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Sample Report Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected] PATIENT INFORMATION SAMPLE REFERRING PHYSICIAN Name: Test, Matthew Date Collected: April 16, 2018 Name: Gregory House, MD DOB: November 1, 1960 Date Received: May 4, 2018 Institution: ADHD Plus Inc Age: 57 Case ID: PGPSL18-000001 Address: 1046 Central Parkway South Sex: Male Source: Buccal Swabs San Antonio, TX 78232 Address: 123 Main Street Phone: (910)123-4567 Suite 1000 COPY TO: Marcus Welby, M.D. Any Town, Any State 12345 Address: 1 Any Street Any Town, NJ 12345 Phone: 555-456-5768 Comprehensive Drug Information for Test, Matthew NORMAL RESPONSE EXPECTED PROCEED WITH CAUTION Drug Impacted Drug Impacted Clinical Interpretation ADHD: CNS STIMULANTS $PSKHWDPLQH $GGHUDOO 'H[WURDPSKHWDPLQH $GGHUDOO Due to increased severity of social 'H[PHWK\OSKHQLGDWH )RFDOLQ 0HWK\OSKHQLGDWH 5LWDOLQ withdrawal or nausea /LVGH[DPIHWDPLQH 9\YDQVH 0HWKDPSKHWDPLQH 'HVR[\Q ADHD: SEROTONIN AND NOREPINEPHRINE REUPTAKE INHIBITORS (SNRIS) $WRPR[HWLQH 6WUDWWHUD REPORT ALCOHOLISM: ALDEHYDE DEHYDROGENASE INHIBITORS 'LVXOILUDP $QWDEXVH ANTIANXIETY %XVSLURQH %XVSDU ANTIANXIETY: BENZODIAZEPINES $OSUD]RODP ;DQD[ SAMPLE'LD]HSDP 9DOLXP Due to possible increased ADRs /RUD]HSDP $WLYDQ 0LGD]RODP 9HUVHG 2[D]HSDP 6HUD[ ANTIDEPRESSANTS: DOPAMINE/NOREPINEPHRINE-REUPTAKE INHIBITORS %XSURSLRQ :HOOEXWULQ Due to reduced response and increased risk of side effects PGxPsych™ Report for Test, Matthew Laboratory Director: Dr. James Dermody CLIS ID: 0005783 CLIA ID: 31D2038676 PFI ID: 8972 Page 1 of 50 Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected] NORMAL RESPONSE EXPECTED PROCEED WITH CAUTION Drug Impacted Drug Impacted Clinical Interpretation ANTIDEPRESSANTS: SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIS) (VFLWDORSUDP /H[DSUR &LWDORSUDP &HOH[D Due to reduced response 9LOD]RGRQH 9LLEU\G )OXR[HWLQH 3UR]DF Due to elevated risk for drug overdose 9RUWLR[HWLQH 7ULQWHOOL[ resulting in adverse events and drug interaction )OXYR[DPLQH /XYR[ Due to reduced response 3DUR[HWLQH 3D[LO 6HUWUDOLQH =RORIW ANTIDEPRESSANTS: SEROTONIN AND NOREPINEPHRINE REUPTAKE INHIBITORS (SNRIS) 'XOR[HWLQH &\PEDOWD 0LOQDFLSUDQ 6DYHOOD Due to reduced response /HYRPLOQDFLSUDQ )HW]LPD 5HER[HWLQH (GURQD[ ANTIDEPRESSANTS: SEROTONIN REUPTAKE INHIBITORS/ANTAGONISTS 7UD]RGRQH 'HV\UHO ANTIDEPRESSANTS: ALPHA-2 ANTAGONISTS REPORT 0LUWD]DSLQH 5HPHURQ Due to possible increased ADRs ANTIPSYCHOTICS $ULSLSUD]ROH $ELOLI\ Chlorpromazine Due to possible increased QT interval %UH[SLSUD]ROH 5H[XOWL Fluphenazine +DORSHULGRO +DOGRO &OR]DSLQH &OR]DULO Due to increased risk of side effects ,ORSHULGRQH )DQDSW including hyperprolactinemia and Perphenazine weight gain 3LPR]LGH 2UDS SAMPLE2ODQ]DSLQH =\SUH[D Due to increased risk of side effects 4XHWLDSLQH 6HURTXHO MOOD STABILIZER: ANTIMANIC AGENTS &DUEDPD]HSLQH 7HJUHWRO /LWKLXP /LWKRELG Due to possible less drug response /DPRWULJLQH /DPLFWDO 9DOSURLF$FLG 'HSDNRWH OPIOID OVERDOSE: OPIOIDS ANTAGONISTS 1DOR[RQH (Y]LR 1DOWUH[RQH 5HYLD PGxPsych™ Report for Test, Matthew Laboratory