Principles of Pharmacogenomics by Anita Siu, Pharm.D.
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Questions and Answers

What is the main focus of pharmacogenomics?

  • The study of drug absorption mechanisms
  • The development of new drugs
  • The study of general genetic functions
  • The study of genes' impact on drug response (correct)

Which term refers to a common and functional gene in pharmacogenomics?

  • Genotype
  • Single Nucleotide Polymorphism (SNP)
  • Wild type (correct)
  • Haplotype

In pharmacogenomics, what does the term 'Phenotype' often refer to?

  • Statistical linkage of SNPs
  • Activity of a drug-metabolizing enzyme (correct)
  • DNA sequence variation
  • Person's genetic constitution

What does a 'Poor Metabolizer' phenotype in pharmacogenomics indicate?

<p>Nonfunctional protein due to two allele variants (C)</p> Signup and view all the answers

How is an 'Ultra-rapid Metabolizer' phenotype characterized in pharmacogenomics?

<p>Possible gene duplication and high enzymatic activity (C)</p> Signup and view all the answers

What are Cytochrome P-450 enzymes primarily responsible for in drug metabolism?

<p>Multiple genetic variants affecting drug metabolism (B)</p> Signup and view all the answers

What is the primary goal of the Human Genome Project?

<p>To sequence the entire complement of human genes by 2005 (D)</p> Signup and view all the answers

Which of the following factors is NOT considered in the current approach to medicine response?

<p>Molecular mechanisms (B)</p> Signup and view all the answers

According to the passage, which of the following is a key factor that influences medicine response?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary goal of the novel approach to medicine response described in the passage?

<p>To individualize the dosing regimen and improve therapeutic response while reducing adverse drug reactions (B)</p> Signup and view all the answers

What is the significance of the completion of the Human Genome Project on April 25, 2003?

<p>Both a and b (A)</p> Signup and view all the answers

Which of the following molecular mechanisms is NOT mentioned in the passage as influencing medicine response?

<p>Pharmacokinetics (B)</p> Signup and view all the answers

What is the mechanism of action of tramadol?

<p>Agonism at the µ-opioid receptor and inhibition of neurotransmitter reuptake (C)</p> Signup and view all the answers

Why is tramadol not FDA approved for use in children?

<p>Used off-label due to lack of FDA approval (C)</p> Signup and view all the answers

Which enzyme is responsible for metabolizing a small amount of tramadol?

<p>CYP2D6 (A)</p> Signup and view all the answers

What is the primary concern regarding tramadol use in poor metabolizers?

<p>Risk of drug accumulation due to slower metabolism (D)</p> Signup and view all the answers

Which medication has been contraindicated by the FDA for use in children under 12 years old for pain treatment?

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

What is the recommended maximum dose of vortioxetine for poor metabolizers?

<p>10 mg/day (B)</p> Signup and view all the answers

What is the recommended starting dose for patients with the CYP2C9*2 genotype?

<p>5 mg/day (D)</p> Signup and view all the answers

Which ethnic group has the highest prevalence of the CYP2C9*2 genotype?

<p>White (B)</p> Signup and view all the answers

What is the primary reason for conducting TPMT testing in patients receiving 6-mercaptopurine?

<p>To predict the risk of hematologic toxicity (B)</p> Signup and view all the answers

What is the recommended action for patients with intermediate TPMT enzyme activity?

<p>Decrease initial dose by 30-50% and follow closely (A)</p> Signup and view all the answers

Which metabolite of 6-mercaptopurine is considered hepatotoxic?

<p>6-methylmercaptopurine (D)</p> Signup and view all the answers

What is the primary reason for the FDA's boxed warning and contraindication for codeine use in pediatrics under 12 years old?

<p>Risk of opioid intoxication in ultra-rapid CYP2D6 metabolizers (C)</p> Signup and view all the answers

Which population group is most likely to experience ultra-rapid codeine metabolism?

<p>East African, Middle Eastern, and Oceania populations (B)</p> Signup and view all the answers

What is the primary metabolic pathway for codeine?

<p>Metabolism to an inactive compound, with a minor CYP2D6 pathway to morphine (B)</p> Signup and view all the answers

Which CYP enzyme exhibits the most clinically relevant genetic polymorphism?

<p>CYP2D6 (A)</p> Signup and view all the answers

What is a potential consequence of being a poor CYP2D6 metabolizer when taking codeine?

<p>Lack of analgesic efficacy (A)</p> Signup and view all the answers

Which population group is least likely to experience poor CYP2D6 metabolism?

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

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