Drug interaction: Difference between revisions
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Patients have abnormal metabolism by [[cytochrome P-450]] due to either inheriting abnormal [[allele]]s or due to drug interactions. Tables are available to check for drug interactions due to [[cytochrome P-450]] interactions.<ref>{{cite web |url=http://medicine.iupui.edu/flockhart/ |title=Drug-Interactions.com |accessdate=2007-09-18 |format= |work=}}</ref>. | Patients have abnormal metabolism by [[cytochrome P-450]] due to either inheriting abnormal [[allele]]s or due to drug interactions. Tables are available to check for drug interactions due to [[cytochrome P-450]] interactions.<ref>{{cite web |url=http://medicine.iupui.edu/flockhart/ |title=Drug-Interactions.com |accessdate=2007-09-18 |format= |work=}}</ref>. | ||
==Resources about drug interactions== | ==Prevention== | ||
===Resources about drug interactions=== | |||
In detecting drug-drug interactions, the accuracy of software used by hospital pharmacies range from:<ref name="pmid16792445">{{cite journal |author=Abarca J, Colon LR, Wang VS, Malone DC, Murphy JE, Armstrong EP |title=Evaluation of the performance of drug-drug interaction screening software in community and hospital pharmacies |journal=J Manag Care Pharm |volume=12 |issue=5 |pages=383–9 |year=2006 |month=June |pmid=16792445 |doi= |url=http://amcp.org/data/jmcp/contemproary_subjects_383-389.pdf |issn=}}</ref><ref name="pmid11297332">{{cite journal |author=Hazlet TK, Lee TA, Hansten PD, Horn JR |title=Performance of community pharmacy drug interaction software |journal=J Am Pharm Assoc (Wash) |volume=41 |issue=2 |pages=200–4 |year=2001 |pmid=11297332 |doi= |url= |issn=}}</ref> | In detecting drug-drug interactions, the accuracy of software used by hospital pharmacies range from:<ref name="pmid16792445">{{cite journal |author=Abarca J, Colon LR, Wang VS, Malone DC, Murphy JE, Armstrong EP |title=Evaluation of the performance of drug-drug interaction screening software in community and hospital pharmacies |journal=J Manag Care Pharm |volume=12 |issue=5 |pages=383–9 |year=2006 |month=June |pmid=16792445 |doi= |url=http://amcp.org/data/jmcp/contemproary_subjects_383-389.pdf |issn=}}</ref><ref name="pmid11297332">{{cite journal |author=Hazlet TK, Lee TA, Hansten PD, Horn JR |title=Performance of community pharmacy drug interaction software |journal=J Am Pharm Assoc (Wash) |volume=41 |issue=2 |pages=200–4 |year=2001 |pmid=11297332 |doi= |url= |issn=}}</ref> | ||
* [[Sensitivity and specificity|Sensitivity]] | * [[Sensitivity and specificity|Sensitivity]] | ||
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===List of resources=== | ===List of resources=== | ||
* [http://www.firstdatabank.com/products/evaluations/ First Databank] | * [http://www.firstdatabank.com/products/evaluations/ First Databank] | ||
===Medical order entry system=== | |||
{{main|Medical order entry system}} | |||
Perhaps due to imperfect specificity of drug interaction resources, health care providers overide 49% to 96% of alerts.<ref name="pmid16357358">{{cite journal |author=van der Sijs H, Aarts J, Vulto A, Berg M |title=Overriding of drug safety alerts in computerized physician order entry |journal=J Am Med Inform Assoc |volume=13 |issue=2 |pages=138–47 |year=2006 |pmid=16357358 |pmc=1447540 |doi=10.1197/jamia.M1809 |url=http://www.jamia.org/cgi/pmidlookup?view=long&pmid=16357358 |issn=}}</ref> | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Revision as of 09:28, 7 July 2009
In pharmacology, drug interactions are "the action of a drug that may affect the activity, metabolism, or toxicity of another drug."[1]
Mechanisms
Protein binding
These interactions are usually transient and mild until a new steady state is achieved.[2][3] These are mainly for drugs without much first-pass liver metabolism. The principle plasma proteins for drug binding are:[4]
- albumin
- α1-acid glycoprotein
- lipoproteins
Some drug interactions with warfarin are due to changes in protein binding.[4]
Cytochrome P450
Patients have abnormal metabolism by cytochrome P-450 due to either inheriting abnormal alleles or due to drug interactions. Tables are available to check for drug interactions due to cytochrome P-450 interactions.[5].
Prevention
Resources about drug interactions
In detecting drug-drug interactions, the accuracy of software used by hospital pharmacies range from:[6][7]
In detecting drug-drug interactions, the accuracy of PDA-based software range from:[8]
- Sensitivity 84% to 100%
- Specificity 68% to 95%
List of resources
Medical order entry system
Perhaps due to imperfect specificity of drug interaction resources, health care providers overide 49% to 96% of alerts.[9]
References
- ↑ Anonymous (2024), Drug interaction (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ DeVane CL (2002). "Clinical significance of drug binding, protein binding, and binding displacement drug interactions". Psychopharmacology bulletin. 36 (3): 5–21. PMID 12473961. [e]
- ↑ Benet LZ, Hoener BA (2002). "Changes in plasma protein binding have little clinical relevance". Clin. Pharmacol. Ther. 71 (3): 115–21. DOI:10.1067/mcp.2002.121829. PMID 11907485. Research Blogging. OVID full text summary table at OVID
- ↑ 4.0 4.1 Sands CD, Chan ES, Welty TE (2002). "Revisiting the significance of warfarin protein-binding displacement interactions". The Annals of pharmacotherapy 36 (10): 1642–4. PMID 12369572. [e]
- ↑ Drug-Interactions.com. Retrieved on 2007-09-18.
- ↑ 6.0 6.1 6.2 Abarca J, Colon LR, Wang VS, Malone DC, Murphy JE, Armstrong EP (June 2006). "Evaluation of the performance of drug-drug interaction screening software in community and hospital pharmacies". J Manag Care Pharm 12 (5): 383–9. PMID 16792445. [e]
- ↑ 7.0 7.1 7.2 Hazlet TK, Lee TA, Hansten PD, Horn JR (2001). "Performance of community pharmacy drug interaction software". J Am Pharm Assoc (Wash) 41 (2): 200–4. PMID 11297332. [e]
- ↑ Robinson RL, Burk MS (March 2004). "Identification of drug-drug interactions with personal digital assistant-based software". Am. J. Med. 116 (5): 357–8. DOI:10.1016/j.amjmed.2003.09.025. PMID 14984827. Research Blogging.
- ↑ van der Sijs H, Aarts J, Vulto A, Berg M (2006). "Overriding of drug safety alerts in computerized physician order entry". J Am Med Inform Assoc 13 (2): 138–47. DOI:10.1197/jamia.M1809. PMID 16357358. PMC 1447540. Research Blogging.