Term
| What Pharmocogenomic Information is required on drug labeling? |
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Definition
Impact/lack of impact of genotype on phenotype
If genomic test is available - Recommended or necessary
Pharmoacogenomic info subsection
Changes in dose based on genotype |
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Term
| What 3 factors can cause variations in drug response? |
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Definition
Environmental factors
Drug Interactions
Genetic Factors |
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Term
| What 6 factors affect absorption of drugs? |
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Definition
IV compatibility & dilution problems
Chelators
Changes in Gastric pH
Alterations in gastric emptying time
Alterations in GI transit time
P-gp substrate |
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Term
| How do changes in gastric pH affect absorption of drugs? |
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Definition
Increase pH (Antacids, H2 blockers)
-decrease weak acid absorption
-increase weak base absorption
Decrease pH (Infections)
-increase weak acid absorption
-decrease weak base absorption |
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Term
| Over expression of what protein in intestinal epithelium can decrease absorption and overall plasma levels of the drug? |
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Definition
P-gp
**Mutated or decreased expression will cause Increased plasma levels** |
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Term
| What SNP has been associated with increased plasma levels of simvastatin, rosuvastatin, pravastatin, and atorvastatin? |
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Definition
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Term
| What CYP enzymes are the most commonly involved in Drug Metabolism? |
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Definition
46% CYP3A
16% CYP2C9
12% CYP2C19
12% CYP2D6
9% CYP1A
2% CYP2B6
2% CYP2E1 |
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Term
| How does induction and inhibition of CYPs affect drug metabolism? |
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Definition
Induction - decreases substrate T1/2
Inhibition - Increases substrate T1/2 |
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Term
| How are Basic drugs effect by urine pH? (antihistamines, amohetamines, meperidine, etc) |
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Definition
Decreased Reabsorption by Decreased pH (NH4Cl)
Increased reabsorption by Increased pH (NaHCO3) |
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Term
| How are Acidic drugs effected by Urine pH? (aspirin, phenobarbital, streptomycin, etc) |
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Definition
Decreased reabsorption by Increased pH (NaHCO3)
Increased reabsorption by Decreased pH |
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Term
| What CYP isoenzyme is needed for greatest efficacy of Tamoxifen? |
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Definition
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Term
| What CYP isoenzyme do Ultra-rapid metabolizers of Codeine -> Morphine have? What does this result in? |
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Definition
CYP2D6*2x2
Higher than expected serum morphine levels. |
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Term
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Definition
Clopidogrel
reduced metabolism -> decreased active metabolite -> higher CV risk
Voriconazole
reduced metabolism -> Increased drug exposure |
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Term
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Definition
Warfarin
Reduced metabolism -> Higher bleeding time |
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Term
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Definition
Codeine
Ultra rapid metabolism
Tamoxifen
Poor metabolism -> higher plasma conc. |
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Term
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Definition
Rasburicase
Severe haemolysis with several drugs |
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Term
| Polymorphism of HLA-B*1502 |
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Definition
Carbamazepine and Abacavir
Hypersensitivity Reaction |
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Term
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Definition
Atorvastatin
LDL receptor deficiency -> familial hypercholesterolaemia |
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Term
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Definition
Rifampicin
Increased drug exposure |
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Term
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Definition
Azathioprine
Slow metabolism -> increased risk of myelotoxicity |
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Term
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Definition
Irinotecan
increased neutropenia risk
Nilotinib
Increased Jaundice |
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Term
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Definition
Warfarin
SNPs associated with lower dose requirements |
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