NR 565 Week 1 Pharmacogenomics Discussion A GRADED

Week 1 Discussion: Pharmacogenomics 1. Before initiating abacavir, an anti-retroviral, for a newly diagnosed HIV positive patient the nurse practitioner orders HLA-B*5701 allele genetic testing. The test confirms that the patient carries the HLA-B*5701 allele. a. Describe what these results mean. HLAB is responsible for distinguishing the body’s own proteins from those that are foreign. If a patient is a carrier of the HLA-B allele, they are at risk for allergic reaction to the drug. This is due to evidence that suggests that abacavir binds to HLA-B changing the peptides that can be presented by the protein and the new peptides that are presented are perceived as foreign by the immune system. This triggers a reaction by the immune system and thus a hypersensitivity reaction Annotation of CPIC Guideline for abacavir and HLAB., n.d.). b. Should the nurse practitioner prescribe abacavir in this case? If not, state why. The Nurse Practitioner should not prescribe abacavir in this case. Prescribing abacavir in patients whom carry the HLA-B*5701 allele can cause sever hypersensitivity reactions including fever, rash, fatigue, cough, or dyspnea. If the drug is discontinued after a hypersensitivity reaction and then restarted, patients can experience life-threatening reactions including anaphylaxis and death (Annotation of CPIC Guideline for abacavir and HLA-B, n.d.).