Personalized Medicine

Question 1

Most common drugs to have ADRs

Answer 1

diuretics, opioids, anticoagulants

Question 2

HLA-B*5701

Answer 2

pharmacogenetic test for a single gene

tests for abacavir

Question 3

Oncotype DX

Answer 3

pharmacogenetic test for 16 genes

tests for breast cancer progression

Question 4

HER2 status by FISH

Answer 4

Used for breast cancer to decide treatment with antibody
Probe DNA that is complimentary to DNA you are interested in and you incubate it in tissue and look for the glow
If the probe responds really well to HER2 (2+ or 3+), then it will work with Trastuzumab, but if it doesn’t then it prob won’t work

Question 5

Clopidogrel is metabolized by what?

Answer 5

prodrug that is metabolized by CYP2C19
intermediate metabolizers and poor metabolizers have increased risk of CV event
IM= needs higher dose
PM= alternate agent

Question 6

Abacavir has what adverse effect?

Answer 6

HSR= idiosyncratic hypersensitivity rxn
Decreased HSR in African Americans
associated with HLA-B*5701 (more in Caucasian males) –> must screen for this marker now prior to initiating therapy

Question 7

Oncotype DX

Answer 7

helps classify cancer pts to determine if they need chemotherapy or not

Question 8

Types of chemotherapy

Answer 8

Traditional/ cytotoxic
Targeted= trastuzumab; antibody that kills only cells expressing HER2
Hormonal= tamoxifen, aromatase inhibitors; cancer can a lot of times have estrogen receptors that can stop them from growing

Question 9

Interpreting Oncotype DX

Answer 9

• Low risk= do not use chemo cause it will have no benefit
• Intermediate risk= little improvement but not statistically significant
• High risk= use chemo