FRCA Notes


Pharmacogenetics


  • Pharmacogenetics describes how a patient's genetic variations impact on their drug pharmacokinetics
  • Pharmacogenetic changes can be classified as occurring in:
    • Enzymes (most notably the CYP450 system)
    • Transport proteins
    • Receptors

CYP2D6

  • CYP2D6 is responsible for metabolism of:
    • Codeine to morphine, via O-demethylation
    • Tramadol to its O-methyl metabolite, which has 1000x μ-opioid (MOP) receptor potency

  • Allelic variations cause a significant effect in the metabolism of some opioids
  • Patients can be classed as:
    • Ultra-fast metabolisers - gene duplications cause a larger proportion of drug conversions and side-effects, and increased morphine in breast milk, occurs in 30% East Africans
    • Expected metabolisers
    • Poor metabolisers - absent function with CYP2D6 *3 / *4 / *5 and *9 alleles, occurs in 7-10% of Caucasians

CYP2C9

  • Responsible for the metabolism of S-warfarin
  • S-warfarin is a vitamin K reductase (VKOR) inhibitor, with VKOR itself also exhibiting genetic variability
  • This necessitates treatment algorithms for warfarin based on ethnicity, gender, weight/height, other drugs used etc.

CYP2C19

  • Responsible for the metabolism of the pro-drug clopidogrel to its active form
  • CYP2C19 genotypes include:
    • *1 (wild type) - normal activity
    • *2 and *3 (approx. 30%) - reduced activity and may require alternative antiplatelets
    • *17 has increased activity although this doesn't require alternative therapeutic strategies

CYP2C & CYP24A

  • Genetic polymorphisms of these renal CYP enzymes can predispose to hypertension

Acetyltransferases

  • Hepatic N-acetyltransferases (NAT1 and NAT2) are responsible for acetylation as part of hepatic phase II metabolism, as well as processing of carcinogens
  • Paracetamol, isoniazid, hydralazine are amongst drugs metabolised via this pathway

  • Patients may have different acetylation status depending on their genotype:
    • Fast acetylator status is inherited in an autosomal dominant fashion (40% of population)
    • Slow acetylator status is inherited in an autosomal recessive fashion (60% of population)
      • Slow acetylators (NAT2*5 allele) represent 50% of the Caucasian population


P-glycoprotein (PGP)

  • Found in the GIT, hepatocytes, renal tubules and vascular portion of BBB
  • Tends to prevent flow of drug in direction that is clinically necessary e.g. limits transfer from intestinal lumen to plasma
  • Wild type PGP has increased activity and therefore reduce oral bioavailability
  • Inhibitors of PGP include amiodarone, verapamil and cyclosporin (these also happen to be CYP3A4 inhibitors so will increase bioavailable fraction of drugs)

Solute carrier SLC6A

  • SLC6A is responsible for the reabsorption of neurotransmitters
    • SLC6A-1: GABA
    • SLC6A-2: Noradrenaline
    • SLC6A-3: Dopamine
    • SLC6A-4: Serotonin
  • Variations in SLC6A-4 have been linked to personality disorder and responsiveness to SSRIs

Beta-1-adrenoreceptor

  • Coded for by the ADRB1 gene
  • Wild type and heterozygous mutations show good adrenoreceptor response to metoprolol
  • Homozygous mutations or those with a SNP at an important site show no response to metoprolol
    • Increased risk of HTN, congestive cardiac failure, cardiomyopathy
    • More common in Afro-Caribbeans