Exam 1 - Pharmacogenomics Flashcards
study of how an individual’s genes influence effects of drugs on that individual’s health
pharmacogenomics
entire genetic information of an organism
genome
study of structure and function of genomes
genomics
reduces adverse drug events (ADEs, something related to patient that gets reported), reduces health care costs, improves health care outcomes, stakeholders demand use of PGx
applications of PGx to health care
anticoagulants, antidiabetics, antiepileptics, opioids, aspirin
most common ADR culprits
lead to increased length of hospital stays, readmission rates, total hospitalization costs, inpatient mortality
ORADEs (opioid related ADEs)
pharmaceutical companies received this saying that they must use genomic information as part of med guides
FDA issued guidance
President Bush signs this into law in 2008
Genetic Information Nondiscrimination Act (GINA)
how many nucleotides in human genome?
3.2 billion
what percentage of the human genome constitutes genes?
less than 2%, many repeated sequences, many movable/jumping elements
gene or element that moves from place to place in genome
movable/jumping elements
our genomes are ____ not ____, ______% same only _____% different, these differences are what cause us to respond differently to _____
similar, same, 99.9, 0.1, drugs
chromosomes number variations, gene copy number variations,insertion/deletion nucleotides, SNPs
types of DNA sequence variations
differences in one nucleotide, good because it is better than, for example, a whole chromosome being added/deleted, predominate variations (98%)
single nucleotide polymorphisms (SNPs)
study of biological variation and principles governing the inheritance and maintenance of that variation
definition of genetics
variation is essential for survival, some variation may be disadvantageous (the ones that get discarded), or may be advantageous (the ones that stay)
central assumptions of genetics
threadlike structures in which an organism’s genetic material is organized, composed of DNA RNA proteins (eukaroytic), composed of two chromatids joined at centromere, normally present in pairs, different species have different numbers of these, specific to each organism
chromosomes
somatic cells, double chromosome number (2N/2n)
diploid cells
reproductive cells/gametes have half the number of chromosomes (N/n) as that of somatic cells
haploid cells
technique to display chromosomes
karyotyping
chromosome pairs 1-22 are called _____ while pair 23 is called ____ and is designated ____ or ____
autosomes, sex chromosomes, XX, XY
Down syndrome
trisomy 21, extra copy of chromosome 21
severe retardation, death
trisomy 13, extra copy of chromosome 13
microcephaly (smaller brain size)
trisomy 18, extra copy of chromosome 18
behavioral defects
trisomy X, extra copy of chromosome X in females
sterility, gynecomastia (breasts developed)
XXY, extra copy of X in males
hyperactivity
XYY, extra copy of Y in males
physical transfer of part of one chromosome to another, often cause schizophrenia or bipolar disorders and some cancers
translocations
why does DNA folding happen?
DNA is a very large structure and needs to fit inside nucleus of cells, also needs to be able to unfold at will
coiling and compaction is an intrinsic property of cellular DNA, all cellular DNA is reversibly supercoiled to various degrees, cellular proteins affect degree of coiling and compaction
DNA supercoiling
enzyme that bind to DNA/”rides” DNA, enzyme opens DNA strand but remains attached to 3’ end of DNA, once enzyme releases itself of DNA a phosphodiester bond is formed to close DNA strand (anytime there is a strand that is broken and remain unfixed the cell will die), relieve supercoiling of DNA
mechanism of action of topoisomerases
cut only one strand of DNA and unwind supercoils
Type I topoisomerases
cut both DNA strands and unwind supercoils
Type II topoisomerases
make it so that topoisomerases must remain bound to DNA, in case of antibiotics, the drug remains bound to bacterial DNA to cause cells to die because broken strands that remain unfixed die
topoisomerase inhibitors
gastric, colon, lung, ovarian cancers, leukemias
camptothecin
testicular, lung, gastric cancers, leukemias, sarcomas
etoposide (VP-16)
breast cancer, osteogenic sarcomas, lymphomas
doxorubicin
leukemia
daunorubicin
acute lymphoblastic leukemia
teniposide (VM-26)
used against pathogens resistant to other antibiotics
moxifloxacin
used against pathogens resistant to other antibiotics and anthrax
ciprofloxacin
