Pharmacogenetics

Question 1

Pharmacokinetic diff. result from..

Answer 1

differences in drug metabolism

Question 2

Pharmacodynamics diff. result from..

Answer 2

differences in target or downstream elements.

Not well understood

Question 3

Phase II conjugation by ___________ affects aromatic amines, alcohols, and hydroxylamines.

Answer 3

N-acetyltransferases (NAT-1 and NAT-2)

10% Asian Pop
50% White and Black Pop
85% Egyptian Pop

Question 4

Consequences of slow acetylation: _____ could lead to peripheral neuropathy

Answer 4

isoniazid (treat tuberculosis)

Question 5

Consequence of slow acetylation: ______ could lead to systemic lupus erythematosus

Answer 5

Procainamide (local anesthetic)

Question 6

Consequence of slow acetylation: _______ could lead to enhanced myelosuppresion (good)

Answer 6

Amonafide (treat cancer)

Question 7

Exposure to aromatic and heterocyclic amines..

Answer 7

cancer predisposition

Question 8

Three most important Cytochrome P450 enzymes..

Answer 8

CYP2D6, CYP2C9, CYP2C19

Question 9

CYP2D6 action..

Answer 9

removes methyl from oxygen and metabolizes about 25% of all drugs

Question 10

Drugs affected by variations in CYP2D6..

Answer 10

cevimeline
tamoxifen
codeine

Question 11

cevimeline

Answer 11

muscarinic agonist used to treat dry mouth; parasympathetic side effects from altered CYP2D6

Question 12

Tamoxifen

Answer 12

estrogen receptor antagonist used to treat breast cancer – activated by CYP2D6

Poor pt outcome if are a CYP2D6 poor metabolizer

Question 13

Codeine

Answer 13

Opioid agonist

CYP2D6 poor - ineffective anesthetic
CYP2D6 ultra - abdominal pain

Question 14

Warfarin fxns as..

Answer 14

anti-clotting drug

Question 15

Warfarin is dependent upon _______ and poor metabolizers may have serious bleeding complications

Answer 15

CYP2C9

Question 16

Plasma Choline Esterase fxns to..

Answer 16

metabolize succinylcholine

Question 17

Succinylcholine is..

Answer 17

depolarizing muscle relaxant

Question 18

Plasma cholinesterase polymorphisms can induce..

Answer 18

prolonged apnea in poor metabolizers

Question 19

Ryanodine receptor mediates..

Answer 19

calcium-mediated calcium release from SR

Question 20

Anesthetics can cause _____ _______ due to aberrant Ca++ release mediated by ryanodine receptors.

Answer 20

Malignant Hyperthermia