The Pseudobulbar Effect

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In addition to the importance of knowing the effects of substrates on a given phenotype, it is also important to note the effects of inducers and inhibitors of CYP enzymes. Medications that are either inhibitors or inducers of a CYP enzyme can change a person’s given phenotype by increasing or decreasing the protein’s metabolic capabilities. For example, a PM for CYP2D6 who receives an inhibitor of 2D6, such as the antiarrhythmic quinidine, will have greatly increased metabolism of dextromethorphan, a substrate of 2D6. Interestingly, this mechanism is used in the treatment of pseudobulbar affect, a symptom associated with numerous neurological conditions. In treating this disorder, the therapeutic agent dextromethorphan, often used as a cough suppressant, is paired with the inhibiting quinidine to allow for greater amounts of dextromethorphan to build up within the body. Pseudobulbar affect (also known as PBA) has gained more attention in recent years, in part due to the memorable commercials for the …show more content…

al. One of the first widely-available tests to hit the market is AmpliChip, introduced by Roche in 2004 (Kaplan, 2011). This genetic assay tests for 29 different polymorphisms of CYP2D6, as well as two polymorphisms of CYP2C19. An experiment comparing the results of the AmpliChip test with those of real-time polymerase chain reaction (PCR) techniques found that the AmpliChip “is rapid, reliable, accurate and very easy to perform” (Rebsamen et. al., 2008). Numerous other tests for CYPs have been developed since the introduction of AmpliChip, including laboratory services and reports offered by Seryx-Signature Genetics and Genelex Corporation, Third Wave Technology’s Invader UGT1A1 assay, and GE Healthcare’s Codelink to name a few (Gates & Davies,

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