and complete verified 100% correct
answers
4. All of the above - answer ✔✔-Genetic polymorphisms account for differences in metabolism,
including:
1. Poor metabolizers, who lack a working enzyme
2. Intermediate metabolizers, who have one working, wild-type allele and one mutant allele
3. Extensive metabolizers, with two normally functioning alleles
4. All of the above
2. Increased dosages needed of drugs metabolized by 2D6, such as the selective serotonin
reuptake inhibitors - answer ✔✔-Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading
to:
1. A need to monitor drugs metabolized by 2D6 for toxicity
2. Increased dosages needed of drugs metabolized by 2D6, such as the selective serotonin
reuptake inhibitors
,3. Decreased conversion of codeine to morphine by CYP 2D6
4. The need for lowered dosages of drugs, such as beta blockers
3. Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic failure -
answer ✔✔-Rifampin is a nonspecific CYP450 inducer that may:
1. Lead to toxic levels of rifampin and must be monitored closely
2. Cause toxic levels of drugs, such as oral contraceptives, when coadministered
3. Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic failure
4. Cause nonspecific changes in drug metabolism
4. Increased levels of a coadministered drug, such as digoxin, that requires P-
glycoprotein for absorption and elimination - answer ✔✔-Inhibition of P-glycoprotein by a drug
such as quinidine may lead to:
1. Decreased therapeutic levels of quinidine
2. Increased therapeutic levels of quinidine
3. Decreased levels of a coadministered drug, such as digoxin, that requires P-
glycoprotein for absorption and elimination
,4. Increased levels of a coadministered drug, such as digoxin, that requires P-
glycoprotein for absorption and elimination
2. Decreased response to warfarin - answer ✔✔-Warfarin resistance may be seen in patients
with VCORC1 mutation, leading to:
1. Toxic levels of warfarin building up
2. Decreased response to warfarin
3. Increased risk for significant drug interactions with warfarin
4. Less risk of drug interactions with warfarin
2. False - answer ✔✔-Genetic testing for VCORC1 mutation to assess potential warfarin
resistance is required prior to prescribing warfarin.
1. True
2. False
3. Cetuximab - answer ✔✔-Pharmacogenetic testing is required by the U.S. Food and Drug
Administration prior to prescribing:
1. Erythromycin
2. Digoxin
, 3. Cetuximab
4. Rifampin
3. Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-B*1502 allele -
answer ✔✔-Carbamazepine has a Black Box Warning recommending testing for the HLA-
B*1502 allele in patients with Asian ancestry prior to starting therapy due to:
1. Decreased effectiveness of carbamazepine in treating seizures in Asian patients with the HLA-
B*1502 allele
2. Increased risk for drug interactions in Asian patients with the HLA-B*1502 allele
3. Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-B*1502 allele
4. Patients who have the HLA-B*1502 allele being more likely to have a resistance to
carbamazepine
2. Increased adverse drug reactions, such as neutropenia - answer ✔✔-A genetic variation in
how the metabolite of the cancer drug irinotecan SN-38 is inactivated by the body may lead to:
1. Decreased effectiveness of irinotecan in the treatment of cancer
2. Increased adverse drug reactions, such as neutropenia
3. Delayed metabolism of the prodrug irinotecan into the active metabolite SN-38