Drug interactions and anti-infective therapies

Gregg, Clark R.

doi:10.1016/s0002-9343(98)00408-2

Cited by 35 publications

(18 citation statements)

References 67 publications

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“…Although trimethoprim-sulfamethoxazole and nitroimidazoles are also not metabolized by CYP-enzymes, sulfamethoxazole may inhibit CYP2C9, the major cytochrome P450 isoenzyme responsible for S-warfarin metabolism, leading to warfarin over-anticoagulation [19]. The role of metronidazole as a potential CYP3A4 inhibitor is still unclear [20].…”

Section: Anti-bacterial Drugsmentioning

confidence: 99%

“…Rifampicin, and to a lesser extent rifabutin, are inducers of CYP3A4, CYP2C9, CYP2C19, membrane transporters, and potentially of CYP1A2. Many relevant clinical DDIs have been reported [12,19], notably with oral contraception failures [25].…”

Section: Anti-bacterial Drugsmentioning

confidence: 99%

“…In addition to potential DDIs linked to CYP enzymes, oral metalcontaining compounds (antacids or electrolyte supplements) can significantly reduce fluoroquinolone absorption [12,19].…”

Section: Anti-bacterial Drugsmentioning

confidence: 99%

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Concomitant drugs with low risks of drug–drug interactions for use in oncology clinical trials

Ranchon

Vial²,

Rioufol

et al. 2015

Critical Reviews in Oncology/Hematology

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Section: Anti-bacterial Drugsmentioning

confidence: 99%

Section: Anti-bacterial Drugsmentioning

confidence: 99%

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Concomitant drugs with low risks of drug–drug interactions for use in oncology clinical trials

Ranchon

Vial²,

Rioufol

et al. 2015

Critical Reviews in Oncology/Hematology

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“…The problem is to investigate various reasons, including the relevant importance of data obtained from theoretical in vitro models used to study this phenomenon, which can differ significantly even for the same molecule in relation to concentration, temperature and pH, and which do not reflect exactly in vivo conditions. These models instead are influenced by a series of variables such as drug and protein levels, interindividual variations, pathological status and pharmacological interactions [6].…”

Section: Distributionmentioning

confidence: 99%

The difficulties of Polytherapy: examples from antimicrobial chemotherapy

Mazzei

2011

Intern Emerg Med

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Medical therapy in patients with more than one pathology means using more pharmaceuticals, which results in a higher risk of drug interactions which are modifications in the action of one drug when it is administered in the presence of another. The consequences can be diminished therapeutic effect or increased adverse reactions. The pharmacological interactions can be either physico-chemical, pharmacokinetic or pharmacodynamic, on the basis of their mechanisms. Pharmacokinetic interactions are the most important and can emerge during various phases of absorption, distribution, metabolism and drug elimination. The absorption of many antimicrobial agents can be modified through various mechanisms. Some drugs (for example the anticholinergics and opiates) or food can slow gastric motility, slowing the absorption and reducing maximum concentrations of the antibiotic. Variations in gastric pH can alter the solubility or chemical stability of molecules such as the beta-lactams, the natural macrolides and some azoles. The bioavailability of these drugs can be reduced due to molecules used to raise gastric pH. Antibiotics such as tetracycline or the fluoroquinolones have reduced bioavailability due to chelation from bi- and trivalent cations. The primary number of clinically relevant pharmacological interactions is correlated with modifications of biotransformation of drugs due to Cytochrome P450 (CYP) hepatic enzymes which are involved in oxidative drug processes, including lipophilic antimicrobial drugs such as the macrolides, the fluoroquinolones (to be considered amphoteric) and the antifungal azole derivatives. CYP3A is probably one of the most important isoenzymes since it contributes to at least the partial transformation of 60% of drugs that undergo oxidation: erythromycin and clarithromycin are CYP3A4 substrates. Many isoenzymes can also be inhibited by antimicrobial drugs, including both antibacterials and antifungals (for example the macrolides, fluoroquinolones, metronidazole, sulfonamides and azole derivatives) with a consequent reduction in the metabolism of other drugs, thus increasing their blood concentrations and possible correlated adverse reactions. On the other hand, rifampicin, rifabutin and some anticonvulsants can induce enzymatic metabolism, causing reduced blood concentrations and lower AUC of itraconazole and voriconazole with possibly lower therapeutic efficacy. This brief review of pharmacological interactions among certain chemotherapeutic agents leads us to believe that this problem is destined to occur with more frequency in daily clinical practice. What is needed is basic knowledge of drug interactions on the part of all physicians who work in the fields of clinical therapeutics with the goal of reducing the high number of medical errors.

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“…Als Opfer, wenn das Antibiotikum seine Wirkung einbüßt, als Täter wenn das Antibiotikum klinisch relevant die Wirkung eines coadministrierten Arzneimittels verändert [8][9][10][11][12][13].…”

Section: Die "Antibiotische" Arzneimittelinteraktionunclassified

Cytochrom-P450 mediierte Arzneimittelinteraktionen mit Antibiotika

Thallinger

Joukhadar

2006

Wien Med Wochenschr

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This review focuses on drug interactions with commonly prescribed antibiotics. With each drug coadministered, the likelihood of an adverse interaction increases exponentially. Thus, poly-pharmacotherapy possesses important clinical challenges for clinicians and exposes patients to potentially life-threatening risks. In particular, following co-administration of drugs such as tricyclic antidepressants, anticoagulants and antiarrhythmics, which are characterized by narrow therapeutic windows, even small changes in plasma levels can cause serious adverse reactions and/or therapeutic failure. The hepatic and intestinal cytochrome, or CYP-450 enzyme system is responsible for the biotransformation of a multitude of drugs and is frequently involved in drug interactions. The present review therefore presents a comprehensive overview on potential drug interactions with antibiotics, which are mediated by the cytochrome-P450-enzymes.

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Drug interactions and anti-infective therapies

Cited by 35 publications

References 67 publications

Concomitant drugs with low risks of drug–drug interactions for use in oncology clinical trials

Concomitant drugs with low risks of drug–drug interactions for use in oncology clinical trials

The difficulties of Polytherapy: examples from antimicrobial chemotherapy

Cytochrom-P450 mediierte Arzneimittelinteraktionen mit Antibiotika

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