Pharmacogenomics

Question 1

Clopidogrel

Answer 1

Cyp2c19. Prodrug. Gets activated from this enzyme

Question 2

Carbmazepine (Tegretol)

Answer 2

Test for HLA-B 1502 if of Asian ancestry. Don’t use if positive. Otherwise, may have severe SJS or TEN.

Question 3

Trastuzumab (Herceptin)

Answer 3

HER2/neu oncogene. Overexpression of these genes are required. (2+ or 3+)

Question 4

Crizotinib (xalkori)

Answer 4

Anaplastic lymphoma kinase (ALK). Needs to be positive in order to use for NSCLC

Question 5

Abacavir (Ziagen)

Answer 5

HLA-B 5701 (if positive, can’t use) may cause fever, rash,gi, fatigue

Question 6

Maraviroc (selzentry)

Answer 6

Tropism testing. Only adult patients infected with CCR5-tropic HIV-1 should use maraviroc

Question 7

Azathiopurine and Mercaptopurine

Answer 7

Monitor for TPMT. Pts with this deficiency may have increase risk of myelosuppressive effects

Question 8

Rituxomab (rituxan)

Answer 8

CD-20 receptor status positive on cell surface.

Question 9

Phenytoin (Dilantin)

Answer 9

If Asian ancestors test for HLA-B 1502 bc increased risk for SJS and TEn

Question 10

Codeine

Answer 10

Extensive 2D6 metabolizes may have an exaggerated response