Pharm 737 Exam 2 Flashcards
The process of drug disposition includes what functions?
Absorption
Distribution
Metabolism
Excretion
Cytochrome P enzyme controls these functions:
Oxidation
Reduction
Hydrolysis
Cytochrome P450s:
Heme-containing enzyme responsible for Phase 1 metabolism reactions
Detoxification of foreign pollutants
Regulate Blood Homeostasis
Cytochrome 2Cs
Are found most abundantly expressed in human liver
metabolizes 15-20% of prescribed and OTC drugs
CYP3A4
most abundantly expressed P450 in human liver
Metabolizes over 120 different drugs
SNP on CYP3A5
Creates a non-functional enzyme by introducing an early stop codon, creating a non-functional protein
CYP3A4/5 Regulation
requires both pregnane X receptor and Reitinoid X receptor as well as something to dimerize the two in order to activate CYP3A for enzyme production.
SLC and ABC
Solute carrier transporter - passive and active transporters that rely on chemical or electrical gradients for transport
ATP-binding Casette - Primary active transporters that are ATP-dependent
Biomarker
Gene, Protein, or other change that indicates a biomedical phenotype before that phenotype is clinically apparent.
What is Warfarin used for and how does it work?
The most commonly prescribed anticoagulant for the treatment and prevention of thromboembolic events. It is a synthetic derivative of coumarin, which was originally developed as rat poison, (class of Vitamin K antagonist), it decreases blood coagulation by interfering with vitamin K metabolism.
Warfarin Metabolism
Metabolized by CYP2c9 and inhibits Vitamin K complex (VKORC1). a deficiency in CYP2C9 would result in increased risk of bleeding.
S-warfarin has five times the potency of the R-isomer with respect to vitamin K antagonism
What is Clopidogrel used for and how does it work?
Antiplatelet Drug for stent associated thrombosis. (up to 30% of patients do not dispay adequate antiplatelet response to clopidogrel) Metabolized by Cyp3A4
Statins are metabolized by:
Are metabolized by CYP3A4
ApoE4 is associated with:
An allele within Chromosome 19 that has been associated with late onset form Alzheimer’s disease
Antimicrobial Therapy and G6PD deficiency is
G6PD deficiency linked to increased risk of hemolysis.
Individuals taking primaquine reduced their expression of G6PD and developed hemolytic anemia.
N-Acetyl Transferase (NAT2) Polymorphism
result in slow acetylators, these polymorphisms may modulate the risk of cancer of lung, bladder, and colon due to NAT2 acetylation of aromatic amines found in tobacco smoke and cooked foods.
Isoniazid pathway
NAT2 activates
Hydrolysis leads to excretion