Ethnopharmacology and Drug Response

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Questions and Answers

What does the term 'race' imply in the context of genetics?

  • A social construct without any biological underpinnings
  • A group of people who share the same language and traditions
  • A classification based on genetic similarities reflecting geographic origins (correct)
  • A category defined solely by physical appearance

How do cultural attitudes potentially influence medication prescriptions?

  • By promoting universal techniques for prescribing medication
  • Through underlying racial biases that may affect decision-making (correct)
  • By ensuring all ethnic groups receive equal treatment
  • Through standardized guidelines that disregard cultural differences

What is the primary focus of ethnopharmacologic research?

  • Understanding the financial implications of drug distribution
  • Analyzing the environmental factors affecting drug efficacy
  • Investigating how different ethnic groups metabolize drugs (correct)
  • Exploring the historical context of drug use in various cultures

What does pharmacodynamics refer to in drug studies?

<p>The mechanisms of action and effects of drugs at the target site (A)</p> Signup and view all the answers

What significant issue arises from historically conducting clinical drug trials mainly on white men?

<p>It results in generalized findings that may not apply to diverse groups (C)</p> Signup and view all the answers

Which racial/ethnic group may experience reduced efficacy from ACE inhibitors compared to others?

<p>African Americans (D)</p> Signup and view all the answers

What factors contribute to the differences in drug efficacy among racial/ethnic groups?

<p>Genetic variations (C)</p> Signup and view all the answers

Which of the following medications are categorized as beta blockers?

<p>Metoprolol (D)</p> Signup and view all the answers

In the context of drug efficacy, what is a primary reason beta blockers may be less effective in individuals of African descent?

<p>Differences in genetic variations (A)</p> Signup and view all the answers

Which system is affected by the genetic variations that influence ACE inhibitor effectiveness?

<p>Renin-angiotensin-aldosterone system (D)</p> Signup and view all the answers

What role does genetic variability in the vitamin K pathway play in pharmacogenomics?

<p>Affecting warfarin dosage responses (A)</p> Signup and view all the answers

What is a common medication class used to treat high blood pressure and heart failure apart from ACE inhibitors?

<p>Calcium channel blockers (A)</p> Signup and view all the answers

Which condition is NOT commonly treated with beta blockers?

<p>Asthma (A)</p> Signup and view all the answers

What is the primary focus of ethnopharmacology?

<p>The observation and experimental investigation of indigenous drugs (C)</p> Signup and view all the answers

Which of the following best describes pharmacogenetics?

<p>It studies the genetic variations in responses to drugs. (A)</p> Signup and view all the answers

Which components does ethnopharmacology include in its study?

<p>Substances employed in indigenous medicines (B)</p> Signup and view all the answers

What does the term 'interdisciplinary' imply in the context of ethnopharmacology?

<p>The integration of multiple scientific disciplines (D)</p> Signup and view all the answers

What role does ethnicity play in drug response according to ethnopharmacology?

<p>It influences drug absorption, metabolism, distribution, and excretion. (A)</p> Signup and view all the answers

Which organization is concerned with the physiological actions of substances used in indigenous medicines?

<p>International Society of Ethnopharmacology (B)</p> Signup and view all the answers

What does the CYP 450 system primarily relate to in ethnopharmacology?

<p>The metabolism of drugs within the body (D)</p> Signup and view all the answers

Which term refers to the study of individual genetic differences in drug response?

<p>Pharmacogenetics (D)</p> Signup and view all the answers

What is the primary role of the CYP2D6 gene in drug metabolism?

<p>To affect the rate of drug metabolism (A)</p> Signup and view all the answers

What characterizes individuals known as 'ultrarapid metabolizers'?

<p>They have more than two functional copies of the CYP2D6 gene (C)</p> Signup and view all the answers

What adverse effect did the 49-year-old man experience after taking codeine?

<p>Severe respiratory depression (C)</p> Signup and view all the answers

How does having two non-functional copies of the CYP2D6 gene affect drug metabolism?

<p>It leads to slower than normal enzyme activity (B)</p> Signup and view all the answers

Which statement correctly describes the genetic variation in drug metabolism?

<p>Genetic variations can alter drug response significantly (B)</p> Signup and view all the answers

What was the outcome of the genetic testing for the patient in the case study?

<p>He was identified as a rapid metabolizer of codeine (C)</p> Signup and view all the answers

What should be closely monitored in individuals with genetic variations in drug-metabolizing enzymes?

<p>Adverse effects of medications (A)</p> Signup and view all the answers

Which factor is explicitly mentioned as varying by race or ethnic group concerning drug metabolism?

<p>Genetic ability to produce CYP enzymes (B)</p> Signup and view all the answers

What is the primary function of drug metabolism in the body?

<p>To eliminate drugs and terminate their biological activity (D)</p> Signup and view all the answers

Which phase of drug metabolism involves reactions such as acetylation and glucuronidation?

<p>Phase II reactions (B)</p> Signup and view all the answers

What type of genetic variation leads to differences in drug metabolism among individuals?

