Ethnopharmacology and Drug Response

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Questions and Answers

How do cultural attitudes influence medication prescriptions?

They may create biases that affect doctors' prescribing habits. (correct)

They dictate the efficacy of medications for all ethnic groups.

They solely reflect the historical usage of medications in different cultures.

They enhance the understanding of pharmacodynamics universally.

What distinguishes race from ethnicity in the context of health?

Race refers only to genetic similarities, whereas ethnicity includes historical contexts.

Race and ethnicity are interchangeable terms in medical studies.

Race is determined by geographical ancestry while ethnicity reflects cultural bonds. (correct)

Race focuses on genetic diversity and ethnicity on shared customs alone.

Which aspect of drug response is influenced by genetic variations?

Medication branding and marketing strategies.

Both pharmacodynamics and pharmacokinetics. (correct)

Pharmacodynamics exclusively.

Pharmacokinetics only.

What has been historically problematic in clinical drug trials?

They have focused on white men, leading to generalized results for all patients. Signup and view all the answers

What can cause differing drug responses among ethnic groups?

Genetic variations in metabolic enzymes. Signup and view all the answers

Which factor is least likely to influence a gene's expression in relation to drug effects?

Air temperature Signup and view all the answers

Which of the following is a biological factor influencing drug absorption?

Age Signup and view all the answers

What genetic factor may require individuals of certain ethnic backgrounds to adjust their dosage of warfarin?

Genetic variations in metabolism Signup and view all the answers

Which drug listed is known to have varying effects based on ethnic background?

Warfarin Signup and view all the answers

Which psychosocial-cultural factor is not mentioned as influencing drug effects?

Gender identity Signup and view all the answers

Which of the following best describes the role of smoking in drug metabolism?

It may alter gene expression affecting drug metabolism. Signup and view all the answers

What is a key factor that affects drug distribution in the body?

Systemic circulation Signup and view all the answers

Considering environmental factors, which is most relevant to drug efficacy?

Pollution levels Signup and view all the answers

What is the primary purpose of ACE inhibitors?

To treat high blood pressure and heart failure Signup and view all the answers

How do genetic variations influence the effectiveness of beta blockers in different populations?

They may lead to lower effectiveness in individuals of African descent Signup and view all the answers

Which drug may be less effective for African American patients due to genetic differences?

ACE inhibitors Signup and view all the answers

In the context of pharmacogenomics, what is a significant factor affecting warfarin dosage?

Genetic variability in the vitamin K pathway Signup and view all the answers

What condition is treated with the drug isoniazid?

Tuberculosis Signup and view all the answers

Which medication class has shown varied effectiveness based on genetic differences particularly in the renin-angiotensin-aldosterone system?

ACE inhibitors Signup and view all the answers

What is a common issue in the pharmacological treatment of hypertension in different ethnic groups?

Differences in genetic variations leading to altered drug metabolism Signup and view all the answers

Which of the following statements is true regarding the efficacy of beta blockers?

Beta blockers may be more effective in individuals of European descent. Signup and view all the answers

What is the primary function of cytochrome P-450 enzymes?

Phase 1 metabolism of drugs Signup and view all the answers

Which of the following is most likely to experience increased liver toxicity from isoniazid?

Individuals of Asian descent Signup and view all the answers

Which of the following CYP enzyme subgroups is crucial for the metabolism of many drugs?

CYP3A4 Signup and view all the answers

Which statement is true regarding genetic abnormalities in CYP enzymes?

They are common and can significantly affect drug metabolism. Signup and view all the answers

What can be inferred about individuals with certain genotypes of CYP enzymes?

They may be more susceptible to drug toxicity. Signup and view all the answers

Which of the following drugs is an antibiotic used to treat tuberculosis?

Isoniazid Signup and view all the answers

What is the significance of the peak absorbance at 450 nm in relation to CYP enzymes?

It is characteristic of CYP450 study. Signup and view all the answers

Which of the following is a common effect of genetic variations in drug metabolism?

Altered efficacy for specific drugs Signup and view all the answers

What characterizes individuals who are 'ultrarapid metabolizers' of codeine?

They have more than two functional copies of the CYP2D6 gene. Signup and view all the answers

What is a consequence of individuals with two non-functional copies of the CYP2D6 gene?

They are labeled as 'poor metabolizers'. Signup and view all the answers

Why did the patient experience severe respiratory depression despite taking a prescribed dose of codeine?

He was a rapid metabolizer, which altered his drug metabolism. Signup and view all the answers

What should be considered when prescribing codeine to patients with genetic variations in drug-metabolizing enzymes?

The likelihood of adverse effects due to altered drug response. Signup and view all the answers

Which factor directly influences the rate of drug metabolism for CYP2D6?