Director: Dr. James Dermody CLIS ID: 0005783 CLIA ID: 31D2038676 PFI ID: 8972 Page 2 of 50 Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected] NORMAL RESPONSE EXPECTED PROCEED WITH CAUTION Drug Impacted Drug Impacted Clinical Interpretation OTHER STIMULANTS Cocaine Cannabinoids Due to increased risk of tetrahydrocannabinol (THC) dependence REPORT SAMPLE PGxPsych™ Report for Test, Matthew Laboratory Director: Dr. James Dermody CLIS ID: 0005783 CLIA ID: 31D2038676 PFI ID: 8972 Page 3 of 50 Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected] Table of Contents I. Results Driven ICD -10 Diagnosis Code and Current Medication II. Current Medication List Clinical interpretation for patient’s current medications provided by physician Includes pharmacogenomics and drug interactions (drug-drug, drug-food, drug-alcohol, drug-lab) III. Summary Psychiatric Drugs A summary of commonly prescribed medications for psychiatric illnesses by drug class. Including drugs that go through multiple pathways and final recommendations Color boxes: clinically significant pathway Gray box: clinically limited relevant pathwayREPORT IV. Comprehensive Drug List Includes clinical interpretation for a 53-gene panel and over 300 drugs, arranged by therapeutic area This section is designated to help optimize treatment options and manage patients with multiple conditions, effectively and efficiently SAMPLE Level of Evidence Legend z FDA Actionable PGx – Package insert PharmGKB, CPIC, EMA, DPWG, PMDA, HCSC { Medical Literature PGxPsych™ Report for Test, Matthew Laboratory Director: Dr. James Dermody CLIS ID: 0005783 CLIA ID: 31D2038676 PFI ID: 8972 Page 4 of 50 Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected] I. ICD-10 Diagnosis Code and Current Medication Driven Result for Test, Matthew ICD-10: F32.9 Major depressive disorder, single episode, unspecified;F41.9 Anxiety disorder, unspecified;F31.9 Bipolar disorder, unspecified Action Drug Impacted Evidence Clinical Interpretation Gene/Genotype Phenotype Level Alpha-2 Antagonists: 0LUWD]DSLQH 5HPHURQ USE CAUTION CYP2D6 Intermediate Metabolizer *4/*10 1 due to possible increased ADRs 2 3 Anti-Anxiety Agents: %XVSLURQH %XVSDU { NORMAL RESPONSE EXPECTED HTR1A rs6295 CC WT/WT genotype/rs1800044 C Allele 1 Carrier 2 3 Anticonvulsant Drugs: &ORED]DP 2QIL z NORMAL RESPONSE EXPECTED CYP2C19 Intermediate Metabolizer *1/*2 1 2 3 Anticonvulsant Drugs: 9DOSURLF$FLG 'HSDNRWH NORMAL RESPONSEREPORT EXPECTED ANKK1 A1 Heterozygous WT/c.2137G>A 1 2 3 Antilipemic Agents (Statins): $WRUYDVWDWLQ /LSLWRU USE CAUTION KIF6 rs20455 AA genotype WT/WT 3UDYDVWDWLQ 3UDYDFKRO due to poorer response to statin treatment with decreased risk for 1 adverse cardiovascular events 2 Antilipemic Agents (Statins):SAMPLE $WRUYDVWDWLQ /LSLWRU USE CAUTION ABCB1 rs2032582 AA due to higher risk of developing WT/WT genotype/rs1045642 AA 1 genotype myalgia 2 3 Antilipemic Agents (Statins): /RYDVWDWLQ 0HYDFRU NORMAL RESPONSE EXPECTED CYP3A5 Expresser *1A/*3A 5RVXYDVWDWLQ &UHVWRU 1 2 PGxPsych™ Report for Test, Matthew Laboratory Director: Dr. James Dermody CLIS ID: 