Pharmacogenomic topic · dashboard states: NM · PM · IM · UM
PGx describes inherited differences in drug handling. AUC measures total exposure, not benefit or toxicity by itself. Ask whether the pathway clears a drug or activates it: slower clearance can raise exposure; slower activation can reduce benefit. Lower inactive-metabolite exposure does not imply lost efficacy.
Dashboard vocabulary: NM = Normal metabolizer; PM = Poor metabolizer; IM = Intermediate metabolizer; UM = Ultrarapid metabolizer. RM = Rapid metabolizer appears only under CYP2C19; EXP = Expresser appears only under CYP3A5. These interface labels do not establish clinical phenotypes for every gene. Prescribing uses the laboratory report, current guidance and monitoring.
Test at a glance
Clears efavirenz and helps form active hydroxybupropion from bupropion.
Clinical role
Established guidance supports efavirenz dosing. CPIC also gives optional sertraline recommendations for IMs and PMs.
Practical pearls
Bupropion and hydroxybupropion are both active: less metabolite does not prove less benefit.
CYP2B6 status alone does not justify changing methadone prescribing.
Safety / monitoring
Review efavirenz-related dizziness, sleep disturbance and mood symptoms; check interactions.
Self-check
What happens to efavirenz when clearance slows? Exposure rises, increasing adverse-effect risk.
Is bupropion simply an inactive prodrug? No. Both parent drug and metabolites contribute to activity.