Review of Drug Interactions: A Comprehensive Update

Apply

Review of Drug Interactions: A Comprehensive Update

Journal Title: Journal of Pharmaceutical Research International - Year 2014, Vol 4, Issue 8

Abstract

Prescribing multiple medications predisposes to possibilities of occurrence of drug interactions. Various different terminology and ways exist to classify or arrange drug interactions. Drugs interact with other drugs, foods, beverages and herbs; outside or inside the body. Knowledge of In vitro interactions is essential to avoid loss of activity of drugs before administration. Although every theoretical drug interaction may not manifest in practice, drug interaction is a prominent cause of adverse or undesired events related to drug administration. Amongst the herbs, St. John’s wort has a potential of producing significant drug interactions due to its capacity to induce metabolism of number of drugs. In vivo interactions at pharmacokinetic level affect absorption, distribution, biotransformation or excretion of drugs. Induction or inhibition of cytochrome P450 (CYP450) enzymes forms a major basis of drug interactions. Induction of metabolism of a substrate drug leads to treatment failure. Inhibition of metabolism leads to serious interactions by aggravating toxicity of substrate drugs. As compared to induction, inhibition is a fairly rapid process, and number of precipitant drugs which inhibit the metabolism is much more than that of inducers. Role of drug transporters, especially P-glycoprotein (P-gp), in causation of drug interactions is being increasingly identified. P-gp affects absorption, distribution and excretion, and hence plays a major role in pharmacokinetic drug interactions. Additionally, P-gp works hand in hand with CYP450 enzymes. In pharmacodynamic interactions, the drugs synergise or antagonise the effect at the level of target of action. Clinically beneficial and reparative drug interactions are explored to obtain useful drug combinations. Extensive research has led to development of a large number of In vitro and In vivo methods to detect and predict drug interactions. Appropriate awareness and knowledge of possible drug interactions is crucial in prevention of drug interactions and their consequences.

Authors and Affiliations

Madhav Mutalik, Dhara Sanghavi

Keywords

Drug interactions; transporter; P-glycoprotein; methods for detection; CYP450.

In vitro Evaluation of Antidiabetic and Anti-Inflammatory Activity of Ethanolic and Methanolic Extracts of Ceropegia juncea

Antidiabetic and anti-inflammatory activity of ethanol and methanol extracts of in vivo and in vitro plants of Ceropegia juncea were evaluated by in vitro methods. Antidiabetic activity was studied using α-amylase inhibi...

Use of Mobile Phones for Monitoring Adverse Drug Reaction in Pharmacy and Drug Stores in Ishaka, Uganda - a Pilot Assessment of Willingness to Report

Aim: We investigated reporting of Adverse Drug Reaction (ADR) following use of drugs purchased from open system pharmacy (OSP) and drug stores, and the effectiveness of mobile phones for reporting drug reactions and dete...

EP ID EP344947
DOI 10.9734/BJPR/2014/8531
Views 90
Downloads 0