NeuroGenetics
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Pharmacogenetics in Neurology
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Question 1
A woman with epilepsy well-controlled on lamotrigine 300 mg/day becomes pregnant. Her seizure control begins to deteriorate in the second trimester. The pharmacogenetic principle underlying this is:
A
Pregnancy induces CYP2D6 activity, dramatically increasing lamotrigine metabolism
B
Estrogen and progesterone are competitive inhibitors of lamotrigine at the sodium channel
C
Pregnancy-related induction of UGT1A4 (a lamotrigine-glucuronidating enzyme) dramatically increases lamotrigine clearance, reducing serum levels
D
Fetal tissue absorbs lamotrigine, reducing maternal serum concentration
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