Drug interaction: Difference between revisions
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imported>Robert Badgett (New page: In pharmacology, '''drug interactions''' are "the action of a drug that may affect the activity, metabolism, or toxicity of another drug."<ref>{{MeSH}}</ref> ==Protein binding== These...) |
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In [[pharmacology]], '''drug interactions''' are "the action of a drug that may affect the activity, metabolism, or toxicity of another drug."<ref>{{MeSH}}</ref> | In [[pharmacology]], '''drug interactions''' are "the action of a drug that may affect the activity, metabolism, or [[drug toxicity|toxicity]] of another drug."<ref>{{MeSH}}</ref> | ||
==Protein binding== | ==Mechanisms== | ||
===Protein binding=== | |||
These interactions are usually transient and mild until a new steady state is achieved.<ref name="pmid12473961">{{cite journal |author=DeVane CL |title=Clinical significance of drug binding, protein binding, and binding displacement drug interactions |journal=Psychopharmacology bulletin. |volume=36 |issue=3 |pages=5–21 |year=2002 |pmid=12473961 |doi=}}</ref><ref name="pmid11907485">{{cite journal |author=Benet LZ, Hoener BA |title=Changes in plasma protein binding have little clinical relevance |journal=Clin. Pharmacol. Ther. |volume=71 |issue=3 |pages=115–21 |year=2002 |pmid=11907485 |doi=10.1067/mcp.2002.121829}}[http://gateway.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=11907485.ui OVID full text] [http://gateway.ovid.com/ovidweb.cgi?T=JS&NEWS=N&PAGE=image&IMAGE=00003098-200203000-00001%7cTT2&D=ovft summary table at OVID]</ref> These are mainly for drugs without much first-pass liver metabolism. The principle plasma proteins for drug binding are:<ref name="pmid12369572">{{cite journal |author=Sands CD, Chan ES, Welty TE |title=Revisiting the significance of warfarin protein-binding displacement interactions |journal=The Annals of pharmacotherapy |volume=36 |issue=10 |pages=1642–4 |year=2002 |pmid=12369572 |doi=|url=http://www.theannals.com/cgi/reprint/36/10/1642}}</ref> | These interactions are usually transient and mild until a new steady state is achieved.<ref name="pmid12473961">{{cite journal |author=DeVane CL |title=Clinical significance of drug binding, protein binding, and binding displacement drug interactions |journal=Psychopharmacology bulletin. |volume=36 |issue=3 |pages=5–21 |year=2002 |pmid=12473961 |doi=}}</ref><ref name="pmid11907485">{{cite journal |author=Benet LZ, Hoener BA |title=Changes in plasma protein binding have little clinical relevance |journal=Clin. Pharmacol. Ther. |volume=71 |issue=3 |pages=115–21 |year=2002 |pmid=11907485 |doi=10.1067/mcp.2002.121829}}[http://gateway.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=11907485.ui OVID full text] [http://gateway.ovid.com/ovidweb.cgi?T=JS&NEWS=N&PAGE=image&IMAGE=00003098-200203000-00001%7cTT2&D=ovft summary table at OVID]</ref> These are mainly for drugs without much first-pass liver metabolism. The principle plasma proteins for drug binding are:<ref name="pmid12369572">{{cite journal |author=Sands CD, Chan ES, Welty TE |title=Revisiting the significance of warfarin protein-binding displacement interactions |journal=The Annals of pharmacotherapy |volume=36 |issue=10 |pages=1642–4 |year=2002 |pmid=12369572 |doi=|url=http://www.theannals.com/cgi/reprint/36/10/1642}}</ref> | ||
# [[albumin]] | # [[albumin]] | ||
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Some drug interactions with [[warfarin]] are due to changes in protein binding.<ref name="pmid12369572"/> | Some drug interactions with [[warfarin]] are due to changes in protein binding.<ref name="pmid12369572"/> | ||
==Cytochrome P450== | ===Cytochrome P450=== | ||
Patients have abnormal metabolism by [[cytochrome P-450]] due to either inheriting abnormal [[allele]]s or due to drug interactions. Tables are available to check for drug interactions due to [[cytochrome P-450]] interactions.<ref>{{cite web |url=http://medicine.iupui.edu/flockhart/ |title=Drug-Interactions.com |accessdate=2007-09-18 |format= |work=}}</ref>. | Patients have abnormal metabolism by [[cytochrome P-450]] due to either inheriting abnormal [[allele]]s or due to drug interactions. Tables are available to check for drug interactions due to [[cytochrome P-450]] interactions.<ref>{{cite web |url=http://medicine.iupui.edu/flockhart/ |title=Drug-Interactions.com |accessdate=2007-09-18 |format= |work=}}</ref>. | ||
