Testable CYP First Exam

Question 1

Fluoxetine

Answer 1

Substrate of 2D6 --> norfluoxetine
Inhibits 2D6 (strong) and 2C19 (moderate)

Question 2

Paroxetine

Answer 2

Substrate 2D6

Question 3

Sertraline

Answer 3

Inhibits 2D6 (moderate)

Question 4

Citalopram/Escitalopram

Answer 4

Substrate of 2C19 and 3A4

Question 5

Venlafaxine

Answer 5

Substrate of 2D6 and 3A4

Question 6

Desvenlafaxine

Answer 6

None

Question 7

Duloxetine

Answer 7

Substrate of 1A2 and 2D6

Inhibitor of 2D6 (moderate)

Question 8

Bupropion

Answer 8

Inhibitor of 2D6

Question 9

Mirtazapine

Answer 9

Substrate of 1A2, 2D6, 3A4

Question 10

Trazadone

Answer 10

Substrate of 3A4

Question 11

Amitriptyline to nortriptyline via?

Answer 11

2D6

Question 12

Imipramine to desipramine via?

Answer 12

2D6

Question 13

TCAs

Answer 13

Substrate of 2D6 and 2C19

Question 14

Buspirone

Answer 14

Substrate of 3A4

Question 15

BZDs except Lorazepam

Answer 15

Substrate of 3A4 (coadmin with 3A4 inhibitors is CI)

Question 16

1st gen antipsychotics

Answer 16

Substrate of 2D6 +/- 3A4

Mod inhibitor of 2D6

Question 17

Atypicals

Answer 17

Above your paygrade bucko

Question 18

Melatonin receptor agonists

Answer 18

Substrates of 1A2 and 3A4

Question 19

Atomoxetine

Answer 19

Substrate of 2D6 (major)

Question 20

Celecoxib

Answer 20

Substrate of 2C9

Question 21

Codeine –> morphine via?

Answer 21

2D6

Question 22

Hydrocodone –> hydromorphone via?

Answer 22

2D6

Question 23

Oxycodone –> oxymorphone via?

Answer 23

2D6

Question 24

Tramadol –> active metabolite via?

Answer 24

2D6

Question 25

BBW for oxycodone about interactions with? BOLD

Answer 25

3A4 inhibitors

Question 26

Fentanyl

Answer 26

3A4 major

Question 27

Hydrocodone and oxycodone

Answer 27

3A4 (major) and 2D6 (minor)

Question 28

Tramadol (prodrug)

Answer 28

3A4 and 2D6 (major)

Question 29

Codeine (prodrug)

Answer 29

2D6 (major)

Question 30

NO CYP metab with opioids

Answer 30

Morphine, Hydromorphone, Oxymorphone

Question 31

Dihydroergotamine

Answer 31

3A4 substrate

Question 32

Almotriptan & Eletriptan

Answer 32

3A4 substrate

Question 33

Sumatriptan, Rizatriptan, Zolmitriptan

Answer 33

Metabolized by MOA enzymes

Question 34

Gepants

Answer 34

3A4, PgP substrates

Question 35

Dementia Meds

Answer 35

all “fairly clean”

no cyp concerns for us

Question 36

Carbamazepine

Answer 36

3A4 substrate (major)

Induces (strong) 2C9 and 3A4 - autoinduction**

Question 37

Phenytoin

Answer 37

2C9 substrate

Induces (potently) 2C9 & 3A4 - autoinduction**

Question 38

Lamotrigine

Answer 38

Does not induce or inhibit CYP enzymes

** VPA INC [lamotrigine] > 2x **

Question 39

Lacosamide

Answer 39

Interactions: concomitant PR-prolonging drugs (b-blockers, CCBs) **

Question 40

Rufinamide

Answer 40

Interactions: drugs that SHORTEN QT interval **

Question 41

Ezogabine

Answer 41

Interactions: concomitant QT prolongers **

Question 42

Gabapentin

Answer 42

Not metabolized *

Question 43

Phenobarbital

Answer 43

Induces 2C9, 3A4 - autoinducer **

Question 44

Tiagabine

Answer 44

3A4 substrate

Question 45

Felbamate

Answer 45

3A4 substrate

Question 46

Brivaracetam

Answer 46

2C19 substrate

Question 47

Levodopa

Answer 47

MOA inhibitors block levo metabolism