Pharmacogenetics -nanda

Question 1

contrast pharmacogenetics and pharmacodynamics

Answer 1

pharmacogenetics is how the person reacts to the drug, metabilizes it and clears it. pharmacodynamics in downto the molecular level how different drugs interact with their substrates etc.

Question 2

what is CYP

whre is it found

what does it do?

Answer 2

CYP is a heme containing cytochrome p450.

it is found primarily in the liver where it detoxifies drugs

Question 3

in addition to detoxifying drugs, what characteristic does CYP2D6 have?

Answer 3

CYP2D6 can also activate drugs. it converts codein to morphine

Question 4

how can a CYPs play a role in drug interaction?

Answer 4

well there are many CYPs but if you take two drugs that is acted on by the SAME CYP then you will not want to take them together because 1 might not work since the CYP will be busy thus the second drug’s action will be missing

Question 5

what is Warfrin used to treat?

Answer 5

Warferin is used to prevent thrombosis and embolisms in the heart

Question 6

what is the direct action of warferin on what molecule?

Answer 6

Waferin succesffully prevents clots by imparing the synthesis of vitamine K dependent clotting factors. Warferin is a competitive inhibitor of vitamin K so it prevents the downstream production of those clotting factors that the body needs vitamin K to make. See picture

Question 7

why is there such a large variation between tolerance and sensitivity to Warferin?

Answer 7

There are so many CYP pathways that are involved in Wafrin metabolism that a mutation in one can change the tolerance of a person to the drug. see picture

Question 8

CYP2C9 interaction with Wafrin is considered

Answer 8

pharmacokinetics (drugs in body over time)

Question 9

how can you describe how there is a continium with the the variability in Warfrin tolerance?

Answer 9

first off there a shit load of CYPs. and Second with every defect in 1 CYP basically takes you down a notch

Question 10

Gama glutamyl carboxylate of coagulation factors cause clots…how does Warfrin prevent this from happening?

Answer 10

the critical step for this cascade is reducing vitamine K by the Vitamin K epoxide reductase. If Warfrin binds to the VKORC then vitamine K cannot bind to it,vitamine K is never reduced and the clotting factors are never carboxated.

Question 11

How does altering of the vitamine K reductase play a factor in creating more variation

Answer 11

You can also have a defect in the vitamine K reductase which causes further variation