Clinically significant pharmacokinetic drug interactions with benzodiazepines

Tanaka, Einosuke

doi:10.1046/j.1365-2710.1999.00247.x

Cited by 40 publications

(23 citation statements)

References 84 publications

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“…Inhibition of CYP450 metabolism) producing elevated serum BZD concentrations. The CYP3A4 system is primarily responsible for the metabolism of the majority of BZDs, followed by CYP2C19 [89]. The 3-hydroxybenzodiazepines such as lorazepam, oxazepam and temazepam undergo Phase II conjugation reactions and are therefore devoid of CYP450 interactions [90].…”

Section: Psychotropic Drug Interactionsmentioning

confidence: 99%

Clinically Significant Psychotropic Drug-Drug Interactions in the Primary Care Setting

English

Dortch

Ereshefsky

et al. 2012

Curr Psychiatry Rep

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In recent years, the growing numbers of patients seeking care for a wide range of psychiatric illnesses in the primary care setting has resulted in an increase in the number of psychotropic medications prescribed. Along with the increased utilization of psychotropic medications, considerable variability is noted in the prescribing patterns of primary care providers and psychiatrists. Because psychiatric patients also suffer from a number of additional medical comorbidities, the increased utilization of psychotropic medications presents an elevated risk of clinically significant drug interactions in these patients. While life-threatening drug interactions are rare, clinically significant drug interactions impacting drug response or appearance of serious adverse drug reactions have been documented and can impact long-term outcomes. Additionally, the impact of genetic variability on the psychotropic drug’s pharmacodynamics and/or pharmacokinetics may further complicate drug therapy. Increased awareness of clinically relevant psychotropic drug interactions can aid clinicians to achieve optimal therapeutic outcomes in patients in the primary care setting.

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Section: Psychotropic Drug Interactionsmentioning

confidence: 99%

Clinically Significant Psychotropic Drug-Drug Interactions in the Primary Care Setting

English

Dortch

Ereshefsky

et al. 2012

Curr Psychiatry Rep

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“…The use of erythromycin in patients undergoing benzodiazepine therapy should be carefully monitored [93,94].…”

Section: Infectionsmentioning

confidence: 99%

Respiratory problems in advanced cancer

Ripamonti¹,

Fusco²

2002

Support Care Cancer

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Respiratory problems are an important issue in the palliative care setting, not only from a diagnostic and therapeutic point of view but also from emotion-related aspects involving both the patients and their families and also caregivers. In this paper we consider some of the most common respiratory problems, such as dyspnea, infections, hemoptysis, hiccup. A review of the literature was performed with reference to the frequency, diagnosis and management of the above respiratory problems in patients in advanced and terminal stages of the disease. Particular emphasis was given to the importance of communication with the patients and their families, which is considered a crucial point in the care and the cure of such patients.

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“…Benzodiazepines used in interventional procedures include midazolam, lorazepam, and diazepam. In general, many of the benzodiazepines are hepatically metabolized by the CYP450 system to active or inactive metabolites, especially via CYP3A4 (67). Therefore, classically "strong" CYP3A4 inhibitors might result in prolonged or excessive sedation in these patients when used concurrently.…”

Section: Antiplateletsmentioning

confidence: 99%

Drug–Drug Interactions in Cardiovascular Catheterizations and Interventions

Dunn

Holmes

Moliterno

2012

JACC: Cardiovascular Interventions

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Patients presenting for invasive cardiovascular procedures are frequently taking a variety of medications aimed to treat risk factors related to heart and vascular disease. During the procedure, antithrombotic, sedative, and analgesic medications are commonly needed, and after interventional procedures, new medications are often added for primary and secondary prevention of ischemic events. In addition to these prescribed medications, the use of over-the-counter drugs and supplements continues to rise. Most elderly patients, for example, are taking 5 or more prescribed medications and 1 or more supplements, and they often have some degree of renal insufficiency. This polypharmacy might result in drug-drug interactions that affect the balance of thrombotic and bleeding events during the procedure and during long-term treatment. Mixing of anticoagulants, for instance, might lead to periprocedural bleeding, and this is associated with an increase in long-term adverse events. Furthermore, the range of possible interactions with thienopyridine antiplatelets is of concern, because these drugs are essential to immediate and extended interventional success. The practical challenges in the field are great-some drug-drug interactions are likely present yet not well understood due to limited assays, whereas other interactions have well-described biological effects but seem to be more theoretical, because there is little to no clinical impact. Interventional providers need to be attentive to the potential for drug-drug interaction, the associated harm, and the appropriate action, if any, to minimize the potential for medication-related adverse events. This review will focus on drug-drug interactions that have the potential to affect procedural success, either through increases in immediate complications or compromising longer-term outcome.

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Clinically significant pharmacokinetic drug interactions with benzodiazepines

Cited by 40 publications

References 84 publications

Clinically Significant Psychotropic Drug-Drug Interactions in the Primary Care Setting

Clinically Significant Psychotropic Drug-Drug Interactions in the Primary Care Setting

Respiratory problems in advanced cancer

Drug–Drug Interactions in Cardiovascular Catheterizations and Interventions

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