Adverse pharmacokinetic interactions between illicit substances and clinical drugs

Abbott, Kodye L.; Flannery, Patrick; Gill, Kristina; Boothe, Dawn M.; Dhanasekaran, Muralikrishnan; Mani, Sridhar; Pondugula, Satyanarayana R.

doi:10.1080/03602532.2019.1697283

Cited by 21 publications

(34 citation statements)

References 188 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…the CYP metabolic pathway (especially CYP3A4). A case in point is that of bPIs [14], where pDDIs often result in changes in (ART or illicit) drug concentrations [38,39]. In our study, 97.3% of the pharmacokinetic pDDIs analysed would result in an accumulation of recreational drugs or their toxic metabolites, worsening the adverse effects of these drugs through the CYP metabolic pathway.…”

Section: Plos Onementioning

confidence: 68%

Prevalence, beliefs and impact of drug-drug interactions between antiretroviral therapy and illicit drugs among people living with HIV in Spain

et al. 2021

View full text Add to dashboard Cite

Drug use implies important challenges related to HIV management, particularly due to an increased risk of potential interactions between antiretroviral therapy (ART) and illicit drugs (pDDIs). This study analyses the prevalence and severity of pDDIs among people living with HIV (PLHIV). It also explores their awareness of pDDIs and their beliefs about the toxicity that they may cause, as well as the impact of pDDIs on selected health variables. We conducted an on-line cross-sectional survey across 33 Spanish hospitals and NGOs to collect demographics and clinical data. pDDIs were checked against the Interaction Checker developed by Liverpool University. The sample of the present study was composed of 694 PLHIV who used illicit drugs. They represented 49.5% of the 1,401 PLHIV that participated in the survey. After excluding 38 participants due to lack of information on their ART or illicit drug use, 335 (51.1%) participants consuming drugs presented with some potentially significant pDDIs between their ART and illicit drugs, with a mean of 2.1±1.7 (1–10) pDDIs per patient. The drugs most frequently involved in pDDIs were cocaine, cannabis, MDMA and nitrates ("poppers"). The prevalence of pDDIs across ART regimens was: protease inhibitors (41.7%); integrase inhibitor-boosted regimens (32.1%), and non-nucleoside reverse transcriptase inhibitors (26.3%). An awareness of pDDIs and beliefs about their potential toxicity correlated positively with intentional non-adherence (p<0.0001). Participants with pDDIs exhibited a higher prevalence of intentional non-adherence (2.19±1.04 vs. 1.93±0.94; p = 0.001). The presence of pDDIs was not associated with poorer results in the clinical variables analysed. A significant proportion of PLHIV who use drugs experience pDDIs, thereby requiring close monitoring. pDDIs should be considered in the clinical management of HIV patients. Adequate information about pDDIs and indicators about how to manage ART when PLHIV use drugs could improve ART non-adherence.

show abstract

Section: Plos Onementioning

confidence: 68%

Prevalence, beliefs and impact of drug-drug interactions between antiretroviral therapy and illicit drugs among people living with HIV in Spain

et al. 2021

View full text Add to dashboard Cite

show abstract

“…By providing an opioid substitute, it also enabled the patient to cease co-codamol use which was being taken at levels which may have resulted in an accidental paracetamol overdose. Furthermore, it reduced the risk of toxicity from her illicit opioid consumption interacting with her prescribed medication (namely sertraline) which may interact with hepatic enzymes (Abbott et al., 2020; Obach et al., 2005). Concomitant metoclopramide has also been reduced and prolactin levels are expected to normalise as she continues with her recovery from opioid dependency.…”

Section: Discussionmentioning

confidence: 99%

“…Kratom is known to affect Cytochrome P450 pathways, so may interact with some prescription medicines such as modafinil and quetiapine, in some cases with tragic consequences (Abbott et al, 2020). As with other non-regulated substances, unknown excipients and strength of active ingredients increases the risk of untoward effects.…”

