SCENARIO 3
Where are the majority of cytochrome P450 (CYP) enzymes located? Using the Medscape pill identifier, enter the following characteristics to identify the medication. What CYP enzyme metabolizes this medication? How can this information be applied to medication therapy management? Write a sample prescription for the identified medication and strength.
Imprint (292) Shape (Oval) Color (Brown) Form (Tablet) Scoring (None)
Scenario 3
The liver is the largest organ specialized in detoxification of chemical agents ingested in the body. This is why it has the highest concentration of the cytochrome P450 or CYP enzymes (Rosenthal & Burchum, 2020). These are the enzymes that metabolize medications taken orally. According to the Medscape pill identifier (Medscape, 2025d), the particulars of the medication given yield a possible 93 different medications with different nuances of the color brown. The most befitting one chosen for this exercise is the anticonvulsant cenobamate (Xcopri). It undergoes extensive metabolism by in the liver.
Cytochrome P450 (CYP) enzymes metabolize cenobamate by oxidation. The specific CYP enzymes that metabolize cenobamate in the liver are CYP2A6, CYP2E1, and CYP2B (Błaszczyk et al., 2024). This information can be applied to medication therapy management in that it will help tailor the dose to the patient’s needs. Cenobamate also inhibits other CYP enzymes, and this information can also help medication therapy management by preventing drug-drug interactions. A sample prescription of cenobamate is as follows:
Cenobamate (Xcopri) 200 mg tablets 1 (one) tablet PO daily, #30, RF 1
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