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In the 45-patient pilot study of inpatients treated with CYP450 substrates noted above, individuals with either poor metabolism or ultrarapid metabolism had 1-year treatment costs approximately $4000-$6000 greater than wild-type metabolizers or IMs, and PMs had longer mean durations of hospitalization (15).
However, if there were a duplication of the entire 2D6 gene, the correct phenotype would be *1XN, ultrarapid metabolizer.
In August 2007, a year after the case report was published, the Food and Drug Administration issued an alert, based on this report, warning about the potential increased risk for morphine overdose in nursing infants, whose mothers are taking codeine and are ultrarapid metabolizers of codeine, with the recommendation that manufacturers add this information to the label of their products.
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.
CHICAGO -- AstraZeneca (NYSE: AZN) today announced results from a sub-analysis of the PLATO genetic sub-study that evaluated the impact of poor metabolizers of clopidogrel.
2 allele are defined as intermediate metabolizers and noncarriers are defined as extensive metabolizers.
Cure of refractory duodenal ulcer and infection caused by Helicobacter pylori by high doses of omeprazole and amoxicillin in a homozygous CYP2C 19 extensive metabolizer patient.
Some have been withdrawn from clinical use because of their associated side effects such as the occurrence of significant cardiovascular adverse effects including orthostatic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.
This latter observation reflects the fact that at this time point no dose adjustments could have been made on the basis of therapeutic drug monitoring, and dosing thus was independent of genotype or metabolizer status.
In the meantime, Kadlubar observes, their data show "a very rough relationship between the number of cups of coffee an individual consumes each day and whether they're a rapid-rapid metabolizer.
Some clinical reference laboratories now offer CYP2D6 genotyping, which will indicate whether a patient is a poor, intermediate, extensive, or ultra-rapid metabolizer.
The problem metabolizer carries no distinguishing marks as he or she walks through a physician's door.
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