Lecture 1 Introduction to Personalised Medicine Flashcards Preview

CDL301 Cardiovascular Pharmacology > Lecture 1 Introduction to Personalised Medicine > Flashcards

Flashcards in Lecture 1 Introduction to Personalised Medicine Deck (26)
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1

What is meant by mutlimorbitidy

The presence of two or more chronic medical conditions in an individual

2

What is meant by the term pharmacogenomics

The study of how a person’s genome influences their response to medications

3

Give examples of the benefits of personalised medicine in the clinic

Can reduce trial and error prescribing avoid adverse reactions increase patient compliance reveal additional uses control costs of health care

4

What development lead to major advances in the pharmacogenomic realm of medicine

Completion of the human genome project

5

Give an example of a pharmacogenomic drug that is targeted to patients with a particular disease in the right genomic background

Plavix /Clopidogrel is a drug that inhibits platelet aggregation. The drug is metabolised to its active form by the Cyp2c19 family of enzymes. If these enzymes contain polymorphisms they may be unable to metabolise it and the patient will be resistant to the drug. Hence this is only given to patients after a genetic test reveals their responsiveness to the drug

6

What is meant by inter-individual variation

Variations in concentrations of the drug at the site of action or different responses to the same concentration of a drug

7

What is meant by pharmacokinetics

Where the drug concentration changes in the different compartments of the body

8

What are some of the main causes of variability in drug responses

Age ethnicity genomics immunological factors concomitant disease and other drug interactions

9

How does drug elimination change with age

Drug elimination is less efficient in new-borns and older people

10

What is significant about GFR in terms of the excretion of drugs

GFR in new-borns is 20% of the adult value

11

How can the half-life of digoxin vary across different ages

In new-borns the half-life of digoxin is 200h whereas in adults in only 40hrs. This does however decrease to 80hrs in the elderly

12

Give of example of a factor that can contribute to the altered activity of a drug in the elderly and in new-borns

In new-borns the drug metabolising enzymes are altered this accounts for their slower metabolism of compounds. Meanwhile in the elderly body composition has changed which alters the way drugs act

13

How can ethnicity alter drug action

There are variations in genetics between ethnicities as well as differing environmental factors like diet

14

Some ethnicities can receive increased benefit to drugs over the normal responses T or F

T

15

Give an example of where a patient’s ethnicity impacts the metabolism of a drug

Ethanol metabolism is less efficient in Chinese patients

16

What is meant by a polymorphism

An alternative sequence at loci within the DNA strand

17

What is the most common form of an SNP

C-T base change

18

Inherited thrombophilia is a genetic condition associated with an SNP where is this found

The SNP is found in the coagulation factor V

19

Concomitant disease is another issue to consider in the variation of individuals in their response to a drug which organs are drug-modifying disease often seen

Kidney and liver

20

Give an example of a concomitant disease that means that patients will be resistant to a particular drug

Familial hypercholesterolaemia is an inherited high cholesterol condition leading to a lack of function in LDLR receptor. Statins are therefore not effective in lowering cholesterol in these patients

21

What kind of interactions need to be considered when administering a drug

Interactions with other drugs and with chemicals

22

Give an example of a drug whose interaction with another drug needs to be considered

The vasodilator sildenafil’s mechanism of action potentiates organic nitrates and as a result should not be given in combination with these drugs as it can lead to severe hypotension

23

What two genes does the warfarin genetic test look at

CYP29C - the enzyme that metabolises warfarin and VKORC – a gene that encodes the target of warfarin

24

Describe the warfarin genetic test

The warfarin genetic test looks for specific genomic variants in the CYP2C and VKORC genes. This determines the dose of warfarin that the patients receives as too much for some genotypes can cause bleeding whereas too little in other patients can cause thrombosis

25

How many different genotypes of CYP2C are there

3

26

How many different genotypes of VKORC are there

3