Genetic variations in the CYP2D6 gene. Signup and view all the answers

What aspect of the CYP2D6 gene is particularly notable compared to other genes?

It is unique in its tendency to undergo duplication or multiplication. Signup and view all the answers

During the case study in 2007, what specific medical intervention did the patient undergo before he was prescribed codeine?

Surgical removal of a nasal polyp. Signup and view all the answers

What is the possible outcome of having genetic variations in CYP enzymes like CYP2D6 when prescribed codeine?

Experiencing life-threatening respiratory depression. Signup and view all the answers

What is a clinical consequence of the enzyme CYP1A2?

Decreased theophylline metabolism Signup and view all the answers

Which enzyme is associated with possible increased cancer risk due to estrogen metabolites?

CYP1B1 Signup and view all the answers

The enzyme CYP2C9 primarily influences the metabolism of which of the following drugs?

Warfarin Signup and view all the answers

What is the significance of genetic polymorphisms in CYP2B6?

Unknown clinical significance Signup and view all the answers

Which CYP enzyme's metabolites lead to tardive dyskinesia from antipsychotics?

CYP2D6 Signup and view all the answers

What is a known effect of CYP2A6 on nicotine?

Decreased nicotine metabolism and potential for increased addiction Signup and view all the answers

Which clinical consequence is associated with the enzyme CYP3A4/3A7?

Dose requirement adjustments in pediatric cancer patients Signup and view all the answers

Which substrate is metabolized by CYP2C19 and can affect peptic ulcer response?

Omeprazole Signup and view all the answers

Study Notes

Ethnopharmacology: Understanding Drug Response Based on Race/Ethnicity

Ethnopharmacology is a multidisciplinary field studying indigenous drugs and their biological activities.
It's an interdisciplinary scientific exploration of biologically active agents traditionally used by humans.
The field also investigates the physiological actions of plant, animal, and other substances used in indigenous medicines of past and present cultures.
Most clinical drug trials have historically been conducted using white men, and results have often been generalized to all patients.
Ethnopharmacological research reveals significant differences in how different ethnic groups metabolize drugs.
This includes both pharmacodynamics (drug action) and pharmacokinetics (drug movement-absorption, metabolism, distribution, excretion).
Genetic variations influence drug responses, impacting how enzymes metabolize drugs.
Factors like diet and tobacco use can affect a gene's expression and a drug's effectiveness.
Other factors include ethnicity, age, gender, genetics, and disease.
Specific drugs, like warfarin, ACE inhibitors, beta-blockers, and isoniazid, have shown varied effects on different ethnic groups due to genetic variations.

Race, Culture & Ethnicity

"Race" is often described as a group of people with a common lineage, with different populations having different distributions of gene frequencies.
The term generally reflects geographic origins of ancestry.
"Ethnicity" can refer to shared cultural bonds or a common genetic heritage, or both.
"Culture" is an integrated system of learned beliefs, values, and customs within a group, typically passed down through generations.

Genetic Polymorphism

Genetic polymorphism is the existence of multiple forms of a single gene within a population.
These variants are identified by letters and numbers, such as CYP2C9, CYP2C19, CYP2D6, and CYP3A4.
Genetic variations can affect the ability of certain enzymes to metabolize drugs, causing differences in drug response between ethnic groups.
These enzymes, known as cytochrome P-450 (CYP), are key in the first phase of drug metabolism.
Variations in CYP enzymes can impact the metabolism rate of certain drugs.
Certain genes, like CYP2D6, can be duplicated or multiplied, affecting metabolism. People with more functional copies (ultra-rapid metabolizers) metabolize drugs quicker, resulting in lower serum levels. Those with non-functional copies (poor metabolizers) metabolize drugs slower, leading to higher serum levels.
This variation in metabolism can lead to varied responses to medications among different groups.

Drug Metabolism

Drug metabolism is the process of breaking down drugs into more water-soluble forms.
This is essential for their elimination from the body.
Metabolism is categorized as phase I (oxidation, reduction, hydrolysis, methylation) and phase II (acetylation, glucuronidation, sulfation, methylation) reactions.
The liver is the primary site for these reactions, carried out by CYP enzymes (cytochrome P450 isoforms) and other transferases.

Clinical Implications

Careful monitoring of patients is crucial to prevent adverse effects from medication dosage variation.
Understanding patients' cultural backgrounds and communication styles is important to elicit necessary information.
Use of appropriate terminology when discussing illness is also essential.
The field of pharmacogenomics provides personalized medication options tailored to the patient's unique genetic makeup.

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Description

Explore the fascinating field of ethnopharmacology, which examines how race and ethnicity influence drug response. This quiz delves into the biological activities of indigenous drugs, the significance of genetic variations, and the implications of diverse clinical trial populations. Test your knowledge on pharmacodynamics, pharmacokinetics, and the historical context of drug testing.