Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

4 Pharm Unit > Pharmcogenetics > Flashcards

Pharmcogenetics Flashcards

1
Q

The most well-documented examples of differences in drug effects are due to what? What branch is now starting to be heavily researched?

A
  1. Metabolism- liver enzymes

2. pharmocodynamic- mechanism of action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Phase I enzymes are associated with what? Phase II?

A
  1. CYP-oxidation, hydrolysis, reduction

2. Conjugating enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What variant number is the most clinically important UGT variant?

A

28

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ultra rapid metabolizers with usually gene multiplication are usually associated with what enzyme?

A

CYP2D6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The extensive metabolizer is characterized as what?

A

Normal activity, two copies of normal gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The intermediate metabolizer is characterized as what?

A

– Roughly half-normal enzyme activity– Usually one copy of low activity active gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The poor metabolizer is characterized as what/

A

– Little or no enzyme activity– Two copies of low activity gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Wat are the 4 most important CYP enzymes?which one does over half of prescription drugs? 25%?

A
  1. 2C9, 2C19, 2D6, 3A4
  2. 3A4
  3. 2D6
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What enzyme converts tomoxifen to active metabolite?

A

CYP2D6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What converts codeine to morphine

A

CYP2D6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are 3 major drug class metabolized by CYP 2 D6

A
  • Anti-depressants (SSRIs, tricyclics)
  • Anti-psychotics (aripiprazole, olanzapine)
  • Adrenergic antagonists (carvedilol, metoprolol)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What converts azathioprine and 6 mercaptopurine?

A

Thiopurine methyltransferase TPMT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What metabolizes irinotecan?

A

UGT1A1- Gilbert’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What metabolizes warfarin and phenytoin?

A

CYP2C9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What metabolizes isoniazid, hydalazine, procainamide?

A

N-acetyltransferase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What enzyme converts clopidogrel, carisoprodol, and diazepam?

A

CYP2C19

17
Q

Variant 3 for CYP2D6 is what mutation and population percentage? 4? 5?

A
  1. frame shift- 2%
  2. Splicing- 22 %
  3. gene deletion- 5%
18
Q

If metabolism of a drug is slower than average, what do we often see?

A

wanted effects not elicited from certain prodrugs, but toxicity on standard dose

19
Q

If metabolism of a drug is faster than average, what do we often see?

A

-no drug response at ordinary dosage

20
Q

If you are a rapid metabolizer with CYP2D6 multiplication, what happens?

A

Convert codeine very rapidly to morphine,sometimes resulting in toxicity[Tragic cases reported in infants who breast-fed from mothers who were ultra-rapidmetabolizers and had taken codeine Infants died of respiratory arrest fromexcess levels of morphine that transferred tothe breast milk]

21
Q

What protein kinase is important in regards to being mutated for melanoma? What drug is used to inhibit its constitutive activity?

A
  1. B-RAF

2. Vemurafenib

22
Q

What is the importance of vemuradenib?

A

It was part of the first wave of companion diagnostics specifically targeted at a subset of cancers with a particular molecular alterations

23
Q

A mutation in VKORC1 causes what?

A

warfarin resistance in humans and rats

24
Q

What CYP enzyme metabolizes warfarin? what are the most common variants?

A
  1. CYP2C9

2. 2 and 3

25
Q

if evidence is available to supportthe safety and effectiveness of thedrug only in selected subgroups ofthe large population with a disease,, what then needs to happen?

A

identify specific testsneeded for selection or monitoring ofpatients who need the drug

26
Q

How much does genetic variation account for of clinical variation in warfarin effects?

A

only 1/3medications, diet, age, weight, and sex[all included only account for about 50% of effect]

27
Q

What are the 5 general issues in implementing pharmacogenetics in clinical practice?

A
  1. Nomenclature
  2. Understanding genetic variation in context
  3. Insurance coverage
  4. Inertia of status quo
  5. Establish new standard of care

4 Pharm Unit (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions