pharmgenomics Flashcards

1
Q

Pharmacogenomics, definition

A

how individual genome affects response of RX

Goal is match the drug with person genome

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2
Q

Rates of adverse drug reactions (ADRs) low or high?

A

ADR- 6-7% in all hos
100K COD/yr
40% in target group will not respond

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3
Q

Name a few causes of ADRs

A
Interactions
Changes d/t age
Dx- kidney, liver
Lifestyle- alcohol smoking
Errors
Genetics
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4
Q

Arno Motulsky (1923-2018), not the name, the concept that he came up with

A

Drug rxn of this type may be caused by otherwis genetic trains or enzyme deficiencies

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5
Q

Define a single nucleotide polymorphism (SNP

A

single base pair substitions
Variability in enzymes and proteins which lead to drug respone
Human genone 30K genes- over 11m SNPs

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6
Q

Lactose free milk and lactose intolerance, why?

A

Lactase converts to glucose w/in jejunum
beta galactosidase deficiency (same as Lactase)
SNPs lead to intolerance

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7
Q

ADRs and SNPs in Phase I enzymes, concept

A

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

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8
Q

codeine

A

CYP 2D6, EM, PM, IM and UM

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9
Q

clopidogrel

A

Treats stroker and MI

Active metabolits inhibit platet aggregation

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10
Q

5-fluoroacil

A

inhibits DNA synthesis

dihydropyrimidine dehydrogenase- deficeny reduces anticancer meds

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11
Q

irinotecan

A

UGT 1A1, topoisomerase I inhibitor

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12
Q

succinylcholine

A

six steps in muscle firing prolonged apnea

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13
Q

coumarin

A

bleeding disorder
dose reduction 90% for Theaptuic window
statin
inhibits activion of PT by Vk

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14
Q

ezetimibe/simvastatin

A

lower cholesterol

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15
Q

isosorbide/hydralazine

A

lower blood pressure (bp) AA improved

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16
Q

fava beans

A

divicine and red cell hemolysis

17
Q

primaquine

A

hemolytic anemia (red cell hemolysis), glucose-6-phosphate dehydrogenase (G6PD) enzyme in red cells

18
Q

isoniazid

A

slow vs rapid acetylators and peripheral neuropathy

slow-AA,whites, fast Asian,

19
Q

omeprazole

A

failure to work

20
Q

azathioprine

A

TMP enzyme deficiency and death of the patient

inactivates cancer drugs

21
Q

Phenotypic vs Genotypic testing

A

Enzyme
vs.
Race

22
Q

Types of genetic polymorphisms tested for on a drop of blood

A
CY2D6- PM, UM, EM, IM
Inactive enxyme
Red. catatlytic activity
Inc. amount of enzyme
Altered Bio trans-mutant
23
Q

2FDA Product Labeling requirements for pharmacogenomic information

A

Adjust dose CYP ensymes
ADR / genotypes
Responder or Non responder