Wild Type Alleles
This wild-type allele is associated with normal metabolism of codeine into morphine.
What is CYP2D6*1?
What is a decreased 6MP dose?
This drug produces an irreversible inhibition of thymidylate synthase.
What is 5-fluorouracil?
This (mostly) liver enzyme is involved in converting codeine to morphine.
What is CYP2D6?
Warfarin targets this enzyme involved in Vitamin K recycling.
What is VKORC1?
Patients who test as homozygous for this common, wild-type allele can receive normal doses of 6-mercaptopurine.
What is TPMT*1?
5-fluorouracil is relatively ineffective in patients with this allele for the thiamine synthase or TYMS gene.
What is 3R/3G?
(high transcriptional activity -> more TS than safe levels of 5-FU can shut down)
This anticoagulant is on Dr. Lee's drug list.
What is Warfarin?
This treatment alternative is used for patients who are poor codeine metabolizers.
What are opioid analgesics not dependent on CYP2D6?
In most patients, this enzyme metabolizes and inactivates warfarin.
What is CYP2C9?
This analgesic is partially converted to morphine by CYP2D6.
What is codeine?
This adverse reaction can occur in patients with TPMT*3A and TPMT*3C inactive alleles who are treated with thiopurines.
What is myelosuppression?
Or: What is bone marrow suppression?
This pyrimidine analog is used as an immunosuppressant and anti-cancer drug.
What is 5-fluorouracil (5FU)?
This ultra-metabolizer allele can cause rapid conversion of codeine to morphine, leading to fatal respiratory depression.
What is CYP2D6*2xN?
A rotund term for some genetic variant testing leading to warfarin adverse reactions.
What is the Nanosphere?
Even patients with the Wild-Type allele for TPMT should have their Thiopurine doses reduced if they're on this anti-gout/anti-tumor lysis syndrome drug.
What is allopurinol?
Some patients who would otherwise get morphine are prescribed buprenorphine or hydromorphone because of this ADR-associated trait.
What is ultra-metabolizing?
(What is the CYP2D6*2xN allele?)
These hexy purines analogs are used to treat acute lymphoblastic leukemia and acute myeloid leukemia.
What are thiopurines?
Or: what are 6-mercaptopurine and 6-thioguanine?
This class of patients get poor to no conversion of codeine into morphine.
What are poor metabolizers?
Or: What are patients with CYP2D6*10?
This racial group often has bleeding susceptibility alleles not tested by Nanosphere.
Who are African Americans?
This VKORC1 allele is associated with low transcription activity and excess bleeding.
What is the VKORC1 ”A” allele?
This drug decreases uric acid levels and is commonly used in combination with 6MP, but causes an increased risk of tumor lysis syndrome.
What is allopurinol?
The only painkiller on the Foundations 3 exam.
What is codeine?
These two alleles are tested by Nanosphere.
What are the CYP2C9 and VKORC1 alleles?