It’s not something I’ve studied in depth yet but I know we have a module this term which will cover more of this which I’m excited for, but what I know is that there are a whole range of factors which determine the way your body metabolizes drugs, eg your sex, age, weight, race, kidney function, hepatic function etc. and your individual genetic make up also definitely plays a huge part in the way your body reacts to drugs.
Some people have mutations in the genes which code for enzymes in the cytochrome P450 family which are responsible for the metabolism of many substances, and these mutations can change the speed of which they metabolize certain drugs. An example off the top of my head is the CYP2C19 enzyme, which is responsible for metabolizing quite a lot of common medications such as amitriptyline, sertraline and citalopram, as well as omeprazole and clopidogrel. Depending on which mutations you have to this enzyme, your body will either speed up the metabolization process of the drugs which it breaks down, or it could slow it down. This generally means that you’ll need either a higher or lower dose of medication, and it can also mean that you suffer worse/fewer side effects compared to someone who has normal enzyme function.
That’s just one example of a particular enzyme that we know of, but drug metabolism is a super complex process, there are countless enzymes involved. We can find out if someone has one of these genetic mutations and is therefore a rapid/slow metabolizer through genetic testing, but that’s quite expensive and I don’t think they offer it on the NHS.
So yeah, tldr it’s really difficult to know in advance how any drug will effect any individual because of a multitude of factors including genetics! That said, genome sequencing is becoming cheaper every year and our knowledge of genetics is constantly expanding, so who knows, hopefully in the future we might actually have an inexpensive test to determine exactly how someone will react to a drug in advance so we can somewhat avoid the annoying trial and error period that many have to deal with in order to find the right medication for them!
Hopefully he'd have spotted her as more of a Cut-Me-Own-Throat Dibbler than a Capt Vimes.
