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9 Cards in this Set

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CYP2D6: debrisoquin-sparteine polymorphism
metabolizes Codeine to active Morphine, also metablizes beta blockers, tricyclic antidepressants, dextromethorphan. .///

7% slow metablizers. So, slow effect of codeine on them. 30% east african fast metabolizers
CYP2C19
slow metabolizers in Asian population..//substrate: omeprazole, phenytoin, diazepam etc. /// Omeprazole is proton pump inhib. so beneficial against H. pylori
CYP2C9
slow metabolizers: enhance effects of S. Warfarin, phenytoin and Losartan. CYP2C9 is the primary metabolizer of Warfarin and hence these pts are oversensitive to this drug.
CYP1A2
eliminates caffeine slowly
Dihydropyrimidine dehydrogenase
metabolizes 5-fluorouracil., can result in neurotoxicity
psuedocholinesterase
succinylcholine sensitity. >>> prolong action. Rare in asians and Africans.
N-Acytylation (NAT-2)
a Phase II reactant, acytylate isoniazid (INH), procainamide, sulfonamides, histamines etc.//

Slow metabolizers increases neurtotoxicity, chemical carcinogens from smoke, increased risk of bladder cancer. //

fast acytylators increased risk for colon cancer
Thiopurine methyl transferase (TPMT)
Thiopurine metabolized to active form, 6-thioguanine and inactivated by TPMT. So slow metabolizers end up with elevated 6-thioguanine, resulting in life-threatening myeolosupression.
Others
MDR-1.///
Beta 2 adr. Receptor: Arg/Arg in venodilation desensitizes very quickly, but gives increased bronchodilator response relative to Gly/Gly or Arg/Gly. //

VKORC1: mutation causes insensitity to Warfarin, requiring more drugs.