{"id":27294,"date":"2021-03-25T12:40:14","date_gmt":"2021-03-25T10:40:14","guid":{"rendered":"https:\/\/www.asperbio.com\/?page_id=27294"},"modified":"2021-03-25T14:44:38","modified_gmt":"2021-03-25T12:44:38","slug":"antidepressandid-pgx","status":"publish","type":"page","link":"https:\/\/www.asperbio.com\/et\/asper-pharmacogenetics\/antidepressandid-pgx\/","title":{"rendered":"Antidepressandid PGx"},"content":{"rendered":"<h2 style=\"padding-left: 5px;\"><span style=\"color: #00a898;\">Antidepressandid PGx<\/span><\/h2>\n<div class=\"sm_post_content\" style=\"background: url('https:\/\/www.asperbio.com\/wp-content\/uploads\/Asper-Pharmacogenetics-01.png') repeat-y; padding-left: 40px;\">\n<table class=\"table no-border no-margin\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td width=\"110\"><strong>Geenid:<\/strong><\/td>\n<td><em> CYP2C19, CYP2D6<\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<hr style=\"color: #00a898; background-color: #00a898; height: 2px; border: none; width: 100%;\" \/>\n<table class=\"table no-border no-margin\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td width=\"110\"><strong>Metoodika:<\/strong><\/td>\n<td>NGS, Long PCR<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<hr style=\"color: #00a898; background-color: #00a898; height: 2px; border: none; width: 100%;\" \/>\n<table class=\"table no-border no-margin\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td width=\"110\"><strong>Testi valmimisaeg:<\/strong><\/td>\n<td>10-15 t\u00f6\u00f6p\u00e4eva<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<hr style=\"color: #00a898; background-color: #00a898; height: 2px; border: none; width: 100%;\" \/>\n<table class=\"table no-border no-margin\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td width=\"110\"><strong>N\u00f5uded proovi-materjalile:<\/strong><\/td>\n<td>2-4 ml t\u00e4isverd antikoagulandiga EDTA (lilla korgiga katsuti)<\/p>\n<p>1 \u00b5g DNA-d elueerituna TE, AE puhvris v\u00f5i steriilses vees, kontsentratsiooniga 100-250 ng\/\u00b5l<br \/>\nDNA saata toatemperatuuril v\u00f5i k\u00fclmutatuna. A260\/A280 suhe peaks olema 1.8-2.0. DNA peab agaroosgeelis pikkusmarkeri juuresolekul olema detekteeritav \u00fche tervikliku b\u00e4ndina.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<hr style=\"color: #00a898; background-color: #00a898; height: 2px; border: none; width: 100%;\" \/>\n<table class=\"table no-border no-margin\" border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td width=\"110\"><strong>Tellimine:<\/strong><\/td>\n<td>Proovimaterjal saata koos <span style=\"color: #00a898;\"><strong><a style=\"color: #00a898;\" href=\"https:\/\/www.asperbio.com\/wp-content\/uploads\/Asper-Pharmacogenetics-saatekiri.docx\">saatekirjaga<\/a><\/strong><\/span> Asper Biogene laborisse<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<hr style=\"color: #00a898; background-color: #00a898; height: 2px; border: none; width: 100%;\" \/>\n<\/div>\n<p><strong>N\u00e4idustused geenitesti tegemiseks:<\/strong><\/p>\n<ol>\n<li>Patsientide ravitulemuse optimeerimine v\u00e4ltides ravimi k\u00f5rvaltoimeid ja maksimeerides ravitoimet<\/li>\n<li>Ravimi annuste kohandamine v\u00f5i alternatiivse preparaadi valimine<\/li>\n<\/ol>\n<p>Testi tulemused sisaldavad informatsiooni <strong><em>CYP2D6<\/em><\/strong> ja <strong><em>CYP2C19<\/em> genot\u00fc\u00fcpide ja ravimi metabolismiga seotud fenot\u00fc\u00fcpide<\/strong> kohta. Samuti soovitusi <strong>selektiivsete serotoniini tagasihaarde inhibiitorite<\/strong> (SSTI) ja <strong>trits\u00fckliliste antidepressantide<\/strong> (TTA) dooside optimeerimiseks vastavalt <em>Clinical Pharmacogenetics Implemetation Consortium<\/em> (CPIC) ravijuhistele.