase risk of what cancers?
lung, liver, colon, bladder, non-hodgkin’s lymphoma
slow acetylators:
increases toxicities
fast acetylators
decreases therapeutic effects
drug toxicity
drug induced anemia (G6PD enzyme)
drug efficacy
colorectal cancer (K-ras & EGFR)
what drugs can cause drug induced anemia due to GDPD
primaquine, salicylates, sulfonamides, nitrofurans, vitamin K derivatives
G6PD is
x-linked recessive
EFGR pathway
causes tumor proliferation if activated
what mutation can occur in tumor cells that makes it not respond to the receptor and be always activated ?
k- ras
a patient would not respond to anti-EGFR therapy if
the tumor has a k-ras mutation
pharmacokinetics is
what the body does to the drug
ADME
absorption
route of dose
first pass metabolism
active transport systems
distribution
protein binding
tissue barriers
metabolism
chemical structure changes in drug
phase I/phase II
P450
Elimination
kidneys/liver
milk
skin, hair
methods in identifying drug response phenotype
drug metabolism drug receptors drug transporters biomarkers- efficacy & toxicity disease susceptibility
major pharmacogenomic considerations
intestinal wall/drug uptake
liver, first pass metabolism
food/water composition
decreased first-pass metabolism often leads to
increased drug bioavailability
alpha1-acid glycoprotein
mainly binding of basic drugs
ORM2- most important; major source of variability in the binding of basic drugs
C3435T mutation
causes reduced levels of P-gp & higher plasma [] of drugs transported through P-gp
P-gp is a biomarker for
drug resistance & prognosis in cancer patients
P-gp is a target for
novel anticancer agents
multiple drug resistance protein (MRP) transport what?
acids
organic acid transporter (OAT) transports
organic acids
Organic anion transporting polypeptide (OATP) transports
lipophilic agents
organic cation transporter (OCT) transports
efflux of cations
test 1=
required
test 2=
recommended
test 3=
info only