mass of nucleic acids (mostly DNA, some RNA) and proteins in the nucleus of eukaryotic cells, undergoes physiochemical changes depending on cell physiology
chromatin
diffused open structure that represents active genes
euchromatin
compact dense structure that is inactive
heterochromatin
fundamental organizational unit of chromatin, formed by DNA and tightly bound proteins (histones), DNA wraps around histones which is important for cancer treatment
nucleosomes
small proteins with high basic amino acid content, five major classes
histones
dynamic nature of chromatin structure governs its function, structure regulates DNA replication, expression, amplification, silencing of genes
therapeutic applications of chromatin structure
chromatin structure application, cancer treatment
histone deacetylase
chromatin structure application, cancer treatment, heart disease
Poly-ADP-Ribose polymerase
chromatin structure application, viral diseases including HIV
DNA polymerase, reverse transcriptase, integrase
most eukaryotic non-gene DNA is ______, about half of which is derived from _______
repetitive, transposable elements (TEs), so of the 98% of DNA that aren’t genes about half of that is movable throughout the genome, may cause mutations
ends of a chromosome, unique function during DNA replication
telomere
highly repetitive DNA, critical in cell division, middle of chromsome
centromere
basic unit of inheritance responsible for determining a trait of an organism, contains all genetic information necessary and sufficient for producing a functional polypeptide or RNA molecule
gene
regulate expression of genes
promoters
sequences that do not code for proteins
introns
code for part or all of a specific protein or RNA product
exons
removes intronic RNA, joins exonic RNA, makes mature message
splicing
amyotrophic lateral sclerosis (ALS), calcium-activated K+ channel in inner ear hair, muscular dystrophy, dementia
alternative splicing defects
skeletal muscle atrophy, X-linked, defects in dystrophin, different forms or subtypes, DMD most common
muscular dystrophy
largest gene in humans, encodes largest human protein dystrophin, multiple isoforms produced by alternative splicing, mutations known to affect splicing
DMD (Duchenne MD) genetics
____ can be in any place on the gene
deletions
during transcription, transcription factors skip certain exons
exon skipping
single stranded oligonucleotides, complementary to target pre-RNA or mRNA, modulate translation and increase/decrease protein level
antisense oligonucleotides (AONs) as drugs
drug used for age related macular degeneration
Macugen / AON: Pegaptanib
drug used for muscular atrophy
Spinraza / AON: Nusinersen
drug used for HF Hypercholesterolemia
Kynamro / AON: Mipomersen
drug used for DMD
Exondys 51 / AON: Eteplirsen
basic unit of hereditary final product may be protein or RNA
gene
different form of a gene, in a population there may be more than one of these per gene
allele
only one copy essential to exhibit a trait
dominant
two copies of allele required to exhibit a trait
recessive
indicates presence of two alleles that are exact copies of each in the same individual organism
homozygous
two different alleles of a gene in the same individual organism
heterozygous
description of the genetic composition of a specific trait
genotype
description of a physical, physiological, biochemical, pharmacological, clinical presentation of a trait, some are visible and others are not
phenotype
any physical or chemical change in the genetic material of an organism, may occur anywhere in the genome of an organism, anytime in the life cycle of an organism, may be disadvantageous/advantageous to organism, heritable these transmitted to offspring
mutations
study of inheritance of a trait in several generations of genetically related individuals, provides valuable information, help understand inheritance patterns of traits within families (many generations), important method of studying inheritance of a known disease or defect, requires precise reliable set of clinical features associated with the conditions, 3-4 generations used, management and counseling
pedigree charts
manifests even if only one copy of the allele is present, males and females are affected in same ratio, condition does not skip generations, whether or not offspring will inherit a dominant trait is 50%, more common in structural protein genes (brittle bone disease), may also result in gain-of function (additional function may be advantageous or deleterious)
autosomal dominant genes/inheritance
Huntington disease, color blindness, polycystic kidney disease, familial hypercholesterolemia
examples of dominant gene disorders