Pgx

Question 1

List the CPIC antidepressant recommendations for CYP2D6 Ultrarapid metabolisers (3)

Answer 1

Paroxetine (change to alt)

Vorioxetine (either incr dose or change)

Venlafaxine (incr dose)

Question 2

List the CPIC antidepressants recommendations for CYP2D6 Intermediate metabolisers (1)

Answer 2

Paroxetine (decr dose)

Question 3

List the CPIC antidepressant recommendations for CYP2D6 poor metabolisers. (4)

Answer 3

Paroxetine (decr dose)

Fluvoxamine, Vorioxetine, Venlafaxine (decr dose or change to alternative)

Question 4

List the CPIC antidepressant recommendations for CYP2C19 Ultrarapid and rapid metabolisers (1)

Answer 4

Escitalopram (incr dose or use alternative)

Question 5

List the CPIC antidepressant recommendations for CYP2C19 intermediate metabolisers (2)

Answer 5

Escitalopram and Setraline (decr dose)

Question 6

List the CPIC antidepressant recommendations for CYP2C19 poor metabolisers (2)

Answer 6

Setraline and Escitalopram (decr dose or switch to alternative)

Question 7

What does HLA predict and whats the exception?

Answer 7

predicts hypersensitivity risk except flucloxacillin where HLA predicts liver failure

Question 8

What is the most accurate description of *1 allele?

Answer 8

Absence of variant covered by the genotyping test

Question 9

List the resources for Pgx-guided prescribing (4)

Answer 9

CPIC
DPWG
PharmGKB
Sequence2Script

Question 10

What are the 2 caveats of Pgx?

Answer 10

1) *1 = wild type allele represents absence of variants included in the genotyping test

2) Phenoconversion

Question 11

Define Phenoconversion

Answer 11

The alteration of Phenotype by social, behavioural and environmental factors e.g. CYP inhibitor/ inducer, liver impairment, nutrition