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The boxed warning recommending pharmacogenomic testing of patients receiving clopidogrel to identify reduced metabolizers seems to be playing to a largely deaf audience.
Individuals carriers of two inactive CYP2C19 alleles are predicted to be gPMs, while carriers of *1/*17 or *17/*17 genotypes are predicted ultrarapid metabolizers (gUMs).
Northern African and middle eastern populations show higher prevalence of ultra-rapid CYP2D6 metabolizers (12), the same ethnicity that the aforementioned player possessed.
However, if there were a duplication of the entire 2D6 gene, the correct phenotype would be *1XN, ultrarapid metabolizer.
Table 5: Comparison of CYP2C19 genotype and poor metabolizer frequency between Turkman ethnic group and other populations.
Evidence has been presented that persons who are poor metabolizers (PMs) may be at increased risk for dose-related adverse events caused by drugs that are metabolized predominately by CYP2D6, while patients with multiple copies of active genes, UMs, may be more likely to experience therapeutic failure due to rapid metabolism (7).
extensive metabolizers (EMs; CYP2C19*1/*1 and CYP2C19*1/ *X; where 'X' represents a mutant allele) and poor metabolizers (PMs; CYP2C19*X/*X) with marked inter-individual variations in the pharmacokinetics and pharmacodynamics of PPIs in the population.
Some have been withdrawn from clinical use because of their associated side effects such as the occurrence of significant cardiovascular adverse effects including orthostatic hypotension, especially in poor metabolizer subjects.
If a patient is genetically predisposed to be a poor metabolizer of a particular drug or class of drugs, when that drug is administered, even at normal dosages, amounts of the agent retained in the system can quickly build to toxic concentrations, leading to an ADR.
One diagnosed the client as a "fast metabolizer," another described her as a "slow metabolizer.
4) 0 Expected phenotype(b) Extensive metabolizer Homozygote 29 (70.