Quiz 4? (ID, HTN, Pain)

Question 1

What polymorphic enzyme affects opioid efficacy?

Answer 1

CYP2D6

Question 2

What are the nonfunctional alleles for CYP2D6?

Answer 2

4, 5, 6

Question 3

What mutation makes a CYP2D6 allele have increased function?

Answer 3

More copies of *1/2

Question 4

What population is more likely to be UM at CYP2D6?

Answer 4

African patients

Question 5

What populations are more likely to be poor metabolizers at CYP2D6?

Answer 5

Hispanic, African, White (not Asian)

Question 6

What metabolizers (poor, intermediate, ultrarapid) should avoid use of opiates?

Answer 6

PM, UM

Question 7

Which opiates have a clinical recommendation based on pharmacogenomics

Answer 7

Codeine, dihydrocodeine

Not oxycodone, hydrocodone, or tramadol

Question 8

Polymorphisms in the u-opioid receptor MOR increase/decrease response to morphine?

Answer 8

Decrease

Question 9

COMT degrades ____

Answer 9

NTs

Question 10

COMT homozygous ___ has ____ response to morphine

Answer 10

Met, higher (lower morphine requirements)

Question 11

Which ADRB1 mutation location causes loss of function: 389 or 49?

Answer 11

389

Question 12

ADRB1 389 mutation is more common in african americans or other populations?

Answer 12

African Americans

Question 13

Which ADRB1 mutation causes gain of function? 389 or 49

Answer 13

49

Question 14

How do the ADRB2 mutations affect receptors?

Answer 14

downregulate them

Question 15

Do the ADRB2 mutations cause loss or gain of function?

Answer 15

Loss of function

Question 16

What populations are more likely to have Gly16Arg mutation?

Answer 16

Asians/AAs

Question 17

What populations are more likely to have Gln 27 Glu mutation?

Answer 17

Caucasians/AAs

Question 18

ADD1 SNP causes blood pressure raising or lowering effects?

Answer 18

Lowering

Question 19

Rs145038 is found near _____

Answer 19

FGF5

Question 20

What’s the significance of FGF5?

Answer 20

Response to HCTZ and atenolol–one SNP (TT) had better response to atenolol, the other (CC) to HCTZ

Question 21

Which Cyp metabolizes efavirenz?

Answer 21

CYP2B6

Question 22

What is the etoxicity associated with poor efavirenz metabolism?

Answer 22

QT Prolongation

Question 23

How does efavirenz cause its toxicity?

Answer 23

Prolongs AP by inhibiting K repolarizing current

Question 24

What are the LOF alleles on CYp2B6?

Answer 24

*6,18

Question 25

What CYP metabolizes voriconazole?

Answer 25

2c19

Question 26

Which CYP2C19 are LOF?

Answer 26

*2/3

Question 27

Which CYp2C19 polymorphisms are GOF?

Answer 27

*17

Question 28

Choose an alternative agent for voriconazole for which populations of metabolizers? (Ultrarapid, poor, rapid, normal?)

Answer 28

UM, PM, RM

Question 29

What infectious disease meds have CPIC guidelines?

Answer 29

Abacavir
Atazanavir
Ribavirin/Peginterferon
Voriconazole

Question 30

Abacavir mutation?

Answer 30

HLA-B

Question 31

Abacavir toxicity?

Answer 31

SJS/TEN

Question 32

Atazanavir mutation?

Answer 32

UGT1A1

Question 33

Atazanavir toxicity?

Answer 33

Jaundice

Question 34

Ribavirin/Peginterferon mutation?

Answer 34

IFNL3

Question 35

Ribaviran/Peginterferon treatment? Viral genotype 1 v. viral genotype 2

Answer 35

Type 1: 48 weeks, less chance of success

Type 2: 24 weeks, higher chance of success

Question 36

IFNL3 mutation affects what system?

Answer 36

JAK-STAT, immune system modulating

Question 37

IFNL3 polymorphism (T) reduces/increases chance of success?

Answer 37

Reduces success

Question 38

CCR5 affects what disease?

Answer 38

HIV

Question 39

32 homozygotes are more/less resistant to R5 HIV?

Answer 39

More resistant