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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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CYP2D6

Much research has been done on CYP450 enzymes and many polymorphisms with clinical significance have been reported. We can't discuss all CYP450s but lets consider CYP2D6 as an example:
  • It is estimated that about 25% of common drugs are metabolized by CYP2D6.
  • CYP2D6 accounts for only about 1% of all CYP450 enzymes, but it is important in the metabolism of about 100 drugs.
  • There are more than 80 genetic variants that have been described in the CYP2D6 gene. The normal, wild-type allele displays normal metabolic activity whereas some of the variant forms have enhanced or diminished activity.
  • The variants can be grouped generally according to the resulting alterations in protein function.
  • The groupings correlate with four major enzyme metabolic capacities (phenotypes):
    • poor metabolizers
    • intermediate metabolizers
    • extensive (normal) metabolizers
    • ultra-rapid metabolizers