Pharmacogenomics, or studying the genetic causes of differences in the way people respond to drugs, will provide the information to improve prescribing. There are genetic polymorphisms which are important both for therapeutic response and for preventing adverse drug reactions. In drug therapy genetic polymorphisms are important in several situations: 1. when drugs are cleared 50% or greater by an enzyme exhibiting a functionally relevant polymorphism 2. when using drugs with a steep dose-response curve and narrow therapeutic window 3. when using drugs whose activity depends on a metabolite formed by a polymorphic enzyme The effects and side effects of a certain drug will significantly depend on the sum of the genetic impact on the multiple factors deciding pharmacokinetics and pharmacodynamics Fagerlund & Braaten, 2001.
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SEQUENCE ANALYSIS OF THE 2B-ADRENERGIC RECEPTOR ADRA2B ; GENE AND IN-VIVO FUNCTIONAL EFFECTS OF NOVEL VARIANTS. M. Muszkat, MD, G. G. Sofowora, MD, D. Kurnik, MD, J. Solus, PhD, L. Jiang, MS, S. M. Williams, PhD, E. Dawson, PhD, A. J. Wood, MD, C. M. Stein, MD, Clinical Pharmacology and Medicine, Vanderbilt University, Bioventures, Inc, Nashville, TN. BACKGROUND: ADRA2B is important in vasoconstriction and blood pressure regulation. The only common variant identified del301303 ; decreased receptor desensitization in vitro but did not alter vascular sensitivity in vivo. We therefore characterized the genetic variation in ADRA2B and related this to in vivo phenotype. METHODS: We examined 5812 bp of contiguous sequence of ADRA2B promoter, exon, and 3' flanking region ; using PCR and bidirectional sequencing n 68 ; . Vasoconstriction in response to the selective 2AR agonist dexmedetomidine 0.011000 ng min ; was measured in the dorsal hand vein using a linear variable differential transformer. ED50 and Emax were used to compare vascular responses in subjects with and without variant alleles. RESULTS: 27 variants were detected, including the previously described 301303 deletion, 15 in the promoter region, 5 2 nonsynonymous ; in the coding region and 7 in the 3'UTR region. Among the 9 variants with a minor allele frequency 5%, 3 SNPs T1901G and G2572T in the promoter region and G4807A in the 3'UTR ; were in linkage disequilibrium and associated with a lower Emax, 61.3 23.5% mean SD ; compared to 77.8 17.0% in wildtype subjects, P 0.048. There was no association between the 9 common variants and ED50. CONCLUSION: We describe novel variants of the ADRA2B gene. These do not alter sensitivity to a selective 2AR agonist but may decrease maximal venoconstriction in vivo.
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Pharmacol Biochem Behav. 2007 Jul 18; [Epub ahead of print] PMID: 17698180 [PubMed - as supplied by publisher].
Department of Rheumatology, Allergy and Immunology Tan Tock Seng Hospital 11 Jalan Tan Tock Seng Singapore 308433 K O Kong, MBBS, MRCP UK ; Registrar H H Chng, MMed Int Med ; , FRCP Glasgow ; , FAMS Senior Consultant and Head Rheumatology Section Department of Medicine National University Hospital Lower Kent Ridge Road Singapore 119074 S Vasoo, MBBS, MRCP UK ; Registrar Department of Respiratory Medicine Tan Tock Seng Hospital 11 Jalan Tan Tock Seng Singapore 308433 N S W Tay, MBBS, MRCP UK ; Registrar Correspondence to: Dr K O Kong Tel: 65 ; 6357 7822 Fax: 65 ; 6357 7837 Email: Kok Ooi Kong ttsh .sg and cyclobenzaprine.
Kluwer Health, Inc. Accessed February 10, 2004. Combivejt [package insert]. Ridgefield, CT: Boehringer Ingelheim; February 1999. DuoNeb [package insert]. Napa, CA: Dey L.P.; March 2001. McEvoy GK, ed. American Hospital Formulary Service, AHFS Drug Information. American Society of Health-System Pharmacists. Bethesda. 2002. Written for The Clmbivent Inhalation Aerosol Study Group. In chronic obstructive pulmonary disease, a combination of ipratropium and albuterol is more effective than either agent alone. A 85-day multicenter trial. Chest 1994 May; 105 5 ; : 14119. FitzGerald JM, Grunfeld A, Pare PD, et al. The clinical efficacy of combination nebulized anticholinergic and adrenergic bronchodilators vs nebulized adrenergic bronchodilators alone in acute asthma. Canadian Cpmbivent Study Group. Chest 1997 Feb; 111 2 ; : 311-5.
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Dependent on time, re-fetalized tumor cells could form Type-II counterregulation of cell dyssymbiosis ; . If in this situation prooxidative chemotherapeutics are in use the desired apoptosis necrosis can be selectively forced in a part of the cells Type-I overregulation of cell symbiosis ; , but by the same token this can also accelerate a fully developed transformation into metastatic cancer cells inside other cells. Basically, all phases of still to be compensated cellular dyssymbiosis, primarily in tumor tissues but also secondarily in differentiated tissues, can switch over unpredictably to a decompensated cellular dyssymbiosis phase. It is a characteristic of the principle of chemotherapeutic treatment that patients with a particularly redox-sensitive disposition, who become ill because of this genetic and supragenetic predisposed redox sensitivity, will not only have cellular dyssymbiosis in manifest tumor tissues but also in other tissue types and that tumor cells will respond to the targeted attack of chemotherapeutics in manifestly decompensated tissues in a diversity of ways in the various phases. Therefore, there can only be a conditional homogenous responsiveness of tumor cells to chemotherapeutics, and the results of therapy schemata cannot be sufficiently calculated individually. Consequently, for patients with a systemic disease, the distinctive genetic polymorphism of carcinogen-activating detoxification enzymes become manifest in the course of the disease. Redox-sensitive variability of the xenobioticmetabolizing enzymes applies mainly to cytochrome P450-dependent and flavin-containing monoxygenases, epoxide hydrolases, glutathione transferases, N-acetyl transferases, NAD P ; H-ubiquinone oxidoreductases, myeloperoxidases etc. overview with Wilkinson.
1SOrlandet Hospital Kristiansand, Setc of Cardiol., Dept. of Med., Kristiansand, Norway; : Vest-Agder Sentralsykehus, Medical Avd., Kristiansand, Norway.
Table 1. Relative representation of molar concentrations of individual phospholipids or cholesterol in plasma membranes isolated from the brain of laboratory rats following 4-week administration of various antidepressants in relation to total molar concentration of phospholipids and cholesterol ; PC 0.208 0.202 0.167 * 0.005 * 0.005 * 0.020 0.075 0.076 PE SM PI 0.018 0.012 CH 0.102 0.101 0.056, for example, combivent dosage.
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