Pharmaco-Genetics

Question 1

What drugs are affected by alterations in CYP2C9? What response effected?

Answer 1

Drugs: Tolbutamide, warfarin, phenytoin, NSAIDs

Response affected: Anticoagulant effect of warfarin

Question 2

What drugs are affected by alterations in CYP2C19? What response effected?

Answer 2

Drugs: Mephenytoin, omeprazole, hexobarbital, mephobarbital, propranolol, proguanil, phenytoin, clopidogrel

Response affected: Peptic ulcer response to omeprazole, CVS events after clopidogrel

Question 3

What drugs are affected by alterations in CYP2D6? What response effected?

Answer 3

Drugs: B- blockers, antidepressants, antipsychotics, codeine, debrisoquine, etc.

Response affected: Tardive dyskinesia from antipsychotics, narcotic side effects, codein efficacy, imipramine dose requirement, B-blocker effect

Question 4

What drugs are affected by alterations in CYP3A4? What response effected?

Answer 4

Drugs: Macrolides, cyclosporine, tacrolimus, Ca2+ channel blockers, midazolam, steroids, etc.

Response affected: Efficacy of immunosuppresive effects of tacrolimus

Question 5

What are the inducers and inhibitors of CYP1A2? Is this enzyme associated with polymorphisms?

Answer 5

Inducers: Aromatic hydrocarbons, cruciferous vegetables

Inhibitors: Quinolones, Macrolides

Polymorphisms: No

Question 6

What are the inducers and inhibitors of CYP2C9? Is this enzyme associated with polymorphisms?

Answer 6

Inducers: General inducers( anticonvulsants, antibiotics, chronic alcohol, St. John’s Wort)

Inhibitors: None

Polymorphisms: Yes

Question 7

What are the inducers and inhibitors of CYP2D6? Is this enzyme associated with polymorphisms?

Answer 7

Inducers: None known

Inhibitors: Haloperidol, Quinidine, SSRIs

Polymorphisms: Yes

Question 8

What are the inducers and inhibitors of CYP3A4? Is this enzyme associated with polymorphisms?

Answer 8

Inducers: General

Inhibitors: General

Polymorphisms: No