MN 553 Unit 9 review latest 2023

Asian metabolizers-poor metabolizer PM phenotype 21% ultrarapid metabolizer CYP2D6, therapeutic failings or need for increased dosage in drugs such as SSRI, increasing risks of ADR especially in polypharmacy (Marked reduced activity of some drugs). Little to no clinical effect of opioids. Drugs active when administered may produce effects of excess drugs at lower levels P-glycoprotein-membrane bound, ATP dependent transport system, xenobiotics from cells to extracellular fluid. Ejection of drugs from cell, usually against concentration gradient Pgp  Variant response to antiepileptic drugs, select cardiovascular drugs  At GI, effluxes hydrophilic drugs out of the cell and inhibits drugs absorption  PGP Affects the level of digoxin available for absorption and elimination  CCB and high-dose steroids are reversible inhibitors of Pgp  Grapefruit and ritonavir are suicidal agents, meaning effect with be prolonged VKORC1 mutation-vitamin K epoxide reductase causes a rare syndrome of Warfarin resistance Pharmacogenetic testing-required with Cetuximab, Trastuzumab, Maraviroc, Daatinib Recommended with warfarin, carbamazepine, Asians at risk for Stephen’s Johnson syndrome or toxic epidermal necrolysis (TEN) 10x higher risk than cauc Carbamazepine-antiepileptic drug (Tegratol, Carbatrol) inhibitor of Pgp Pharmacogenetic testing recommended for HLA B 1202 variant Contraindicated with MAOIs, pregnancy D, suppresses bone marrow, blood dyscrasias Yin (cooling) vs Yang Menopause seen as yin deficiency (mountain peony, philodendron bark) 4. Traditional Chinese medicine utilizes yin (cooling) versus yang (warming) in assessing and treating disease. Menopause is considered a time of imbalance, therefore the Chinese herbalist would prescribe: 1. Herbs which are yang in nature 2. Herbs that are yin in nature 3. Ginger 4. Golden seal 1. The U.S. Food and Drug Administration regulates: 1. Prescribing of drugs by MDs and NPs 2. The official labeling for all prescription and over-the-counter drugs 3. Off-label recommendations for prescribing 4. Pharmaceutical educational offerings 5. Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels include: 1. Dwayne has