Pharmacokinetic drug interactions

Drug-drug interactions Pharmacokinetic and/or pharmacodynamic interactions Pharmacokinetic and/or pharmacodynamic consequence of multiple drug therapy... 

Factors That Affect Compliance Side Effects, Risk-Benefit Ratio, Drug-Drug Interactions, Pharmacokinetic or Pharmacodynamic Effects, Cost, and Preferences... 

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

SAEs), and unexpected ADRs. A common practice in the first phase I clinical trial is to collect blood and urine specimens to obtain preliminary pharmacokinetic information in humans. Additional phase I clinical trials are frequently conducted later to address specific concerns such as relative bioavailability comparison when the formulation is changed effect of food and time of feeding potential for drug-drug interactions pharmacokinetics in subpopulations such as... 

Drug Interactions. Figure 1 Increase in drug concentration caused by pharmacokinetic interactions. Shadow represents the therapeutic range. 

Ito K, Iwatsubo T, Kanamitsu S et al (1998) Prediction of pharmacokinetic alterations caused by drug-drug interactions. Pharmacol Rev 50 387-411... 

Pharmacokinetic interactions between cyclosporine and protease inhibitors in HIV+ subjects. Drug Metab Pharmacokinet 18 114-120... 

The contents of this handbook should be utilized as a guide and in addition to sound clinical judgment. Consult full prescribing information and take into consideration each drug s pharmacokinetic profile, contraindications, warnings, precautions, adverse reactions, potential drug interactions, and monitoring parameters before use. 

Differentiate antidepressants according to pharmacologic properties, adverse-effect profiles, pharmacokinetic profiles, drug interaction profiles, and dosing features. 

The major drug interactions of antidepressants are shown in Table 35—6.9,19,30 Antidepressants cause both pharmacodynamic (e.g., additive pharmacologic effects) and pharmacokinetic (e.g., changes in drug levels) interactions with other medications. 

Vigilance for drug-drug interactions is required because of the greater number of medications prescribed to elderly patients and enhanced sensitivity to adverse effects. Pharmacokinetic interactions include metabolic enzyme induction or inhibition and protein binding displacement interactions (e.g., divalproex and warfarin). Pharmacodynamic interactions include additive sedation and cognitive toxicity, which increases risk of falls and other impairments. 

TABLE 37-5. Pharmacokinetic Drug Interactions with Benzodiazepines44... 

SSRIs are the drugs of choice for PD. All SSRIs have demonstrated effectiveness in controlled trials, with 60% to 80% of patients achieving a panic-free state.28,48,49 With similar efficacy reported and no trials comparing SSRIs with other SSRIs, selection generally is based on pharmacokinetics, drug interactions, side effects, and cost differences (see Chap. 35 for more discussion). The most common side effects of SSRIs include headaches, irritability, nausea and other gastrointestinal complaints, insomnia, sexual dysfunction, increased anxiety, drowsiness, and tremor.49 SSRIs should not be discontinued abruptly to avoid a withdrawal syndrome characterized by dysphoric mood, irritability, and agitation. 

Drug-specific considerations in antimicrobial selection include the spectrum of activity, effects on nontargeted microbial flora, appropriate dose, pharmacokinetic and pharmacodynamic properties, adverse-effect and drug-interaction profile, and cost. 

Pharmacokinetic properties Pharmacodynamic properties Adverse-effect potential Drug-interaction potential Cost... 

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