Pharmacogenomics

Question 1

What genetic testing should be done before staring Abacavir (Ziagen)?

Answer 1

HLA-B *5701 in ALL patients

Question 2

What genetic testing should be considered before starting Allopurinol (Zyloprim,Aloprim)?

Answer 2

HLA-B *5801 at high risk of SJS (AA, Asian, Pacific Islander/Hawaiian)

Question 3

What genetic testing should be considered before starting antiseizure medications (fos-phenytoin, carbamazepine, oxcarbazepine)?

Answer 3

HLA-B*1502 test ALL ASIAN patients before starting

Question 4

What genetic testing should be considered before starting Citalopram (Celexa)?

Answer 4

CYP2C19 2/3 PMs have increased risk of QT prolongation (max 20mg/d)

Question 5

What genetic testing should be considered before starting Clopidogrel (Plavix)?

Answer 5

CYP2C19 2/3 PMs have an increased risk of CV events

Question 6

What genetic testing should be considered before starting Codeine?

Answer 6

2D6; Ultrarapid metabolizers have an increased risk of OD; avoid in children/breastfeeding

Question 7

What genetic testing should be considered before starting Warfarin?

Answer 7

2C9 2/3 PM increased risk of bleeding

Question 8

What genetic test is completed before starting Trastuzumab (Herceptin)?

Answer 8

ONLY use if HER2 positive

Question 9

What genetic test is completed before starting Cetuximab (Erbitux)?

Answer 9

ONLY use of KRAS mutation Negative (wild type)

Question 10

What genetic test is completed before starting Azathioprine (Azasan, Imuran)?

Answer 10

Low/absent TPMT activity; increased risk for Myelosuppression

Question 11

What genetic test is completed before starting Capecitabine (Xeloda)/Flurouracil?

Answer 11

DPD deficiency; increased risk of severe toxicity (Diarrhea, neutropenia, neurotoxicity)