Genomics PDF Flashcards by Veronica Robinson

T/F
Responses to drugs vary between individuals

True

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Which routes typically provide for a short time interval until both intended effects and adverse effects are observed?

Inhalation
IV

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agents used to create and maintain an anesthetized state carry a high risk of a variety of life-threatening effects, such as

changes in intracranial pressure
apnea
bradycardia
vasodilation

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T/F
Anesthetic drugs usually have a small therapeutic window.

True

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T/F
Culture can influence a person’s response to a drug.

True
commonly eaten foods of that culture may alter certain metabolic enzymes

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“ethnic pharmacology” or “ethnopharmacology

cultural and environmental factors influence on drug response

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ethnopharmacology

more accurately refers to the study of a culture’s traditional use of plants for medicinal purposes

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Kalow’s findings

individual differences in the amount of plasma cholinesterase exist as a result of genetics

patients undergoing electroconvulsive therapy experienced a longer-than-expected effect from intravenously administered succinylcholine.

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Pharmacogenetics is a blend of which two sciences?

genetics and pharmacology

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T/F
Pharmacogenetics and pharmacogenomics can be used interchangeably.

True

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Xenobiotics

nonindigenous chemical substances

body sees them as foreign

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Enzymatic systems have developed as a result of…

exogenous substance exposure

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T/F
Repeated exposure to substances is not sufficient to cause anatomic and physiological change.

False

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Repeated exposure to substances can change…(2)

-drug targets
-biochemical systems performing ADME

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Esterases and amidases perform which type of chemical reaction?

hydrolysis

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Flavins are located within which metabolic system?

monooxygenase system

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amino acid N-acyl transferases perform what kind fo chemical reaction?

acetylation

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In humans, there are currently ___ known functionally active enzymes.

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CYP1A2 is involved in the metabolism of…

caffeine
ondansetron
theophylline

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CYP3A4 is involved in the metabolism of…

dexamethasone
fentanyl
oxycodone

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vast majority of drug oxidation involves six CYP enzymes…

CYP1A2
CYP2C9
CYP2C19
CYP2D6
CYP2E1
CYP3A4

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T/F
CYP1A2 or CYP3A4 are enzymes

False
these are genes

the gene that correlates with the enzyme carries the same label but is identified by italic

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T/F
CYPs can be altered by exposure to the chemicals they metabolize.

True

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T/F
If a parent drug compound is more rapidly metabolized, more drug will be available to exert effects.

False
less drug available to exert effect

Rapidly metabolized drugs require (higher/lower) doses for the intended effect if the parent drug is responsible for the effect.

higher vs. prodrug quickly metab into active metabolites --> more active metabolite available --> risk toxicity (when active metabolite is responsible for producing effect)

T/F Prodrugs can be minimally active or inactive.

True

Metabolism of codeine

the parent compound is metabolized more rapidly into the active metabolite more of the active drug metabolite will be available quickly and could lead to a toxic effect

T/F Diet and nutrition are modulators of enzymatic systems.

True

Foods can be seen as....

ingested chemicals

What foods/vitamins alter the effectiveness of Coumadin?

Vit K leafy greens (kale, spinach)

Phytochemicals

"phytonutrients" naturally occurring chemicals in plants that we eat

Phytochemical effects

antioxidants or exhibiting anti-inflammatory effects induce/stimulate cytochrome P-450 enzyme CYP1A2 increases rate of phase I

Lutein is found in..

leafy greens

Beta-carotene is found in...

carrots and pumpkins

Lycopene is found in...

tomatoes

Phytonutrient found in Paclitaxel

Pacific yew tree brand name: Taxol antineoplastic agent

Phytonutrients stimulate which CYP450 enzyme? What does this do?

CYP1A2 increases rate of Phase I metabolism

shown to decrease cytochrome P-450 enzyme activity

Apiaceae family, like carrots and celery

Effects of grapefruit juice on metabolism

interferes with the first-pass metabolism & transport inhibit the intestinal cytochrome P-450 enzyme activity but facilitate drug absorption increased plasma drug level

examples of drugs affected by grapefruit juice

felodipine saquinavir midazolam erythromycin

Grapefruit juice ultimately leads to (increased/decreased) plasma drug levels.

increased

How long do the metabolic effects of grapefruit juice last?

several days

foods high in solanaceous glycoalkaloids

potatoes, tomatoes, and egg- plants

Solanaceous glycoalkaloids reportedly inhibit which compounds?

-acetylcholinesterase -butyrylcholinesterase (plasma cholinesterase

Solanaceous glycoalkaloids affects the metabolism of...

cocaine ester-type local anesthetics NMB esmolol (in potatoes, tomatoes, eggplants)

populations at risk for altered responses to: cocaine ester-type local anesthetics NMB esmolol

Turkey, Morocco, and Middle Eastern (seems like mediterranean?)

Heaviest users of alcohol

Non-Hispanic whites and males between the ages of 18 and 44

How does Acute alcohol intoxication affect drug metabolism?

-higher risk of injury -vomiting -delayed gastric emptying -decisional incapacity -increased sensitivity to other drugs because of its additive depressant efects.

elevated blood alcohol levels (increase/decrease) sensitivity to other drugs because of their ___ effects.

increased sensitivity depressant

Chronic alcohol use is associated with increased risk of post-op ___.

infection

drinking alcohol may modulate synaptic and extrasynaptic ___ receptors in the ____.

g-aminobutyric acid (GABA) thalamus

Would duration of NMB agents in a chronic drinker be longer or shorter?

longer hypoalbuminemic and/or has impaired hepatic blood low, drug distribution and metabolism will be impaired.

Chronic alcohol use induces which CYP enzyme in particular? What is the end result?

CYP2E1 possibly need higher doses for drugs used during an anesthesia (propofol, barbiturates, opioids, and the minimum alveolar concentration (MAC) of inhalation agents)

Chronic drinkers may need (higher/lower) minimum alveolar concentration (MAC) of inhaled agents.

higher

CYP metabolism of some parent compounds to their toxic metabolites, like ___ & ___, provokes hepatotoxicity.

acetaminophen and halothane

T/F The prevalence of smoking is higher among adults than teenagers. (U.S.)

False teenage prevalence is higher

What attributes of smoking influence its effect on drug metabolism?

-length of time an individual has smoked -makeup of the cigarettes -how the smoker inhales

components of cigarette smoke

-benzene -polyphenols -arsenic -carbon monoxide -polycyclic aromatic hydrocarbons (PAHs)