All Qs PGx

38% of patients who have depression show no response to initial treatments. Using the sliding arrow on the left, which of the following would result in therapeutic failure?

• All of the above

• Low systemic concentrations at normal doses

• High systemic concentrations at normal doses

• Both A and B are be correct

Which of the following is associated with increased Phase I metabolism of a drug?

• None of the above

• Increased gene expression of the CYP enzyme

• One or more nonfunctional alleles of the CYP enzyme

• A normal metabolizer

What would be the most likely recommendation for patient on citalopram who is a PM of CYP2D6?

• Avoid CYP2D6 inhibitors

• Decrease the dose of citalopram

• Increase the dose of citalopram

• Avoid CYP3A4 inhibitors

A patient on amitriptyline is determined to be a normal metabolizer of CYP1A2.

1.What would be the recommendation for this patient if the patient is taking no other drugs?

• An increase in dose would be required

• A dose reduction would be required

• No modification is needed

• None of the above

A patient on amitriptyline is determined to be a normal metabolizer of CYP1A2.

2. What would be the recommendation for this patient if the patient is also taking a CYP2C19 inhibitor.

• avoid the CYP2C19 inhibitor or select a CYP2C9 substrate

• A dose reduction would be required

• An increase in dose would be required

• None of the above

What would be the most likely recommendation for the patient above on duloxetine?

• Increase the dose of duloxetine

• Decrease the dose of duloxetine

• Avoid CYP2D6 inhibitors

• All of the above

Using the sample patient GeneSight profile on the left, which of the following antipsychotic drugs would be appropriate for a normal CYP1A2 metabolizer

• iloperidone

• risperidone

• chlorpromazine

• aripiprazole

Patient Z has been diagnosed with ADHD and has a C/C homozygous polymorphism on the ADRA2A gene.  What recommendation would be appropriate for methylphenidate (Ritalin)?

• consider Ketamine

• increase the dose of methylphenidate

• consider a different ADHD medication that is not affected by ADRA2A polymorphisms

• lower the dose of methylphenidate

Answer explanation

Answer:

Choice B or C

Reason: the C/C polymorphism in the ADRA2A gene suggests a reduced response to methylphenidate

Risk of hypersensitivity reaction caused by allopurinol can be to which HLA genotype variant?

• HLA-B*58-01 variant

• HLA-B*57-01 variant

• HLA-B*15-02 variant

• HLA-A*31-01 variant

Which of the following skin reactions is generally more severe?

• Stevens-Johnson Syndrome

  (SJS)

• Toxic Epidermal Necrolysis

  (TEN)

• Hypersensitive Rx Type 1

• Lupus Erythematosus