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ANATASHIA
Chapter 1.
An Introduction to Pharmacogenetics
Multiple Choice
Identify the choice tha bes completes the statemen or answers the question. J J J




1. Genetic polymorphisms account for differences in metabolism, including: J J J J J J




1. Poor metabolizers, wholacka working enzyme
J J J J J J




2. Intermediate metabolizers, who have one working, wild-type allele and one mutant J J J J J J J J J J




3. Extensive metabolizers, withtwo normally functioning alleles J J J J J J




4. All of the above
J J J




J 2. Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to:
J J J J J J J J J J J




1. A need to monitor drugs metabolized by 2D6 for toxicity
J J J J J J J J J




2. Increased dosages needed of drugs metabolized by 2D6, suchas the J J J J J J J J J J JJ




selective serotoreuptake inhibitors J J




3. Decreased conversion of codeine tomorphine by CYP 2D6 J J J J J J J J




4. The need for lowered dosages of drugs, suchas beta blockers
J J J J J J J J J J




J 3. Rifampin is a nonspecific CYP450 inducer that may:
J J J J J J J J




1. Lead to toxic levels of rifampin and must be monitored closely
J J J J J J J J J J




2. Cause toxic levels of drugs, suchas oral contraceptives, whencoadministered
J J J J J J J J J J




3. Induce the metabolism of drugs, suchas oral contraceptives, leading totherapeutic
J J J J J J J J J J J




4. Cause nonspecific changes indrug metabolism
J J J J J




J 4. Inhibition of P-glycoprotein by a drug such as quinidine may lead to:
J J J J J J J J J J J J




1. Decreasedtherapeutic levels of quinidine J J J J




2. Increased therapeutic levels of quinidine J J J J




3. Decreased levels of a coadministered drug, suchas digoxin, that J J J J J J J J J J




requires P-glycoprabsorption and elimination J J J




4. Increased levels of a coadministered drug, such as digoxin, that J J J J J J J J J JJ




requires P-glycoproabsorption and elimination J J J




J 5. Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:
J J J J J J J J J J J J




1. Toxic levels of warfarinbuilding up
J J J J J

, 2. Decreased response to warfarin J J J




3. Increased riskfor significant drug interactions with warfarin
J J J J J J J




4. Less riskof drug interactions with warfarin
J J J J J J




J 6. Genetic testing for VCORC1 mutation to assess potential warfarin
J J J J J J J J J J




resistance is requiredprior to prescribing warfarin.
J J J J J




1. True
2. False

J 7. Pharmacogenetic testing is required by the U.S. Food and Drug
J J J J J J J J J J J




Administration prior toprescribing: J J




1. Erythromycin
2. Digoxin
3. Cetuximab
4. Rifampin

J 8. Carbamazepine has a BlackBoxWarning recommending testing for the
J J J J J J J J J J J




HLA-B*1502 allelein patients with Asian ancestry prior to starting
J J J J J J J J J




therapy due to:
ATASHIA
J J




1. Decreased effectiveness of carbamazepine intreating seizures in Asian patients wit
J J J J J J J J J J J




HLA-B*1502 allele J




2. Increased riskfor drug interactions in Asian patients with the HLA-B*1502 allele
J J J J J J J J J J J




3. Increased riskfor Stevens-Johnson syndrome in Asianpatients with HLA-B*1502 a
J J J J J J J J J J




4. Patients who have the HLA-B*1502 allele being more likely to
J J J J J J J J J J




have a resistance tocarbamazepine
J J J




J 9. Agenetic variationin how the metabolite of the cancer drug
J J J J J J J J J J J J




irinotecan SN-38 isinactivated by the body may lead to:
J J J J J J J J




1. Decreased effectiveness of irinotecanin the treatment of cancer J J J J J J J J




2. Increased adverse drug reactions, suchas neutropenia J J J J J J




3. Delayed metabolism of the prodrug irinotecanintothe active metabolite SN-38
J J J J J J J J J J




4. Increasedconcerns for irinotecanbeing carcinogenic J J J J J




10. Patients who have a poor metabolism phenotype will have:
J J J J J J J J J J




1. Slowed metabolism of a prodrug intoan active drug, leading toaccumulation of pr
J J J J J J J J J J J J J




2. Accumulation of inactive metabolites of drugs J J J J J




3. A needfor increased dosages of medications
J J J J J J




4. Increased elimination of anactive drug J J J J J




11. Ultra-rapid metabolizers of drugs may have:
J J J J J J J

, 1. To have dosages of drugs adjusted downward toprevent drug accumulation
J J J J J J J J J J




2. Active drug rapidly metabolized intoinactive metabolites, leading to
J J J J J J J JJ J




potential therafailure J




3. Increasedelimination of active, nonmetabolized drug
J J J J J




4. Slowed metabolism of a prodrug into anactive drug, leading to anaccumulation of
J J J J J J J J J J J J J




12. A provider may consider testing for CYP2D6 variants prior to
J J J J J J J J J J J J




starting tamoxifen forbreast cancer to:
J J J J




1. Ensure the patient will not have increased adverse drug reactions to the tamoxifen
J J J J J J J J J J J J




2. Identify potential drug-drug interactions that may occur withtamoxifen
J J J J J J J J




3. Reduce the likelihood of therapeutic failure with tamoxifentreatment
J J J J J J J J




4. Identify poor metabolizers of tamoxifen
J J J J

, Chapter 1. An Introduction to
J J J J J




PharmacogeneticsAnswerSection
J




MULTIPLECHOICE J




1. ANS:
J 4 PTS: 1
2. ANS:
J 2 PTS: 1
3. ANS:
J 3 PTS: 1
4. ANS:
J 4 PTS: 1
5. ANS:
J 2 PTS: 1
6. ANS:
J 2 PTS: 1
7. ANS:
J 3 PTS: 1
8. ANS:
J 3 PTS: 1
9. ANS:
J 2 PTS: 1
10. 1 PTS: 1
ANS:
11. 2 PTS: 1
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12. 3 PTS: 1
ANS: