DNP 810 DQ Week 4 Topic 1
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Grand Canyon University *
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810
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Medicine
Date
Jan 9, 2024
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docx
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Topic 4 DQ 1
Upcoming
Assessment Description
In the past decade, there have been many advances in pharmacogenomics affecting
drug therapy that can be used to improve therapeutic efficacy and reduce adverse
events. Identify a gene-drug combination for which there is pharmacogenetic
information (e.g., Table 18-3 in the textbook). Explain the pharmacokinetic and
pharmacodynamic response that occurs.
There have been many changes to drug therapy and what information scientists have gathered over the
years. This unique space of growth for pharmacogenomics has been affecting drug therapy. The
advancement of drugs has been improved in therapeutic efficacy and reduction in adverse events. This
overall is a benefit for patients and the population as a whole. The goal continues to be the reduction of
disease and prolonging of health.
A gene-drug combination which there is pharmacogenetic information as it appears in Table 18-3 in the
textbook is diazepam. Cytochrome P-450 proteins found in humans consists of a large family of 56
different functional enzymes that are encoded by a differing
CYP
gene (Naussbaum et al., 2016). They
are grouped into 20 families and three of them contain enzymes that have substrates which are
xenobiotics. Diazepam works on the cytochrome P-450 genes or more specifically the gene
CYP2C19
.
This gene encodes enzymes responsible for metabolism of 90% of all commonly prescribed medications
(Naussbaum et al., 2016). For most drugs, cytochrome P-450 starts the process of detoxification through
reactions of deactivating the drug for ease of secretion. The
CYP
genes are important as they contain
alleles that result in decreased, increased, or absent enzyme activity which affects the rate at which the
drug is metabolized and the individual’s response to drug therapy (Naussbaum et al., 2016). This
variability is dependent on the individual. Diazepam is primarily metabolized by genes
CYP3A4
and
CYP2C19
. Approximately 2% of Europeans, 13% of East Asians, and 57% of Oceanians have reduced or
absent
CYP2C19
enzyme activity (Dean, 2020). The individual variability of diazepam metabolism is
attributed to the variability in the
CYP2C19
gene. This variation can alter the results and differences in
drug levels when standard dosing is used and can have a direct correlation on both therapeutic and
adverse effects (Dean, 2020).
References
Dean, L. (2020, October 15).
Diazepam therapy and CYP2C19 genotype
. National Library of
Medicine National Center for Biotechnology Information. Retrieved March 16, 2023, from
https://pubmed.ncbi.nlm.nih.gov/28520370/
Naussbaum, R. L., McInnes, R. R., & Willard, H. F. (2016).
Thompson and Thompson genetics in
medicine
(8th
ed.). Elsevier. ISBN-13: 9781437706963
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