<\/p>\n<p>SSTI-d on peamiseks raviv\u00f5imaluseks depressiooni ja \u00e4revush\u00e4irete ravis. SSTI-d suurendavad selektiivselt serotonergilist aktiivsust pres\u00fcnaptilise serotoniini tagasihaarde v\u00e4hendamise teel. Terapeutiline toime s\u00f5ltub pol\u00fcmorfismidest <em>CYP2D6<\/em>\u00a0ja\u00a0<em>CYP2C19<\/em>\u00a0 geenides, mis m\u00f5jutavad SSTI-de metabolismi ja seel\u00e4bi ravimi efektiivsust ja ohutust. Umbes 50% depressiooni diagnoosiga patsientidel eba\u00f5nnestub esialgne SSTI ravimi valik. Sagedasemateks k\u00f5rvaltoimeteks on keskn\u00e4rvis\u00fcsteemi h\u00e4ired (unetus, peavalu), mao- ja seedetrakti h\u00e4ired ja seksuaald\u00fcsfunktsioon. T\u00f5sisemad k\u00f5rvaltoimed nagu QT intervalli pikenemistest p\u00f5hjustatud ar\u00fctmiad on peamiselt kirjeldatud patsientidel, kes on <em>CYP2C19<\/em> aeglased metaboliseerijad ja kellele on m\u00e4\u00e4ratud tsitalopraami ravi.<\/p>\n<p>Trits\u00fcklilised antidepressandid (TTA) on serotoniini ja norepinefriini tagasihaarde inhibiitorid, mida kasutatakse depressiooni ja obsessiiv-kompulsiivse h\u00e4ire ravis, samuti neuropaatilise valu korral ning migreenihoo ennetamiseks. Pol\u00fcmorfismid geenides <em>CYP2D6<\/em>\u00a0ja\u00a0<em>CYP2C19<\/em>\u00a0m\u00f5jutavad TTA-de omastamist, efektiivsust ja ohutust. Patsientidel v\u00f5ib olla eelsoodumus ravi eba\u00f5nnestumiseks v\u00f5i k\u00f5rvaltoimete tekkeks kui neil esinevad <em>CYP2D6<\/em> geenivariandid, mis muudavad ravimi kliirensit v\u00f5i <em>CYP2C19<\/em> geenivariandid, mis muudavad ravimi ja selle metaboliitide suhet. Sagedasemad k\u00f5rvaltoimed on antikolinergilised (suukuivus, k\u00f5hukinnisus, uriinipeetus, n\u00e4gemish\u00e4ired), kardio-vaskulaarsed v\u00f5i m\u00f5jutavad keskn\u00e4rvis\u00fcsteemi.<\/p>\n<p><strong>Farmakogeneetilise testi tulemuste kasutamine depressiooni ravis<\/strong> aitab parandada ravi tulemuslikkust ja v\u00e4hendada k\u00f5rvaltoimete esinemist.<\/p>","protected":false},"excerpt":{"rendered":"<p>Antidepressandid PGx Geenid: CYP2C19, CYP2D6 Metoodika: NGS, Long PCR Testi valmimisaeg: 10-15 t\u00f6\u00f6p\u00e4eva N\u00f5uded proovi-materjalile: 2-4 ml t\u00e4isverd antikoagulandiga EDTA (lilla korgiga katsuti) 1 \u00b5g DNA-d elueerituna TE, AE puhvris v\u00f5i steriilses vees, kontsentratsiooniga 100-250 ng\/\u00b5l DNA saata toatemperatuuril v\u00f5i k\u00fclmutatuna. A260\/A280 suhe peaks olema 1.8-2.0. DNA peab agaroosgeelis pikkusmarkeri juuresolekul olema detekteeritav \u00fche tervikliku [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":27285,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-27294","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.asperbio.com\/et\/wp-json\/wp\/v2\/pages\/27294","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.asperbio.com\/et\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.asperbio.com\/et\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.asperbio.com\/et\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.asperbio.com\/et\/wp-json\/wp\/v2\/comments?post=27294"}],"version-history":[{"count":3,"href":"https:\/\/www.asperbio.com\/et\/wp-json\/wp\/v2\/pages\/27294\/revisions"}],"predecessor-version":[{"id":27301,"href":"https:\/\/www.asperbio.com\/et\/wp-json\/wp\/v2\/pages\/27294\/revisions\/27301"}],"up":[{"embeddable":true,"href":"https:\/\/www.asperbio.com\/et\/wp-json\/wp\/v2\/pages\/27285"}],"wp:attachment":[{"href":"https:\/\/www.asperbio.com\/et\/wp-json\/wp\/v2\/media?parent=27294"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}