Pharmacogenomics Flashcards
What are the benefits of genotype-guided drug therapy?
Better, safer drugs the first time
More accurate methods of determining appropriate drug dosages
Improved ability to predict adverse drug reactions
Helps patients and clients make informed decisions
Better vaccines
Decrease in overall cost of health care
Improvement in the drug discovery and approval process
What is drug disposition testing?
Testing for genes that can alter the pharmacokinetics
What is drug target testing?
Testing for genes that can change the pharmacodynamics
What is targeted cancer therapies testing?
Testing for genes involved with the growth, progression, and spread of cancer
Ultra rapid metabolizers
Have duplicated alleles
Metabolize drugs very quickly - need higher dose
May never reach therapeutic concentrations
Extensive metabolizers
Two normal wild type alleles
Respond to standard drug dosing
Intermediate metabolizers
1 nonfunctional or 2 partially defective alleles
May require lower than normal doses but can generally tolerate normal doses
Poor metabolizers
Both alleles are nonfunctional
Higher levels of drug accumulate in blood
Respond to lower doses of medications
Increased risk for side effects at usual or higher doses
Clinical relevance of CYP2C9 variation
Warfarin
Increased drug response
Increased sensitivity/bleeding
Clinical relevance of CYP2D6
Tamoxifen
Decreased response
Increased recurrence
Worse disease-free survival
Codeine
Increased toxicity
Clinical relevance of CYP2C19 variation
Cloidogrel
Decreased efficacy
Increased stent thrombosis
CV events
What is the relationship between codeine and pharmacogenomics?
CYP2D6 metabolizes codeine into a more potent form in your body
What genes are involved in the pharmacogenomics of warfarin?
CYP2C9
VKORC1