0005783 CLIA ID: 31D2038676 PFI ID: 8972 Page 5 of 50 Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected] Action Drug Impacted Evidence Clinical Interpretation Gene/Genotype Phenotype Level Antilipemic Agents (Statins): 3LWDYDVWDWLQ /LYDOR NORMAL RESPONSE EXPECTED SLCO1B1 Normal Activity *1/*1 5RVXYDVWDWLQ &UHVWRU 1 2 Antimanic Agents: /LWKLXP /LWKRELG USE CAUTION ABCB1 rs2032582 AA due to possible less drug response WT/WT genotype/rs1045642 AA 1 genotype 2 3 Antiplatelets: &ORSLGRJUHO 3ODYL[ z CONSIDER ALTERNATIVES CYP2C19 Intermediate Metabolizer *1/*2 1 (if no contraindication e.g., prasugrel, ticagrelor) 2 3 4 Antipsychotics: 5LVSHULGRQH 5LVSHUGDO z CONSIDER ALTERNATIVES CYP2D6 Intermediate Metabolizer *4/*10 1 (e.g., quetiapine, olanzapine, clozapine) 2 REPORT 3 4 Antipsychotics: 7KLRULGD]LQH 0HOODULO z CONSIDER ALTERNATIVES CYP2D6 Intermediate Metabolizer *4/*10 1 2 3 4 Antipsychotics: SAMPLE Chlorpromazine USE CAUTION CYP1A2 Normal Metabolizer *1A/*1F Fluphenazine due to possible increased QT interval 1 2 Antipsychotics: &OR]DSLQH &OR]DULO USE CAUTION ANKK1 A1 Heterozygous WT/c.2137G>A 1 due to increased risk of side effects including hyperprolactinemia and 2 weight gain 3 PGxPsych™ Report for Test, Matthew Laboratory Director: Dr. James Dermody CLIS ID: 0005783 CLIA ID: 31D2038676 PFI ID: 8972 Page 6 of 50 Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected] Action Drug Impacted Evidence Clinical Interpretation Gene/Genotype Phenotype Level Antipsychotics: &OR]DSLQH &OR]DULO USE CAUTION HTR2C rs1414334 C Allele Carrier WT/WT 1 due to increased risk of developing metabolic syndrome 2 3 Antipsychotics: 2ODQ]DSLQH =\SUH[D USE CAUTION SLC6A4 HTTLPR Long Form LA/LA 4XHWLDSLQH 6HURTXHO due to increased risk of side effects 1 2 Antipsychotics: 2ODQ]DSLQH =\SUH[D USE CAUTION ANKK1 A1 Heterozygous WT/c.2137G>A 1 due to increased risk of side effects including hyperprolactinemia and 2 weight gain 3 Antipsychotics: 2ODQ]DSLQH =\SUH[D USE CAUTION HTR2C rs1414334 C Allele Carrier WT/WT 1 due to increased risk of developing metabolic syndrome 2 3 Antipsychotics: REPORT $ULSLSUD]ROH $ELOLI\ z NORMAL RESPONSE EXPECTED CYP2D6 Intermediate Metabolizer *4/*10 %UH[SLSUD]ROH 5H[XOWL z ,ORSHULGRQH )DQDSW z 3LPR]LGH 2UDS z Antipsychotics: $ULSLSUD]ROH $ELOLI\ NORMAL RESPONSE EXPECTED CYP3A4 Intermediate Metabolizer *1A/*1B 1 2 3 SAMPLE Antipsychotics: +DORSHULGRO +DOGRO NORMAL RESPONSE EXPECTED CYP2D6 Intermediate Metabolizer *4/*10 1 2 3 Antipsychotics: Perphenazine z NORMAL RESPONSE EXPECTED CYP2D6 Intermediate Metabolizer *4/*10 1 2 3 PGxPsych™ Report for Test, Matthew Laboratory Director: Dr. James Dermody CLIS ID: 0005783 CLIA ID: 31D2038676 PFI ID: 8972 Page 7 of 50 Admera Health, LLC 126 Corporate Blvd ā South Plainfield, NJ 07080 +1-908-222-0533ā[email protected] Action Drug Impacted Evidence Clinical Interpretation Gene/Genotype Phenotype Level Benzodiazepines: 'LD]HSDP 9DOLXP z USE CAUTION CYP2C19 Intermediate Metabolizer *1/*2 1 due to possible increased ADRs 2 3 Benzodiazepines: $OSUD]RODP ;DQD[
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