Genes and their Genotypes Comprehensive Nursing Paper Example
Genes and their genotypes impact how individuals react to medication or drugs. These drug-gene combinations inform medication dosing to ensure optimal response to and effectiveness of the drug (Malki & Pearson, 2019). CYP2C9, CYP2C9 3, and CYP2C9 13 polymorphisms affect irbesartan pharmacokinetics. Individuals have different CYP2C9 genotypes (12, 10, and 6 carriers of CYP2C9 1/ 1, 1/ 3, and 1/13 genotypes), which dictates their response to irbesartan. Irbesartan is an angiotensin II antagonist used to treat high blood pressure. Its significant elimination (CL) pathways entail CYP2C9 N-glucuronidation and oxidation. Therefore, an individual’s CYP2C9 genotype impacts irbesartan major elimination (Westervelt et al., 2020).(Genes and their Genotypes Comprehensive Nursing Paper Example)
For instance, a study found that a person with a CYP2C9*1/*3 genotype indicated 12.99 + 3.12 L/hr irbesartan major elimination compared to 21.40 + 5.98 L/hr for wild-type in persons with CYP2C9*1/*1. The drug-gene interaction decreases major elimination in people with the variant *3 type of the CYP2C9 gene (Westervelt et al., 2020). It implies that the genotype differences impact major elimination, hence the response to irbesartan because *1/*2 and *1/*3 participants indicated a greater response to the medication than *1/*1 persons, who experienced a decreased blood pressure.(Genes and their Genotypes Comprehensive Nursing Paper Example)
The study also indicates that the CYP2C9*1/*2 genotype is linked to a statistically significant elevated frequency of severe blood-pressure reduction, identified as an adverse event. The major elimination decrease leads to greater drug exposure, causing a higher-than-desired blood pressure decrease. It informs dosing because the major elimination decrease means that people with CYP2C9*1/*2 and *1/*3 need a low-maintenance dose to produce the desired pharmacological response. Additionally, individuals with CYP2C9*1/*3 and *1/*13 indicated higher maximum plasma concentration and half-lives than those with CYP2C9*1 (Westervelt et al., 2020). Persons with CYP2C9*1/*3 and *1/*13 indicated lower irbesartan oral clearance than those with *1/*1. Conclusively, CYP2C9 genetic polymorphism significantly impacted irbesartan pharmacokinetics. CYP2C9*3 and CYP2C9*13 alleles led to decreased irbesartan metabolism.(Genes and their Genotypes Comprehensive Nursing Paper Example)
References
Malki, M. A., & Pearson, E. R. (2019). Drug–drug–gene interactions and adverse drug reactions. The Pharmacogenomics Journal, 20(3), 355-366. https://doi.org/10.1038/s41397-019-0122-0(Genes and their Genotypes Comprehensive Nursing Paper Example)
Westervelt, P., Cho, K., Bright, D. R., & Kisor, D. F. (2020). Drug-gene interactions: inherent variability in drug maintenance dose requirements. P & T: a peer-reviewed journal for formulary management, 39(9), 630–637(Genes and their Genotypes Comprehensive Nursing Paper Example).
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