Editorial: Drug-drug interactions in pharmacology

Abstract

Editorial on the Research Topic Drug-drug interactions in pharmacologyIn pharmacology, drug-drug interactions result in unintended reactions, toxic side effects, or a lack of clinical efficacy in an individual body when multiple medications are simultaneously administered for one or more diseases (Molenaar-Kuijsten et al., 2021). These are usually considered in terms of two principal classes of underlying mechanisms: pharmacodynamics and pharmacokinetics (Nguyen et al., 2020). Indeed, the pharmacological effect of one or both drugs may be enhanced or suppressed, or a new and unanticipated adverse effect may occur, even leading to fatal consequences (Barbera et al., 2013;Karch et al., 2016).Concerning pharmacokinetics, drug absorption, distribution, metabolism, and excretion (ADME cycle) variations may result in a plasma concentration fluctuation, influencing drug bioavailability. Interactions between drugs at the metabolic level can modify the metabolic enzymes altering drug activation or inactivation. If the metabolism is inhibited, it will remain longer in the body, so its concentration will increase, potentially causing secondary toxic effects. Conversely, metabolism enhancement can decrease plasma concentration and hence its bioavailability.Pharmacodynamically, drugs can interact by binding to the same receptor. Two receptor agonists or two antagonists would increase the pharmacological actions of both, whereas an agonist and an antagonist would decrease each other's pharmacological effects. In some interactions, drugs may produce biochemical changes that alter the sensitivity to toxicities produced by other drugs. Finally, whereas in the majority of cases, drug-drug interactions can cause toxic adverse effects (e.g., beta-blockers and bronchodilators; diuretics and steroids or digoxin; rifampicin and verapamil or carbamazepine), there are also several therapeutically beneficial drug interactions (e.g., docetaxel and piperine; resveratrol and diclofenac; ivermectin and lopinavir or saquinavir).This Research Topic aims to provide original investigations, brief reports, and review papers concerning the latest insights into drug-drug interactions in pharmacology.Recently, physiologically based pharmacokinetic (PBPK) models have been widely applied for the computational description of drug-drug interaction, since regulatory agencies have progressively accepted the model as predictive. To this concern, Chen et al. investigated the influence of triazoles antifungal drugs on the pharmacokinetics of zanubrutinib and acalabrutinib, two Bruton's tyrosine kinase inhibitors commonly used in

Pharmacomicrobiomics and Drug–Infection Interactions: The Impact of Commensal, Symbiotic and Pathogenic Microorganisms on a Host Response to Drug Therapy

“…There are several ways to classify drug interactions; however, the most common approach is to classify them according to their mechanism of action: into pharmacokinetic or pharmacodynamic interactions. The former refers to those that affect how a drug is absorbed, distributed, metabolized, or eliminated in the body, while the latter refers to how drugs interact directly with biological systems to produce therapeutic or side effects [1][2][3][4].…”