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  2. What is the metabolic pathway of Paroxetine and how is it affected by the genetic variant described in this case study?

What is the metabolic pathway of Paroxetine and how is it affected by the genetic variant described in this case study?

Case Studies (up to 2300 words):

read the following three case studies and answer all questions:

1. A patient is taking Paroxetine and presents to A&E with tremor, tachycardia, hypertension
and high temperature. After a genetic screening, the variant CYP2D6*4 is identified. Discuss:

• What is Paroxetine and how does it work (mechanism and clinical use)?
• What is the role of the CYP2D6 in the drugs’ metabolism in general?
• What is the metabolic pathway of Paroxetine and how is it affected by the genetic variant described in this case study?
• What is the resulting alteration in the blood levels of Paroxetine?
• What is the link between the altered blood levels of Paroxetine and the signs and symptoms reported (can you identify the syndrome)?


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