<p>Genetic polymorphisms (D)</p> Signup and view all the answers

Which enzyme systems are primarily involved in drug biotransformation?

<p>CYP450 isoforms and transferases (D)</p> Signup and view all the answers

What might a genetic polymorphism in a drug-metabolizing enzyme result in?

<p>Varying enzyme activity leading to altered drug responses (C)</p> Signup and view all the answers

What is the primary characteristic of phase I metabolic reactions?

<p>They are primarily reduction or oxidation processes (C)</p> Signup and view all the answers

Which statement accurately describes polymorphisms in drug metabolism?

<p>They can lead to increased or decreased enzyme activity (B)</p> Signup and view all the answers

How does genetic variation influence drug metabolism across different racial groups?

<p>It contributes to different rates of enzyme activity (B)</p> Signup and view all the answers

What is the primary focus of pharmacogenomics?

<p>Tailoring medication to an individual's genetic makeup (C)</p> Signup and view all the answers

Why is it important to ask patients specific questions about their symptoms?

<p>It is crucial for effective diagnosis and treatment. (A)</p> Signup and view all the answers

Based on genetic differences, what might occur when individuals of the same demographics are prescribed the same medication?

<p>One person may have an adverse reaction while another feels better. (D)</p> Signup and view all the answers

How has the approach to medication changed from the past to the future in the context of pharmacogenomics?

<p>From non-personalized to personalized medication strategies. (C)</p> Signup and view all the answers

What key factor may affect a patient's communication regarding their condition?

<p>The patient's language preferences for communication. (B)</p> Signup and view all the answers

What insight was humorously suggested by Aaron Bacall's cartoon regarding the future of medicine?

<p>Pharmacists may routinely handle DNA information. (B)</p> Signup and view all the answers

What can careful observation of patients help identify?

<p>Potential adverse effects of treatments. (A)</p> Signup and view all the answers

When considering drug prescriptions today, what is common about the approach?

<p>Drugs are often treated as uniform, with a 'one size fits all' mentality. (A)</p> Signup and view all the answers

Flashcards

Ethnopharmacology Definition

The study of how ethnicity affects responses to medications, focusing on drug absorption, metabolism, distribution, and excretion. It incorporates pharmacogenetics, which studies genetic variations in drug responses.

Ethnopharmacology (Broader Definition)

Multidisciplinary research investigating indigenous drugs, their biological activities, and their traditional medicinal uses.

Pharmacogenetics

The study of how genes influence responses to medications.

CYP 450 System

A group of enzymes that metabolize drugs, and variations in these enzymes can affect how individuals metabolize different medications.

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Genetic Polymorphism

Variations in genes among individuals, which can influence drug response.

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Drug Response Variability

Differences in how individuals react to medications, based on factors like ethnicity and genetics.

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Indigenous Drugs

Medicines traditionally used by specific ethnic groups or cultures.

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Race

A group of people with a common lineage, often based on geographic origins, and presenting differing gene frequencies in a population.

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Ethnicity

Shared cultural bonds and/or a common genetic heritage.

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Culture

A group's integrated set of beliefs, values, and customs, passed down across generations.

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Ethnopharmacologic research

Study of how different ethnic groups respond to drugs, considering cultures and genetics.

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Pharmacodynamics

How a drug works at its target site in the body.

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Pharmacokinetics

The process of drug movement in the body, including absorption, metabolism, distribution, and elimination.

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Drug response variation

Difference in how individuals in diverse ethnic groups metabolize and respond to medications.

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Clinical drug trials

Research studies that test the effects of any new medicine on patients.

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Historical drug trial biases

Past medicine studies often primarily involved white men, leading to broad generalizations that may not apply to all.

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Warfarin Dosage

Genetic variations in the vitamin K pathway influence how effectively warfarin, an anti-coagulant, works in different ethnic groups.

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ACE Inhibitors & African Americans

ACE inhibitors, used to treat high blood pressure and heart failure, might be less effective in African Americans due to genetic differences in the renin-angiotensin-aldosterone system.

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Beta Blockers & African Descent

Beta blockers, used for various conditions including high blood pressure, may show different effectiveness in individuals of African descent due to genetic factors influencing drug metabolism.

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Enalapril & Ethnic Groups

Enalapril, an ACE inhibitor, may show differing effectiveness when used to treat arterial hypertension in different ethnic groups.

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Drug Response & Genetics

Genetic variability between ethnic groups affects how individuals respond to various medications, such as warfarin, ACE inhibitors, and beta blockers.

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CYP2D6 gene duplication

The CYP2D6 gene can be duplicated or multiplied, affecting the rate of drug metabolism.

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Ultrarapid metabolizers

Individuals with more than two functional copies of the CYP2D6 gene; they metabolize drugs faster than average.

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Poor metabolizers

Individuals with two non-functional copies of the CYP2D6 gene; they metabolize drugs more slowly than average

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Drug metabolism

The process by which the body breaks down drugs.

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Drug plasma levels

The concentration of a drug in the blood plasma.

