Concise Guide to the Cytochrome P450 System for Psychiatrists : Drug Interaction Principles for Medical Practice

by Cozza, Kelly L.; Armstrong, Scott C., M.D.; Cole, Michael A., M.D. (CON); Oesterheld, Jessica R., M.D. (CON); Cole, Michael A., M.D.; Oesterheld, Jessica R., M.D.

• ISBN13: 9781585620005
• ISBN10: 1585620009
• Format: Paperback
• Copyright: 2001-05-01
• Publisher: Amer Psychiatric Pub Inc

Summary

Walter Reed Army Medical Center, Washington, D.C. Pocket-sized guide for psychiatrists in clinical practice. Covers basic pharmacology, synthesizing the confusing medical literature in quick-reference tables. Covers drugs used in numerous disciplines, from oncology to gynecology and obstetrics. DNLM: Cytochrome P450--metabolism--Handbooks.

Table of Contents

Contributors	xix
Introduction to the Concise Guides Series	xxi
Preface	xxiii
PART I Introduction to the P450 System and Basic Pharmacology
Introduction to P450 and to This Concise Guide	3	(8)
Why Is It Important to Understand the P450 System?	3	(1)
What Is the P450 System and Why Does It Exist?	4	(3)
How to Use This Guide	7	(1)
References	8	(3)
Basic Pharmacology	11	(14)
Drug Interactions Defined	11	(1)
Pharmacodynamic Interactions	11	(1)
Pharmacokinetic Interactions	11	(1)
Metabolism	12	(10)
Phase I Metabolism	13	(6)
Phase II Metabolism	19	(3)
Summary	22	(1)
References	23	(2)
Metabolic Variability: Inhibition, Induction, and Pharmacogenetics	25	(10)
Inhibition	25	(1)
Induction	26	(2)
Pharmacogenetics: Polymorphisms	28	(3)
Genetic Polymorphisms in Depth	29	(2)
References	31	(4)
PART II P450 Enzymes
2D6	35	(12)
What Does 2D6 Do?	35	(1)
Where Is 2D6?	35	(1)
Does 2D6 Have Any Polymorphisms?	36	(1)
Are There Drugs That Inhibit 2D6 Activity?	37	(1)
Selective Serotonin Reuptake Inhibitors	38	(1)
Cimetidine	38	(1)
Are There Drugs That Induce 2D6 Activity?	38	(1)
References	39	(2)
Study Cases	41	(6)
3A4	47	(22)
What Does 3A4 Do?	47	(1)
Where Is 3A4?	48	(1)
Does 3A4 Have Any Polymorphisms?	48	(1)
Are There Drugs That Inhibit 3A4 Activity?	48	(5)
Inhibition of 3A4: Historical Issues	49	(1)
Inhibition of 3A4: Current Issues	50	(3)
Are There Drugs That Induce 3A4 Activity?	53	(1)
References	54	(4)
Study Cases	58	(11)
1A2	69	(10)
What Does 1A2 Do?	69	(1)
Where Is 1A2?	69	(1)
Does 1A2 Have Any Polymorphisms?	69	(1)
Are There Drugs That Inhibit 1A2 Activity?	70	(1)
Are There Drugs That Induce 1A2 Activity?	71	(1)
References	72	(2)
Study Cases	74	(5)
2C9	79	(8)
What Does 2C9 Do?	79	(1)
Where Is 2C9?	79	(1)
Does 2C9 Have Any Polymorphisms?	79	(1)
Are There Drugs That Inhibit 2C9 Activity?	80	(1)
Warfarin	80	(1)
Phenytoin	81	(1)
Nonsteroidal Anti-inflammatory Inhibitors	81	(1)
Are There Drugs That Induce 2C9 Activity?	81	(1)
References	82	(1)
Study Case	83	(4)
2C19	87	(6)
What Does 2C19 Do?	87	(1)
Where Is 2C19?	87	(1)
Does 2C19 Have Any Polymorphisms?	87	(1)