==Resources about drug interactions== | |||
In detecting drug-drug interactions, the accuracy of software used by hospital pharmacies range from:<ref name="pmid16792445">{{cite journal |author=Abarca J, Colon LR, Wang VS, Malone DC, Murphy JE, Armstrong EP |title=Evaluation of the performance of drug-drug interaction screening software in community and hospital pharmacies |journal=J Manag Care Pharm |volume=12 |issue=5 |pages=383–9 |year=2006 |month=June |pmid=16792445 |doi= |url=http://amcp.org/data/jmcp/contemproary_subjects_383-389.pdf |issn=}}</ref><ref name="pmid11297332">{{cite journal |author=Hazlet TK, Lee TA, Hansten PD, Horn JR |title=Performance of community pharmacy drug interaction software |journal=J Am Pharm Assoc (Wash) |volume=41 |issue=2 |pages=200–4 |year=2001 |pmid=11297332 |doi= |url= |issn=}}</ref> | |||
* [[Sensitivity and specificity|Sensitivity]] | |||
** 2006 study:<ref name="pmid16792445"/> 15% to 94% | |||
** 2001 study:<ref name="pmid11297332"/> 44% to 88% | |||
* [[Sensitivity and specificity|Specificity]] | |||
** 2006 study<ref name="pmid16792445"/>: 81% to 95% | |||
** 2001 study:<ref name="pmid11297332"/> 71% to 100% | |||
In detecting drug-drug interactions, the accuracy of PDA-based software range from:<ref name="pmid14984827">{{cite journal |author=Robinson RL, Burk MS |title=Identification of drug-drug interactions with personal digital assistant-based software |journal=Am. J. Med. |volume=116 |issue=5 |pages=357–8 |year=2004 |month=March |pmid=14984827 |doi=10.1016/j.amjmed.2003.09.025 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002934303006235 |issn=}}</ref> | |||
* [[Sensitivity and specificity|Sensitivity]] 84% to 100% | |||
* [[Sensitivity and specificity|Specificity]] 68% to 95% | |||
===List of resources=== | |||
* [http://www.firstdatabank.com/products/evaluations/ First Databank] | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Revision as of 10:20, 7 July 2009
In pharmacology, drug interactions are "the action of a drug that may affect the activity, metabolism, or toxicity of another drug."[1]
Mechanisms
Protein binding
These interactions are usually transient and mild until a new steady state is achieved.[2][3] These are mainly for drugs without much first-pass liver metabolism. The principle plasma proteins for drug binding are:[4]
- albumin
- α1-acid glycoprotein
- lipoproteins
Some drug interactions with warfarin are due to changes in protein binding.[4]
Cytochrome P450
Patients have abnormal metabolism by cytochrome P-450 due to either inheriting abnormal alleles or due to drug interactions. Tables are available to check for drug interactions due to cytochrome P-450 interactions.[5].
Resources about drug interactions
In detecting drug-drug interactions, the accuracy of software used by hospital pharmacies range from:[6][7]
In detecting drug-drug interactions, the accuracy of PDA-based software range from:[8]
- Sensitivity 84% to 100%
- Specificity 68% to 95%
List of resources
References
- ↑ Anonymous (2024), Drug interaction (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ DeVane CL (2002). "Clinical significance of drug binding, protein binding, and binding displacement drug interactions". Psychopharmacology bulletin. 36 (3): 5–21. PMID 12473961. [e]
- ↑ Benet LZ, Hoener BA (2002). "Changes in plasma protein binding have little clinical relevance". Clin. Pharmacol. Ther. 71 (3): 115–21. DOI:10.1067/mcp.2002.121829. PMID 11907485. Research Blogging. OVID full text summary table at OVID
- ↑ 4.0 4.1 Sands CD, Chan ES, Welty TE (2002). "Revisiting the significance of warfarin protein-binding displacement interactions". The Annals of pharmacotherapy 36 (10): 1642–4. PMID 12369572. [e]
- ↑ Drug-Interactions.com. Retrieved on 2007-09-18.
- ↑ 6.0 6.1 6.2 Abarca J, Colon LR, Wang VS, Malone DC, Murphy JE, Armstrong EP (June 2006). "Evaluation of the performance of drug-drug interaction screening software in community and hospital pharmacies". J Manag Care Pharm 12 (5): 383–9. PMID 16792445. [e]
- ↑ 7.0 7.1 7.2 Hazlet TK, Lee TA, Hansten PD, Horn JR (2001). "Performance of community pharmacy drug interaction software". J Am Pharm Assoc (Wash) 41 (2): 200–4. PMID 11297332. [e]
- ↑ Robinson RL, Burk MS (March 2004). "Identification of drug-drug interactions with personal digital assistant-based software". Am. J. Med. 116 (5): 357–8. DOI:10.1016/j.amjmed.2003.09.025. PMID 14984827. Research Blogging.