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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