News Update on Drug Interactions Research: Oct – 2019

Drug Interactions with Tobacco Smoking

Cigarette smoking remains extremely prevailing in most countries. It will have an effect on drug medical aid by each pharmacokinetic and pharmacodynamic mechanisms. Enzymes evoked by tobacco smoking might also increase the danger of cancer by enhancing the metabolic activation of carcinogens.

Polycyclic aromatic hydrocarbons in tobacco smoke square measure believed to be liable for the induction of haemoprotein P450 (CYP) 1A1, CYP1A2 and probably CYP2E1. CYP1A1 is primarily Associate in Nursing extrahepatic protein found in respiratory organ and placenta. There square measure genetic polymorphisms within the inducibility of CYP1A1, with some proof that top inducibility is a lot of common in patients with carcinoma. CYP1A2 may be a internal organ protein liable for the metabolism of variety of medicine and activation of some procarcinogens.  [1]

Grapefruit juice–drug interactions

The novel finding that fruit juice will markedly augment oral drug bioavailability was supported an surprising observation from an interaction study between the dihydropyridine atomic number 20 channel antagonist, felodipine, and ethyl alcohol within which fruit juice was accustomed mask the style of the ethanol. subsequent  investigations showed that fruit juice acted by reducing presystemic felodipine metabolism through selective post‐translational down regulation of haemoprotein P450 3A4 (CYP3A4) expression within the enteral wall. Since the period of impact of fruit juice will last 24 h, continual juice consumption may end up in an exceedingly accumulative increase in felodipine Autodefensas Unidas de Colombia and Cmax. The high variability of the magnitude of impact among people appeared dependent upon inherent variations in enteric CYP3A4 macromolecule expression such individuals with highest baseline CYP3A4 had the very best proportional increase. [2]

The human orphan nuclear receptor PXR is activated by compounds that regulate CYP3A4 gene expression and cause drug interactions.

The hemoprotein P-450 monooxygenase 3A4 (CYP3A4) is liable for the aerophilous metabolism of a good form of xenobiotics together with associate calculable hr of all clinically used medication. though expression of the CYP3A4 factor is understood to be iatrogenic in response to a range of compounds, the mechanism underlying this induction, that represents a basis for drug interactions in patients, has remained unclear. we tend to report the identification of somebody’s (h) orphan nuclear receptor, termed the pregnane X receptor (PXR), that binds to a response component within the CYP3A4 promoter and is activated by a spread of medicine best-known to induce CYP3A4 expression. Comparison of hPXR with the recently cloned mouse PXR reveals marked variations in their activation by sure medication, which can account partially for the species-specific effects of compounds on CYP3A organic phenomenon. [3]

City-wide electronic health records reveal gender and age biases in administration of known drug–drug interactions

The prevalence of drug–drug-interactions (DDI) from multiple drug dispensations could be a significant issue, each for people and health-care systems, since patients with complications thanks to DDI are probably to reenter the system at a costlier level. we tend to gift a large-scale longitudinal study (18 months) of the DDI development at the primary- and secondary-care level victimisation electronic health records (EHR) from the town of Blumenau in Southern Brazil (pop. ≈340,000). we tend to found that 181 distinct drug pairs legendary to move were distributed concomitantly to 12-tone system of the patients within the city’s public health-care system. Further, four-dimensional of the patients were distributed drug pairs that are probably to lead to major adverse drug reactions (ADR)—with prices calculable to be abundant larger than antecedently reported  in smaller studies. [4]

Prevalence and Risk Factors of Potential Drug Interactions in Hospitalized Cardiovascular Patients Using Three Knowledge Bases

Background: Drug interactions still be a crucial reason behind adverse effects, particularly with vas medicine.

Objective: This cross-sectional empirical  study aimed to acknowledge the frequency of potential drug-drug interactions (pDDIs) mistreatment 3 electronic information bases (KBs); Lexicomp®, Micromedex®, and also the free medicine.com®, compare the inclusion and gradings of pDDIs in these 3 KBs and to spot associated risk factors.

Methods: Medication orders of one hundred twenty five patients within the vas department and its medical care unit (ICU) of Assiut University Hospitals, Egypt were screened for pDDIs. [5]

Reference

[1] Zevin, S. and Benowitz, N.L., 1999. Drug interactions with tobacco smoking. Clinical pharmacokinetics, 36(6), (Web Link)

[2] Bailey, D.G., Malcolm, J., Arnold, O. and Spence, J.D., 1998. Grapefruit juice–drug interactions. British journal of clinical pharmacology, 46(2), (Web Link)

[3] Lehmann, J.M., McKee, D.D., Watson, M.A., Willson, T.M., Moore, J.T. and Kliewer, S.A., 1998. The human orphan nuclear receptor PXR is activated by compounds that regulate CYP3A4 gene expression and cause drug interactions. The Journal of clinical investigation, 102(5), (Web Link)

[4] City-wide electronic health records reveal gender and age biases in administration of known drug–drug interactions
Rion Brattig Correia, Luciana P. de Araújo Kohler, Mauro M. Mattos & Luis M. Rocha
npj Digital Medicinevolume 2, Article number: 74 (2019) (Web Link)

[5] Y. Raslan, H., M. Hassan, A. K., M. El-Mahdy, M. M. and H. Elfaham, T. (2018) “Prevalence and Risk Factors of Potential Drug Interactions in Hospitalized Cardiovascular Patients Using Three Knowledge Bases”, Journal of Advances in Medical and Pharmaceutical Sciences, 18(2), (Web Link)

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