pharmgenomics Flashcards
Pharmacogenomics, definition
how individual genome affects response of RX
Goal is match the drug with person genome
Rates of adverse drug reactions (ADRs) low or high?
ADR- 6-7% in all hos
100K COD/yr
40% in target group will not respond
Name a few causes of ADRs
Interactions Changes d/t age Dx- kidney, liver Lifestyle- alcohol smoking Errors Genetics
Arno Motulsky (1923-2018), not the name, the concept that he came up with
Drug rxn of this type may be caused by otherwis genetic trains or enzyme deficiencies
Define a single nucleotide polymorphism (SNP
single base pair substitions
Variability in enzymes and proteins which lead to drug respone
Human genone 30K genes- over 11m SNPs
Lactose free milk and lactose intolerance, why?
Lactase converts to glucose w/in jejunum
beta galactosidase deficiency (same as Lactase)
SNPs lead to intolerance
ADRs and SNPs in Phase I enzymes, concept
Phase 1 enzymes most important-75% RX biotrans
L/t extra ensyme or too little
PM (poor enzyme metabolier)- produce less morphine
UM- convert too fast L/t ADR, sedation
codeine
CYP 2D6, EM, PM, IM and UM
clopidogrel
Treats stroker and MI
Active metabolits inhibit platet aggregation
5-fluoroacil
inhibits DNA synthesis
dihydropyrimidine dehydrogenase- deficeny reduces anticancer meds
irinotecan
UGT 1A1, topoisomerase I inhibitor
succinylcholine
six steps in muscle firing prolonged apnea
coumarin
bleeding disorder
dose reduction 90% for Theaptuic window
statin
inhibits activion of PT by Vk
ezetimibe/simvastatin
lower cholesterol
isosorbide/hydralazine
lower blood pressure (bp) AA improved