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Genetic variations

Differences in genes between individuals which affect drug response

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Codeine and CYP2D6

Genetic variations in CYP2D6 affect how codeine is metabolized and can lead to adverse responses.

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Genetic Polymorphism

Multiple versions (forms) of a gene existing in a population, often not resulting in disease.

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Drug Metabolism

The process of changing a drug's chemical structure to make it easier to remove from the body.

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Phase I Reactions

Early drug metabolism steps that modify the drug molecule, often making it more water-soluble.

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Phase II Reactions

Further drug metabolism steps that add a molecule to the drug to help eliminate it from the body.

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CYP 450 Enzymes

Enzymes involved in drug metabolism, often affected by genetic variations.

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Drug Response Variability

Different responses to the same drug among individuals, often due to genetics or other factors.

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Polymorphism & Drug Effectiveness

Genetic variations in drug-metabolizing enzymes can lead to different drug effectiveness among individuals.

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Adverse Drug Reactions

Unwanted or harmful effects experienced by a patient due to a medication.

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Personalized Medicine

Tailoring medical treatments to individual genetic makeup to improve effectiveness and safety.

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Pharmacogenomics

Study of how genes affect a person's response to drugs.

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Drug Response Variability

Differences in how individuals respond to the same medicine.

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Specific Questions (Adverse Effects)

Asking patients direct questions about potential side effects of a drug instead of open-ended questions.

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Patient Language Preferences

Understanding and considering how patients communicate their illnesses, taking into account their preferred language and mode of communication.

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Genetic Differences (Drug Metabolism)

Variations in people's genes that affect how their bodies process drugs.

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Study Notes

Ethnopharmacology: Understanding Drug Response Based on Race/Ethnicity

  • Ethnopharmacology is a multidisciplinary field researching indigenous drugs and their biological effects.
  • It explores biologically active agents traditionally used, observed, or employed by humans.
  • The field looks at how cultural beliefs and ethnicity affect responses to medication.
  • This includes factors such as drug absorption, metabolism, distribution, and excretion.
  • Pharmacogenetics, the study of genetic variations in responses to drugs, plays a significant role.
  • Historically, drug trials have often been conducted on white men, with results generalized to all patients.

Race, Culture & Ethnicity

  • Race is considered a group of people with a common lineage, and genetic variations distinguish populations.
  • Ethnicity refers to shared cultural traditions, genetic heritage, and/or geographic origins.
  • Culture encompasses beliefs, values, and customs passed down between generations.

Variability in Drug Response

  • Patients in diverse ethnic groups experience different drug metabolisms.
  • Pharmacodynamics (drug's action) and pharmacokinetics (drug's movement) both impact how a drug is processed in different groups.
  • Genetic variations can influence enzyme function, leading to differing responses to medication.
  • Diet and tobacco use can also change a person's gene expression, affecting drug effectiveness.

CYP 450 System

  • Cytochrome P450 enzymes (CYP) are responsible for metabolizing many drugs.
  • Many CYP subgroups exist, identified by letters and numbers (e.g., CYP2C9, CYP2D6).
  • Genetic variations in CYP enzymes can significantly alter drug metabolism rates.
  • These variations affect how quickly a person metabolizes a drug, influencing drug plasma levels.

Genetic Polymorphism

  • Polymorphism describes different forms of a gene existing in individuals or populations.
  • Drug-metabolizing enzymes have polymorphisms causing different responses and rates of metabolism within different racial groups.
  • Some people are "ultrarapid metabolizers," quickly metabolizing drugs, while others are "poor metabolizers," slowly metabolizing them.
  • Genetic deviations influence drug reactions.

Clinical Implications

  • Careful monitoring of patients is crucial to avoid adverse effects and dosage adjustments.
  • It is essential to understand and communicate with patients from various cultures properly.
  • Cultural attitudes and racial biases can affect prescribing practices.
  • Determining a patient's language preferences is important.
  • Understanding the varied terms individuals use to describe illnesses is key.
  • Pharmacogenomics plays an ever-increasing role in targeted drug therapies.

Drug Metabolism

  • Drugs and other xenobiotics are transformed by the body into more hydrophilic metabolites for excretion.
  • The primary site for this transformation is the liver and is a result of phase 1 (e.g., oxidation, reduction, or hydrolysis) and phase 2 (e.g., conjugation) reactions.
  • CYP enzymes and transferases carry out these reactions.
  • Differences in the function of drug metabolizing enzymes lead to varying drug metabolism in different populations.

Polymorphisms in Clinical Practice

  • Genetic differences across populations affect enzyme performance.
  • These differences show variable metabolism rates and drug reactions within racial groups.
  • The examples of drugs like warfarin, ACE inhibitors, beta-blockers, and isoniazid highlight these variations.

Pharmacogenomics

  • Pharmacogenomics is the study of how genes affect a person's response to medication.
  • Drugs are tailored to patients' genetic makeup, leading to more effective and safer treatment.
  • Genetic profiles aid in tailoring drug therapies to improve effectiveness and minimize adverse reactions.

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