Are There Drugs That Inhibit 2C19 Activity?	88	(1)
Are There Drugs That Induce 2C19 Activity?	89	(1)
References	89	(1)
Study Case	90	(3)
2E1	93	(10)
What Does 2E1 Do?	93	(1)
Where Is 2E1?	93	(1)
Does 2E1 Have Any Polymorphisms?	93	(1)
Are There Drugs That Inhibit 2E1 Activity?	94	(1)
Are There Drugs That Induce 2E1 Activity?	94	(1)
Miscellaneous Issues	95	(1)
References	95	(2)
Study Case	97	(6)
PART III P450 Considerations by Medical Specialty
Gynecology: Oral Contraceptives	103	(12)
Oral Contraceptives	103	(7)
Metabolism of Oral Contraceptives	104	(1)
3A4 Induction of Oral Contraceptives	105	(2)
3A4 Inhibition of Oral Contraceptives	107	(1)
1A2, 2C19, and 3A4 Inhibition by Oral Contraceptives	108	(2)
References	110	(5)
Internal Medicine	115	(24)
Allergy Drugs	115	(6)
Histamine, Subtype 1(H1), Receptor Blockers and Leukotriene D4/E4 Receptor Antagonists	116	(3)
Xanthines	119	(2)
Cardiovascular Agents	121	(8)
Antiarrhythmics	121	(3)
Anticoagulants	124	(1)
Antiplatelet Drugs	124	(1)
Calcium-Channel Blockers	125	(3)
HydroxymethylglutaryI-Coenzyme A Reductase Inhibitors	128	(1)
Gastrointestinal Agents	129	(3)
Oral Hypoglycemics	132	(1)
References	133	(6)
Infectious Diseases	139	(24)
Antibiotics	139	(7)
Macrolides	139	(4)
Fluoroquinolones	143	(3)
Streptogramins	146	(1)
Antifungals: Azoles and Terbinafine	146	(4)
Azoles	146	(3)
Terbinafine	149	(1)
Antimycobacterials/Antitubercular Agents	150	(3)
Rifamycins and Isoniazid	150	(3)
Antiretrovirals	153	(5)
References	158	(5)
Neurology	163	(16)
Antiepileptic Drugs	163	(8)
Antiparkinsonian Drugs	171	(1)
Cholinesterase Inhibitoes	171	(3)
Ergotamines	174	(1)
References	175	(4)
Oncology	179	(22)
Antineoplastic Drugs	180	(12)
Alkylating Agents	180	(2)
Antimetabolites	182	(1)
Taxanes	183	(2)
Vinca Alkaloids	185	(1)
Topoisomerase Inhibitors	186	(1)
Antitumor Antibiotics	187	(1)
Antiandrogens and Antiestrogens	187	(3)
Miscellaneous Agents	190	(2)
Immunomodulators	192	(1)
Interferon-α	192	(1)
Cytokines and Interleukins	193	(1)
Summary	193	(1)
References	193	(8)
Surgery	201	(12)
Analgesics	201	(4)
Nonsteroidal Anti-inflammatory Drugs	201	(2)
Morphine	203	(1)
Methadone	203	(1)
Codeine	203	(1)
Tramadol	204	(1)
Summary	205	(1)
Immunosuppressants	205	(4)
Cyclosporine	207	(1)
Tacrolimus and Rapamycin	208	(1)
Summary	208	(1)
References	209	(4)
APPENDIX A: Guidelines	213	(8)
Guidelines for Prescribing in a Polypharmacy Environment	213	(2)
Guidelines for Assessing and Managing Drug Interactions	215	(5)
References	220	(1)
APPENDIX B: How to Retrieve and Review the Literature	221	(6)
Searching the Internet	221	(2)
Critically Reviewing the Literature	223	(3)
Case Reports	223	(1)
Reports of In Vitro Studies	223	(1)
Reports of In Vivo Studies	224	(1)
Review Articles	224	(1)
Epidemiological Reports	225	(1)
Manufacturer Package Inserts	225	(1)
Summary	225	(1)
References	226	(1)
Index	227