John doe example reports.xlsx

Patient: John Doe (Primary Care)
Patient's genotype will never change.
Login to YouScript to identify possible interaction risks when making medication changes.
Advisory Note to Treating Practitioner:
The prescribing suggestions below are based on standard doses of the medications listed on the patient test requisiton we received from you, do not take into account the full clinical picture and do not supersede your clinical judgment. Please review the medication list for accuracy before proceeding. If you would like to share more information about the patient's history, I may be able to provide more specific guidance regarding potential interactions of prescribed medications with your patient's genotype. If you would like to discuss this case, I can be reached Monday - Friday between 8 a.m. and 4:30 p.m. PST. Consultation by: Sample PharmD/RPh | (877) 796-4362 MEDICATIONS:
Drug Impacted
Drug / Gene
Effect: Clopidogrel's (Plavix) risk for cardiovascular events may increase in CYP2C19 poor
Management: For acute coronary syndrome: Consider prescribing prasugrel (Effient) or ticagrelor
(Brilinta) [per CPIC]. For secondary stroke prevention or peripheral artery disease: Consider
aspirin/dipyridamole (Aggrenox) or aspirin.
Drug Impacted
Drug / Gene
Effect: Citalopram (Celexa) exposure and QTc prolongation risk increases in CYP2C19 poor
Management: Monitor EKG and anticholinergic effects. Use a maximum of 20 mg daily. When
necessary, prescribe sertraline (Zoloft), mirtazapine (Remeron) or vilazodone (Viibryd).
Genelex Corporation 2013
Drug Impacted
Drug / Gene
Effect: Hydroxyzine (Vistaril) exposure may increase in CYP2D6 intermediate metabolizers.
Management: Monitor for anticholinergic effects, sedation and dizziness. When necessary,
decrease dose or prescribe doxylamine (Unisom), cetirizine (Zyrtec), fexofenadine (Allegra) or
fluticasone nasal spray (Flonase).
Laboratory Director: Teresa H. Aulinskas, Ph.D.
CYP2D6 Intermediate Metabolizers exhibit approximately half-normal enzyme activity and consist of one active
and one inactive, one inactive and one partially active, or two partially active CYP2D6 alleles. They may require
less than standard dosage to prevent overdose toxicity, drug interactions and for optimal therapeutic response to CYP2D6 inactivated drugs. For prodrugs, such as opioid analgesics or tamoxifen, requiring activation by CYP2D6, consider increased dosage or alternative treatment.
CYP2C19 Poor Metabolizers have greatly decreased enzyme activity and consist of two inactive CYP2C19
alleles. They may require alternative treatments or less than standard dosage to prevent overdose toxicity, drug interactions and for optimal therapeutic response to CYP2C19 inactivated drugs. For prodrugs, such as clopidogrel requiring activation by CYP2C19, consider alternative treatment.
CYP2C9 Normal Metabolizers are the common phenotype for CYP2C9 enzyme activity and consist of two active
CYP2C9 alleles. In general they can be administered CYP2C9 metabolized drugs following standard dosing
practices. Warfarin (Coumadin): Consult label or for dosing advice.
VKORC1 (-1639 GA) intermediate sensitivity to warfarin. The VKORC1 enzyme is the site of action of warfarin.
Consult label or for dosing advice.
Clinical Indication for Testing: Patient taking medicines metabolized by the cytochrome P450s or other enzymes, has a personal or family history of adverse
reactions including treatment failure, or to confirm the presence or absence of relevant genotypes and as an aid to dosing and co-medication administration. DNA
testing does not replace the need for clinical and therapeutic drug monitoring.
Methodologies: PCR based assays detect listed alleles, including all common and most rare variants with known clinical significance at analytical sensitivity and
specificity >99%. Variants tested may include: CYP2C19: active *1; inactive *2, *3, *4, *5, *6, *7, *8; rapid *17. CYP2D6: active *1, *2; inactive *3, *4, *5, *6, *7, *8,
*11, *12, *14, *15; partially active *9, *10, *17, *41; gene duplications *1, *2, *4, *10, *41. CYP2C9: active *1; inactive *2, *3, *4, *5, *6, *8, *11, *13. VKORC1: high
sensitivity 1639G>A. Rare variants may not have been observed at Genelex. Other known variants not listed are not detected. Assays developed and performance
characteristics determined by Genelex. Rare false negative or false positive results may occur. These tests have not been cleared or approved by the US Food and
Drug Administration. FDA does not require these tests to go through premarket FDA review. These tests are used for clinical purposes and should not be regarded
as investigational or for research. Genelex Corporation is certified under the Clinical Laboratory Improvement Amendments (CLIA No. 50D0980559), Washington
State Medical Test Site No. MTS-3919, New York State Department of Health license no. PFI 8201 and is licensed to perform high complexity clinical testing in all
US states.
Liability Disclaimer: This report is based solely on the medications and other information provided to Genelex and does not take all factors of the patient's care into
account. Genelex is neither responsible or liable for the accuracy of the information supplied to Genelex by the treating healthcare professional. The treating
healthcare professional has ultimate responsibility for all treatment decisions made with regard to the patient, including any made on the basis of the patient's
genotype. Therefore, neither Genelex nor its employees, shall have any liability to any person or entity with regard to claims, loss, damage arising, or alleged to
arise, directly or indirectly, from the use of information contained in this report.
References: Available at or by request. Drug-gene tables with dosing considerations for commonly prescribed
medicines can be accessed from the YouScript software at Log in credentials are the patient's Genelex lab number and date of birth.
Genelex Corporation 3101 Western Ave., Suite 100, Seattle, Washington 98121 800-523-3080
Genelex Corporation 2013


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