The CYP2C19 enzyme plays a role in the processing or metabolizing of at least 10 percent of commonly prescribed drugs, including a drug called clopidogrel (also known as Plavix). A. Others rapidly break down (metabolize) warfarin, so the medication is quickly processed by their bodies; these individuals are classified as "fast metabolizers" or "rapid metabolizers" of warfarin. For examples of drugs that interact with specific enzymes, see tables Common Substances That Interact With Cytochrome P-450 Enzymes and Drug Interactions. This can lead to unexpected or exaggerated reactions. However, 2 to 5 percent of the population who carry an extra copy of the CYP2D6 gene chew up Zofran before it has a chance to do its job, putting them at risk for vomiting under anesthesia and even aspiration pneumonia. A pharmacogenomic test, administered by your physician, can give you insights about how your body processes certain medications based on your genetic metabolism rate. Such individuals tend to accumulate substantially higher drug concent rations than normal metabolizers, which increases their risk for drug-related adverse events. For several reasons, CYP2D6 is especially troublesome for scientists working with discovering new drugs. Glucuronidation, the most common phase II reaction, is the only one that occurs in the liver microsomal enzyme system. A 3-day old premature baby B. Moffitt performs CYP450 testing to better manage invasive fungal infections in leukemia patients, an adverse event that can be fatal and can cost as much as $29,000 to treat. Metabolism is how your body changes food into energy. Keep in mind that many drugs are metabolized by more than one CYP450 enzyme, and CYP2D6 may represent only one pathway. “They are on so many medicines — one could argue even too many medicines — and they have the highest rate of complications from drug-drug and drug-gene interactions,” says Durham, who, in addition to being a practicing psychiatrist, teaches the subject at the University of New Mexico and sits on Genelex’s scientific advisory board. Drugs metabolized by CYP2D6 are called CYP2D6 substrates (see Table 2 at right). The codes listed on Madilyn’s card describe enzymes in the so-called cytochrome P450 (CYP450) superfamily of enzymes, which play a crucial role in the body’s ability to process medications. Here is more information on drugs that are metabolized through CYP2C19 . It is important that clinicians consider the influence of slow metabolizer Aging does not affect glucuronidation. One of the ways in which some healthcare providers are trying to reduce the rate of drug-related adverse events is by testing patients for CYP450 markers, particularly patients who have complex health issues and who are on multiple therapies. A few weeks later, Tschetter-Siedschlaw received test results detailing the top medications her daughter would metabolize well or poorly, as well as the drugs that might interact if prescribed together and cause ill effects in Madilyn. CYP2C19 is an isoenzyme that mediates the metabolic activation and elimination, and hence the therapeutic effect of a variety of drugs including antiplatelet agents, anticonvulsants, anti- Moreover, less than 30 percent of surveyed physicians had received any education about the influence of genetics on drug response or about available tests. Since birth, Madilyn has suffered from a litany of health issues. 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