Drug interactions complexities

These, such as the black box that was the receptor at the turn of the century, usually are simple input/output functions with no mechanistic description (i.e., the drug interacts with the receptor and a response ensues). Another type, termed the Parsimonious model, is also simple but has a greater number of estimatable parameters. These do not completely characterize the experimental situation completely but do offer insights into mechanism. Models can be more complex as well. For example, complex models with a large number of estimatable parameters can be used to simulate behavior under a variety of conditions (simulation models). Similarly, complex models for which the number of independently verifiable parameters is low (termed heuristic models) can still be used to describe complex behaviors not apparent by simple inspection of the system. 

Chemical drug interactions result when two administered substances combine with each other chemically Tetracyclines complex with Ca (in milk), with aluminum (Al) and magnesium (Mg) (often components of antacids), and with Fe (in some multiple vitamins) to reduce the absorption of the tetracycline antibiotic. 

Factors directly related to the drug selection include an inappropriate selection of drug, dosage, or route of administration. Malabsorption of a drug product because of GI disease (e.g., short-bowel syndrome) or a drug interaction (e.g., complexation of fluoroquinolones with multivalent cations resulting in reduced absorption) may lead to potentially subtherapeu-tic serum concentrations. 

Possible drug interactions Doses must be kept small Complex LC/MS/MS method... 

Ma, B., Prueksaritanont, T. and Lin, J.H. (2000) Drug interactions with calcium channel blockers possible involvement of metabolite-intermediate complexation with CYP3A. Drug Metabolism and Disposition, 28 (2), 125-130. 

Preliminary studies [241, 249, 250] of the cardiovascular and sympatholytic properties of prenylamine demonstrated that coronary blood flow and oxygenation could be increased under experimental conditions (in dogs) and that the drug interacted in complex fashion with sympathetically innervated organs, but the picture presented was someudiat confused because of the many uncontrolled variables and limitations of the actual techniques used. Anti-arrhythmic activity of potency comparable with that of quinidine, plus local anaesthetic properties, were also demonstrated [251] but the same worker was notable to reproduce these effects in intact live animals with any consistency. Large doses of the drug actually provoked cardiac fibrillation in some cases. 

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