Pharmacogenomics Flashcards
Drugs affected by BChE polymorphisms
Succinylcholine
Drugs affected by NAT2 polymorphisms
Hydralazine
Procainamide
Isoniazid
Drugs affected by 2D6 polymorphisms
Codeine among others
Drugs affected by thiopurine S-methyl-transferase polymorphisms
6-MP
Azathioprine
Drugs affected by EGFR polymorphisms
Gefitinib
Warfarin is affected by which polymorphisms
2C9
VKORC1 (Vit K epoxide reductase)
Drugs affected by G6PD deficiency (A-)
Primaquine (sulfonamides)
What happens in a BChE polymorphism
AR
Decreased rate of metabolism = longer paralysis
What is a normal Dibucaine number
> 75
What happens in NAT2 polymorphisms
Slow acetylators = increased drug levels (AR homo)
Fast acetylators = decreased drug levels
What happens in 2D6 polymorphisms
Poor = Decreased codeine activation (AR homo) Ultrarapid = Increased morphine effects (multiple copies)
What NAT2 drug can cause lupus
Hydralazine
Procainamide
What NAT2 drug can cause neuropathy and hepatotoxicity
Isoniazid
AE of poor 2D6
Ineffective dose
AE of ultrarapid 2D6
OD leading to resp depression
What happens in TPMT polymorphisms
Decreased activity
Only need 1/10 dose of drug
What does TPMT do
Catalyses S-methylation of anti-CA thiopurines
AE of giving std dose to TPMT polymorphism pt
Myelosupression
What happens in EGFR polymorphisms
ATP binding site mutation
Enhances drug effect
When is EGFR overexpressed
NSCLC
What decreases metabolism of warfarin
2C9 polymorphism
AE of 2C9 polymorphism
Increased hemorrhage risk
AE of VKORC1 polymorphism
Hemorrhage and thrombosis
What happens with a 90-95% reduction in G6PD
Decreased NADPH
Decreased glutathione
Increased H2O2
What is G6PD deficiency protective for
Malaria
G6PD exacerbation can lead to what
Hemolytic anemia