Section: Introductionmentioning

confidence: 99%

Buprenorphine for the management of kratom dependency during covid-19: A case report

Gittins¹,

Cole

2021

Drug Science, Policy and Law

View full text Add to dashboard Cite

We describe a case report where buprenorphine was successfully used for the management of kratom ( Mitragyna speciosa) dependency during the Covid-19 pandemic in a specialist community substance misuse treatment service. The individual had a notable iatrogenic dependency on oral over the counter and prescribed opioid medication. She resorted to using kratom as a ‘tea’ to self-detoxify before getting into difficulty. Upon presentation, she disclosed using kratom up to 70 g/day with hourly dosing, in addition to co-codamol (8 mg codeine/500 mg paracetamol tablets) three times a week. Initiation of oral buprenorphine sublingual tablets was complicated due to Covid-19: dispensing arrangements were liberalised from the outset and the dose was incrementally increased, eventually to 24 mg/day. Comorbidities included mental health conditions and chronic pain which improved with buprenorphine treatment and psychotherapy. Further research is required to determine optimal regimens for the management of kratom dependency. This case study adds to the current paucity of published data regarding how to manage such cases in the community setting, which is important since kratom is thought to be increasingly used in the western world.

show abstract

“…It is important to point out that low rates of metabolic conversion of cocaine to benzoylecgonine could also be a consequence of the concurrent use of cocaine with other substances such as ethanol and clinical drugs (Shimomura et al, 2019;Abbott et al, 2020). The combination of cocaine and ethanol, in addition to forming cocaethylene, dramatically alter the molar ratios of cocaine metabolites.…”

Section: Concentration Of the Target Analytes In Wastewatermentioning

confidence: 99%

Understanding Illicit Drug Use Trends During the Carnival Holiday in the Brazilian Capital Through Wastewater Analysis

et al. 2022

View full text Add to dashboard Cite

Cocaine and cannabis consumption during and after the 2019 Carnival holiday were assessed using the wastewater-based epidemiology (WBE) in the capital of Brazil, Brasília. The substances 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (THC-COOH), cocaine (COC), benzoylecgonine (BE), and cocaethylene (COE) were monitored in composite samples (24 h) collected in the entrance of North-Wing (NW) and South-Wing (SW) wastewater treatment plants (WWTP) for 15 consecutive days, including the Carnival holiday. Aliquots (100 ml) were enriched with isotope-labeled standards, solid-phase extracted and analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Results reveal higher cocaine consumption during the Carnival (average of 2.8 ± 0.7 g/1000inh/day) compared to the subsequent period (average of 1.7 ± 0.3 g/1000inh/day). Cannabis (THC) use was also higher during the holiday (14 ± 5 g/1000inh/day) but differences were not significative (unpaired t-test, 95%) compared to the following days (11 ± 3 g/1000inh/day), where consumption remained relatively constant corroborating that cannabis overall consumption is less affected by occasional abuse. Regarding cocaine, an unusual low consumption was noticed in the weekend immediately after the Carnival Holiday, indicating lower demand or supply issues. Higher cocaine and cannabis use was observed throughout the entire sampling period in the area covered by NW-WWTP, probably due to the higher proportion of young people. This investigation brings the first data on cannabis use in Brazil by WBE and confirms this strategy as a well consolidate tool for estimating illicit drug use and abuse.

show abstract

Adverse pharmacokinetic interactions between illicit substances and clinical drugs

Cited by 21 publications

References 188 publications

Prevalence, beliefs and impact of drug-drug interactions between antiretroviral therapy and illicit drugs among people living with HIV in Spain

Prevalence, beliefs and impact of drug-drug interactions between antiretroviral therapy and illicit drugs among people living with HIV in Spain

Buprenorphine for the management of kratom dependency during covid-19: A case report

Understanding Illicit Drug Use Trends During the Carnival Holiday in the Brazilian Capital Through Wastewater Analysis

Contact Info

Product

Resources

About