pharmacogenomics pollev

therapeutic window

the concentration between the effective dose and the adverse effects

duration of action

length of time the drug is effective; altered by metabolic breakdown/activation

b

Imagine you have a single mutation of CAG to UAG. (Note: CAG codes for Gln and UAG is an
Amber stop codon). What type of mutation is this?

a. silent
b. nonsense
c. missense

a

Which of the following describes pharmacokinetics?

a. the modifications that enzymes in the body make on the drug
b. the effect that the drug has on the body
c. a and b

b

Drug A inhibits CYP2C9. This is an example of...

a. pharmacokinetics
b. pharmacodynamics
c. a and b

b

The amount of time during which a drug is at a concentration which is therapeutic is...

a. the peak effect
b. the duration of action
c. the side effect window
d. the therapeutic window
e. the subtherapeutic window

a

The action of CYP2C19 on clopidogrel is an example of...
a. phase 1 drug metabolism
b. phase 2 drug metabolism
c. phase 3 drug metabolism

c

The effect of SCLO1B1 on simvastatin is an example of...
a. phase 1 drug metabolism
b. phase 2 drug metabolism
c. phase 3 drug metabolism

a

A patient with two gain of function alleles for CYP2C19 would have a \______duration of
action of clopidogrel than a patient with two normal function alleles.
a. longer
b. shorter
c. identical

b

CYP2C19 and CYP2C9...
a. are members of the same family but not the same subfamily
b. share \>55% sequence homology
c. are members of the same superfamily but not the same family
d. are the same isoform

a

The majority of drugs are metabolized by which CYP enzymes?
a. cyp 1, 2, 3
b. cyp 11, 17, 19, 21
c. cyp 4, 5
d. cyp 7, 8, 27

b

What is the name given to a drug that increases the rate of another drug's metabolism?
a. deactivating agent
b. inducing agent
c. inhibiting agent
d. activating agent

a

CYP2D6*1/*2xN...
a. is a diplotype
b. is a phenotype
c. is an allele

b

A patient with "TC" at rs4149056 for SLCO1B1...
a. has two gain of function alleles
b. has one normal and one loss of function alleles
c. has one normal and one gain of function alleles
d. has two loss of function alleles

b

A patient with "TC" at rs4149056 for SLCO1B1...
a. has normal myopathy risk
b. has intermediate myopathy risk
c. has high myopathy risk

e

A patient has been taking a maximum dose of simvastatin for 6 years and has controlled
cholesterol levels. The patient's recent blood test suggest normal levels of creatine kinase,
electrolytes and serum myoglobin. What should you do?
a. suggest an alternative to simvastatin
b. increase the dose of simvastatin
c. suggest genotyping for SLCO1B1
d. decrease the dosage of simvastatin
e. continue to monitor the patient's cholesterol and blood tests

c

A patient is taking carbamazepine and has reported adverse reactions. What might you
suggest?
a. consult cpic to determine if you should reduce the dosage
b. continue to monitor the adverse reactions
c. consider genotype testing for HLA-A and HLA-B

c

You have a patient taking amitriptyline who has recently had surgery and has a
prescription for codeine. You note the patients medical chart the following genetic tests:
CYP2D6 *1/*2xN, CYP2C19 *1/*1. What should you do?
a. consider a reduced dose of amitriptyline
b. consider an alternative to codeine
c. consider an alternative to amitriptyline
d. consider a reduced dose of codeine

b

What does CPIC stand for?
a. Clinical Pharmacy
Individualized Consortium
b. Clinical Pharmacogenetics
Implementation Consortium
c. Clinicians, Pharmacists
Informative Consortium

a

CPIC Level A means...
a. Preponderance of
evidence is high or
moderate in favor of
changing prescribing
b. Preponderance of
evidence is weak with little
conflicting data
c. Evidence levels can vary

c

A patient has a diplotype of CYP2C19*2/*3, what is recommended?
a. decreased dose of clopidogrel
b. increased dose of clopidogrel
c. alternative form of clopidogrel
d. standard dose of clopidogrel

c

A patient has the genotype CYP2D6*1xN/*4. Which of the following is true?
a. The patient has more than one normal function allele and one deleted allele
b. The patient has one
normal function allele and
one loss of function allele
c. The patient has more than one copy of normal
function alleles and one
loss of function allele
d. The patient has 3 or more copies of normal function alleles

b

A patient with an activity score of 0.5 for CYP2D6...
a. will have increased morphine formations
b. will have reduced morphine formations
c. will have greatly reduced morphine formations
d. will have normal morphine formations

c

Which genotype for TPMT is suggestive of starting with a 30-70% of a full dose of mercaptopurine?
a. TPMY*1/*1
b. CYP2C9*1/*4; TPMT *3/*4
c. TPMT *1/*3A; CYP2D6
*1/*1DUP