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Case of Antiplatelet Therapy: Mr. Mark Johnson (MJ) is a 58-year-old Caucasian male who has just undergone percutaneous coronary intervention with coronary artery stent placement. MJ has a history of diabetes and hypertension. MJ is placed on dual-antiplatelet therapy, including aspirin and prasugrel. Pharmacogenetic testing was performed and the results report is available (below, next page). The primary care prescriber wishes to change prasugrel to clopidogrel and you are consulted on this case. What is your recommendation for MJ? Explain in detail and based on scientific evidence.

Case of Antiplatelet Therapy: Mr. Mark Johnson (MJ) is a 58-year-old Caucasian male who has just undergone percutaneous coronary intervention with coronary artery stent placement. MJ has a history of diabetes and hypertension. MJ is placed on dual-antiplatelet therapy, including aspirin and prasugrel. Pharmacogenetic testing was performed and the results report is available (below, next page). The primary care prescriber wishes to change prasugrel to clopidogrel and you are consulted on this case. What is your recommendation for MJ? Explain in detail and based on scientific evidence.

Phlebotomy Essentials
Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
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Case of Antiplatelet Therapy: Mr. Mark Johnson (MJ) is a 58-year-old Caucasian male who has just undergone percutaneous coronary intervention with coronary artery stent placement. MJ has a history of diabetes and hypertension. MJ is placed on dual-antiplatelet therapy, including aspirin and prasugrel. Pharmacogenetic testing was performed and the results report is available (below, next page). The primary care prescriber wishes to change prasugrel to clopidogrel and you are consulted on this case. What is your recommendation for MJ? Explain in detail and based on scientific evidence.
Transcribed Image Text:Case of Antiplatelet Therapy: Mr. Mark Johnson (MJ) is a 58-year-old Caucasian male who has just undergone percutaneous coronary intervention with coronary artery stent placement. MJ has a history of diabetes and hypertension. MJ is placed on dual-antiplatelet therapy, including aspirin and prasugrel. Pharmacogenetic testing was performed and the results report is available (below, next page). The primary care prescriber wishes to change prasugrel to clopidogrel and you are consulted on this case. What is your recommendation for MJ? Explain in detail and based on scientific evidence.
ar wn FOR ACADEMIC PURPOSES ONLY - NOT FOR CLINICAL USE Test Details Gene Genotype Phenotype Alleles Tested CYP2C19 *2/"7 Poor Metabolizer *2, *3, *4, *4B, *5, *6, *7, *8, *9, *17 CYP2D6 *1/4 Intermediate Metabolizer *2, *3, *4, "4M, "6, *7, *8, *9, *10, *12, *14A, *148, *17, *29, *35, *41 СYРЗАS *3/"3 Poor Metabolizer *1D, *2, *3, *38, *3C, *6, *7, *8, *9 CYP3A4 *1/*1 Normal Metabolizer *18, *2, *3, *12, *17, *22 VKORCI -1639G>A G/A Intermediate Warfarin Sensitivity -1639G>A *2, *3 *2, *3, *4, *5, "6, *11 CYP4F2 *1/3 Decreased Function CYP2C9 *1/*1 Normal Metabolizer CYP2B6 *1/*1 Normal Metabolizer *6, *9 *1F/1F Normal Metabolizer - Higher *1C, *1D, *1F, *1K, *1L, *1V, *1W CYPIA2 Inducibility SLCOIB1 521T>C T/T Normal Function 521T>C, 388A>G CFTR FS08del/RS53X Negative Numerous DPYD *1/*1 Normal Metabolizer Numerous *2, *3A, *38, *3C, 4 *2, *3, *4, *5, *6, *7, *8, *9 *6, *27, *28, *36, *37, *60, "80 TPMT *1/3A *1/*1 Intermediate Metabolizer NUDT15 Normal Metabolizer UGTIAI *1/*36 Normal Metabolizer G6PD Bangkok or Bangkok/ Bangkok Deficient with CNSHA Numerous Additional Test Results (added to this original report) HLA-A*31:01 negative/negative Negative HLA-B*15:02 negative/negative Negative HLA-B'57:01 negative/negative Negative HLA-B'58:01 negative/negative Negative
Transcribed Image Text:ar wn FOR ACADEMIC PURPOSES ONLY - NOT FOR CLINICAL USE Test Details Gene Genotype Phenotype Alleles Tested CYP2C19 *2/"7 Poor Metabolizer *2, *3, *4, *4B, *5, *6, *7, *8, *9, *17 CYP2D6 *1/4 Intermediate Metabolizer *2, *3, *4, "4M, "6, *7, *8, *9, *10, *12, *14A, *148, *17, *29, *35, *41 СYРЗАS *3/"3 Poor Metabolizer *1D, *2, *3, *38, *3C, *6, *7, *8, *9 CYP3A4 *1/*1 Normal Metabolizer *18, *2, *3, *12, *17, *22 VKORCI -1639G>A G/A Intermediate Warfarin Sensitivity -1639G>A *2, *3 *2, *3, *4, *5, "6, *11 CYP4F2 *1/3 Decreased Function CYP2C9 *1/*1 Normal Metabolizer CYP2B6 *1/*1 Normal Metabolizer *6, *9 *1F/1F Normal Metabolizer - Higher *1C, *1D, *1F, *1K, *1L, *1V, *1W CYPIA2 Inducibility SLCOIB1 521T>C T/T Normal Function 521T>C, 388A>G CFTR FS08del/RS53X Negative Numerous DPYD *1/*1 Normal Metabolizer Numerous *2, *3A, *38, *3C, 4 *2, *3, *4, *5, *6, *7, *8, *9 *6, *27, *28, *36, *37, *60, "80 TPMT *1/3A *1/*1 Intermediate Metabolizer NUDT15 Normal Metabolizer UGTIAI *1/*36 Normal Metabolizer G6PD Bangkok or Bangkok/ Bangkok Deficient with CNSHA Numerous Additional Test Results (added to this original report) HLA-A*31:01 negative/negative Negative HLA-B*15:02 negative/negative Negative HLA-B'57:01 negative/negative Negative HLA-B'58:01 negative/negative Negative
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