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Canadian Pharmacist Qualifying Exam Practice · Question

A 55-year-old male is initiated on clopidogrel 75 mg daily after a percutaneous coronary intervention. He has a known genetic polymorphism resulting in reduced function of CYP2C19. What is the most likely clinical consequence for this patient?

Clopidogrel is a prodrug that requires activation by CYP2C19 to its active metabolite. Patients with reduced-function CYP2C19 alleles convert less clopidogrel t

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Question: A 55-year-old male is initiated on clopidogrel 75 mg daily after a percutaneous coronary intervention. He has a known genetic polymorphism resulting in reduced function of CYP2C19. What is the most likely clinical consequence for this patient?

Answer options:

  • Increased risk of bleeding due to higher clopidogrel levels. ✅ Decreased antiplatelet effect and increased risk of thrombotic events.
  • Increased risk of gastrointestinal upset due to rapid clopidogrel metabolism.
  • No significant clinical consequence as clopidogrel is not metabolized by CYP2C19.

Correct answer: Decreased antiplatelet effect and increased risk of thrombotic events.

Explanation: Clopidogrel is a prodrug that requires activation by CYP2C19 to its active metabolite. Patients with reduced-function CYP2C19 alleles convert less clopidogrel to its active form, leading to a diminished antiplatelet effect and an increased risk of thrombotic events.

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