Final Genomics (only quiz 5 material added) Flashcards
CYP4F2 — if reduced function it does what to what drug?
reduces warfarin sensitivity
what gene is related to clopidogrel
CYP2C19
what gene is related to warfarin
CYP2C9 and VKORC1 and CYP4F2
what gene is related to statins
SLOCB1
what genotype is ultrarapid metabolizer for CYP2C19
*17
what genotype is poor metabolizer for CYP2C19
*2 and *3 (multiple 2 and 3 genes)
T or F: Clopidogrel has required genetic testing
nah, just recommended — still not routinely performed before PCIs
what is warfarins MOA
Inhibits Vitamin K epoxide reductase 1
VKORC1
PK Of warfarin:
the ______ isomer is the active one
s isomer
Warfarin is eliminated by _______
CYP2C9
CYP2C9 *2 or *3 reduces warfarin clearance the most
*3 (reduces clearance 75-90%)
VKORC Haplotypes:
1639___>___
and
1173___>____
G>A
C>T
Largest doses of warfarin are needed when VKORC1 has
1639____
and
1173____
GG
CC
CYP4F2: results in less ______ for ______
vit. k; clotting factors
what types of patients would benefit from genetic testing — in regards to warfarin
high risk patients for bleeding
and
pts who can’t get INR checked all the time (way to get better guess on right dose
MOA of HMGCoA reductase inhibitors:
upregulate ________
decrease ________
LDL receptors
decrease LDL concentrations
SLOC1B1: transport drug into ______
liver
what SLOC1B1: mutations would increase statin myopathy risk
*5 and *15
CPIC reccomendations for Simvastatin 80 mg:
Avoid ____ mg dose of simvastatin (consistent with labeling)
Exception may be in a patient with a _______ genotype AND a history of tolerating the dose
80;
521TT
we know what is SNP is..what is SNV
Aberration seen in only one individual (not well characterized)
Occur at low frequency so not common
most cancer mutations are somatic or germline?
somatic!! (acquired throughout life… not inherited)
what are the two cancer genes
tumor supressor
and oncogene
For Simvastatin/CPIC Guidelines:
Max of ____ mg in patients with 521 CT and CC genotypes (i.e. *5 or *15 carriers)
20
For Simvastatin/CPIC Guidelines:
Max of 20 mg in patients with 521 CT and CC genotypes (i.e. *___ or *____ carriers)
*5; *15
For Simvastatin/CPIC Guidelines:
Max of 20 mg in patients with 521 ___ and ____ genotypes (i.e. *5 or *15 carriers)
CT;CC
For Simvastatin/CPIC Guidelines:
Routinely monitor ____ if…
521 CT and CC genotypes are present (i.e. *5 or *15 carriers) AND
20 or 40 mg simvastatin is being used
CK
For Simvastatin/CPIC Guidelines:
Routinely monitor CK if…
521 CT and CC genotypes are present (i.e. *5 or *15 carriers) AND
____ or___ mg simvastatin is being used
20 or 40
For Simvastatin/CPIC Guidelines:
Routinely monitor CK if…
521 ____ and ____ genotypes are present (i.e. *5 or *15 carriers) AND
20 or 40 mg simvastatin is being used
CT;CC
T = safe/no myopathy problems, any C is increase myopathy risk
All of the following statements are true regarding CYP4F2:
Metabolizes vitamin K to \_\_\_\_\_\_ metabolite Reduced function results in \_\_\_\_\_\_ warfarin sensitivity Its genotype contributes less to warfarin \_\_\_\_\_\_\_ than VKORC1 Reduced function (does/does not) alter warfarin pharmacokinetics
hydroxyl
decreased
dose variability
does not