Exam 1 - principle of drug individualization Flashcards

1
Q

segment of DNA that contains information for encoding a protein.

A

Gene

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

SNPs
Single nucleotide polymorphism

A

. e.g. rs10516526
an alteration of a single pair in a DNA sequence

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

alleles

A

Different DNA sequences at a locus. e.g. rs10516526 G

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

genotype

A

Pair of alleles at a particular locus:

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

is the observable property of an organism; a trait such as height, weight, medical condition, etc.

A

Phenotype

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

A set of DNA variations, or polymorphisms, that tend to be inherited together

A

halpotype

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

Factors that make individuals or subgroups of a population different from the rest

A

Diversity

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

What are the three main factors affecting patient drug response

A

Environment
Biology
genetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why should you personlize/individualize medicine? why not just use reccomended dose?

A

becuase current knowledge of dosage, outcomes and results of drugs are based on statistics.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is pharmacogenomics

A

the study of how genes affect a persons response to drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the goal of pharmacogenetics (two different phrases)

A

“to get the right dose of the right drug to the right patient at the right time”
“to enhance drug efficacy and reduce drug toxicity”

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

What is a big reason that statistical drug doses do not work for certain populations

A

the statistics were based on people who are “middle of the curve” AKA they were all one race, no co-morbitities, middle-aged ect. If the drug is not working on a person or population it is likely that person or population is “outside the middle of the curve”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the hardest administration type to absorb

A

oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the easiest administration type to absorb

A

intravenous

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

Describe the systemic approach to genetic variations (What, who, how how)

A

What - (what are the genetic variations and what is affected: such as enszymes, transporters, receptors or disease.)
Who - determine who is imacted (what population of indiviuals such as the obese population, a certain race, or age group)
How - how is this relevent to the drug (?)
and how is this relevant to a disease (?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What reactions occur during phase one of drug metabolism

A

oxidation, hydroxylation, reduction, and hydrolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the example for phase 1 of drug metabolism

A

CYPs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What reactions occur during phase 2 of drug metabolism

A

conjugation

19
Q

normal metabolizing persons.

A

extensive metabolizers

20
Q

individuals who are homozygous with two homozygous alleles that are abnormal which results in inactive or absent enzymes

A

Poor metabolizers

21
Q

in between extensive and poor becuase they are heterozygous for the normal and abnormal metabolizing gene

A

Intermediate metabolizer

22
Q

resulted from normal gene duplication or multiplication (look at slide 17 if you are confused)

A

ultra-rapid metabolizer

23
Q

___________________ a transport system superfamily that is one of the largest and possibly one of the oldest gene families

A

ATP binding cassette (ABC)

24
Q

Those who lack CYP2D6 or who do not posses CYP2D6 that works well are considered

A

poor metabolizers

25
Q

CYP2D6 determines __________

A

whether someone has good (high CYP2D6) metabolism or bad (low CYD2D6) metabolism. (Maybe for this specific drug tamoxifen)

26
Q

What is the job of CYPs

A

oxidation, hydroxylation, reduction and hydrolysis

27
Q

what is the job of CYP2D6 specifically

A

hydrolysis

28
Q

INR

A

international normalized ratio

29
Q

UGT1A1*28

A

What is the genetic variant/marker for irinotecan

30
Q

CYP2D6

A

What is the genetic variant/marker for codeine

31
Q

CYP2C19

A

What is the genetic variant/marker for clopidogrel

32
Q

SLCO1B1

A

What is the genetic variant/marker for Simvastatin

33
Q

HER2+

A

What is the genetic variant/marker for Trastuzumab (for breast cancer)

34
Q

ABCB

A

MRD1 -> reduced expression

35
Q

ABCG pathway 1

A

BCRP —> increased expression —-> increased drug clearance

36
Q

ABCG pathway 2

A

BCRP—-> loss of transport activity

37
Q

ABCG pathway 3

A

BCRP —> low expression, impaired transport activity, increased protein poteasoma degredation

38
Q

ABCC pathway 1

A

MRP1 –>reduced transport activity

39
Q

ABCC pathway2

A

MRP2—> no mRNA expression

40
Q

ABCC pathway 3

A

MRP3—> reduced expression

41
Q

ABCC pathway 4

A

MRP4—>reduced expression and function

42
Q

VKOR is responsible for

A

vitamin k synthesis which is reqquired for coagulation

43
Q

how does warfarin work

A

warfarin blocks VKOR –> VKOR is needed for vitamin K synthesis which is needed for coagulation