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The page below is a sample from the LabCE course Pharmacology in the Clinical Lab: Therapeutic Drug Monitoring and Pharmacogenomics. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Enzyme Abnormalities and Drugs

Not all PGx is concerned with CYP450 enzymes. There are other drug-metabolizing enzymes that show polymorphisms and can affect the way people respond to a drug. The following is a list of enzymes for which known mutations have been associated with clinical effects.
Substrates (Drugs)
Acetylaldehyde dehydrogenaseAlcohol
Alcohol dehydrogenaseAlcohol
Dihydropyrimidine dehydrogenase Fluorouracil
CYP2C9Warfarin, phenytoin, losartan
CYP2C19Diazepam, omeprazole (Prilosec)
CYP2D6Many antidepressants, opioids, antiarrhythmics
Glucose-6-phosphate dehydrogenase Aspirin, quinidine
N-acetyltransferase Procainamide, isoniazid
Thioprine methyltransferase 6-mercaptopurine
UDP-glucuronosyl transferase Acetaminophen, tolbutamide, irinotecan