Which of the following is wrongly matched regarding drug elimination? (AIIMS Nov 2011)
|A||Calcium channel blockers: CYP3A4|
|D||Simvastatin: Glucuronide conjugation|
Table 7-3 in Goodman and Gilman 12th/159 clearly writes that CYP2D6 is involved in metabolism of beta blockers and CYP3A4 in calcium channel blockers' metabolism. P-glycprotein polymorphism decreases AUC of digoxin.
Pg 1976 of Goodman and Gilman writes that' irreversible oxidative metabolites of simvastatin are produced by CYP3A enzymes: Another important thing that a student may get confused with is that simvastatin metabolites can be glucuronide conjugated.This is true but the drug no longer remains simvastatin. Clinical importance of this is that if another drug or substance induces UGT glucuronyl transferase, it will not affect the activity of simvastatin. On the other hand if a drug is directly conjugated with glucuronide molecules, the inducers of UGT enzyme will affect the plasma concentration of the drug.