A patient asks the nurse why a medication prescribed by the provider "didn't do anything at all." Which statement by the nurse accurately describes how genetics influence drug action?
1. "Genetic differences can result in significant differences in how each patient's body handles the same medication."
2. "Genetic differences can cause mutations in enzymes, changing the way they function. This can alter how the body metabolizes and excretes drugs."
3. "Because of genetic differences, medication may accumulate to toxic levels in one patient while in another patient may be inactivated before it can have a therapeutic effect."
4. "Genetic differences can be expressed as an alteration in the structure of an enzyme, which can cause a defective receptor and an allergic response to drugs."
5. "Genetic differences in patients who are biracial result in an allergic response to medications."
Correct Answer: 1,2,3
Rationale 1: 99.8% of human DNA sequences are identical. The remaining 0.2% can account for significant differences in people's ability to handle medications.
Rationale 2: The structure of an enzyme is closely related to its function. A mutation can cause a change in the structure of the enzyme, resulting in a change in its function.
Rationale 3: When enzymes are functionally changed by genetics, metabolism and excretion can be altered, resulting in the drug either accumulating or being inactivated.
Rationale 4: Small changes in the structure of a protein may result in a defective receptor that will not accept the drug and the drug not having any therapeutic effect.
Rationale 5: Genetic differences can result in mutations of enzymes or proteins, which may result in changes in function. Being of a certain race may predispose a patient to mutations and, therefore, uncommon responses to medication, but this does not mean the patient will have an allergic response to medications.
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