Drug interactions, definitions

An excellent brief article on buprenorphine treatment has been provided by Taikato et al. (2005), which notes the common possible side-effects (headaches, nausea and vomiting, sweating, constipation, etc.) and drug interactions. The limited central depressant effect of buprenorphine may be compounded by alcohol and antidepressants, while the metabolism of buprenorphine can be enhanced by anticonvulsants, with therefore possibly reduced efficacy. There have been some case reports of liver toxicity from buprenorphine that is reversible if the medication is stopped (Herve et al. 2004), and often clinical guidelines will recommend that liver function tests are included in buprenorphine treatment, as they definitely should be with naltrexone. 

Adverse drug reactions and drug interactions W McCaughey Introduction Definitions Adverse reactions Drug interactions Pharmacokinetic Pharmacodynamic Clinically important interactions INTRODUCTION... 

In a retrospective study of 114 patients admitted to a toxicological ICU with suspected lithium intoxication, 81 had definite intoxication 78% were deliberate overdoses, and 22% were accidental (due, for example, to renal insufficiency, dehydration, drug interactions, poor compliance, drunkenness). Most were treated conservatively with gastric lavage and forced diuresis hemodialysis was used only in 3-6%. Two of those who took a deliberate overdose and one of those who took an accidental overdose died (535). 

This book, written with a definite clinical bias (as the editors and contributors are practising prescribers from a range of disciplines), is designed to be an easily accessible reference for busy prescribers/dispensers who may not have access to, or the time to search, the more comprehensive resources on adverse drug-drug interactions both in print and online. We have considered interactions which we... 

The safety and efficacy of oral cyclodextrin itraconazole (5 mg/kg/day) as antifungal prophylaxis has been assessed in an open trial in 103 neutropenic children (median age 5 years range 0-15 years) (53). Prophylaxis was started at least 7 days before the onset of neutropenia and continued until neutrophil recovery. Of the 103 patients, only 47 completed the course of prophylaxis 27 withdrew because of poor compliance, 19 because of adverse events, and 10 for other reasons. Serious adverse events (other than death) occurred in 21 patients, including convulsions (n = 7), suspected drug interactions (n = 6), abdominal pain (n — 4), and constipation n — 4). The most common adverse events considered definitely or possibly related to itraconazole were vomiting (n = 12), abnormal liver function (n — 5), and abdominal pain (n = 3). Tolerabihty of the study medication at end-point was rated as good (55%), moderate (11%), poor (17%), or unacceptable (17%). There were no unexpected problems of safety or tolerability. 

The following information was taken originally from a comprehensive listing of dmg interactions published in New Zealand (R. Ferguson. Drug Interactions of Clinical Significance, I.M.S., New Zealand, 1977). This selection is intended for illustrative purposes only and must not be used as a definitive source. 

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