A Textbook of Clinical Pharmacology and Therapeutics

70 ADVERSE DRUG REACTIONS FURTHER READING AND WEB MATERIAL Davies DM, Ferner RE de Glanville H. Textbook of adverse drug reac- t ...

●Introduction 71 ●Useful interactions 72 ●Trivial interactions 72 ●Harmful interactions 73 CHAPTER 13 DRUG INTERACTIONS INTRODUC ...

(see Chapter 17) and ‘lifestyle’ drugs taken for social reasons. The greater the number of drugs taken, the more likely things a ...

PLASMA AND TISSUE BINDING SITE INTERACTIONS One large group of potential drug interactions that are seldom clinically important ...

harm (Figure 13.2), and where special caution is required with concurrent therapy. These include: warfarin and other anticoagul ...

PHARMACOKINETIC INTERACTIONS Absorption In addition to direct interaction within the gut lumen (see above), drugs that influence ...

Withdrawal of an inducing agent during continued admin- istration of a second drug can result in a slow decline in enzyme activi ...

FURTHER READING There is a very useful website for CYP450 substrates with inhibitors and inducers: http://medicine.iupui.edu/flo ...

Neuvonen PJ, Niemi M, Backman JT. Drug interactions with lipid- lowering drugs: mechanisms and clinical relevance. Clinical Phar ...

●Introduction: ‘personalized medicine’ 79 ●Genetic influences on drug metabolism 79 ●Genetic influences on drug disposition 82 ● ...

80 PHARMACOGENETICS Table 14.1:Variations in drug metabolism/pharmacodynamics due to genetic polymorphisms Pharmacogenetic Mecha ...

rapid acetylators, particularly when the drug is not given daily, but twice weekly. In addition, slow acetylators are more likel ...

Heterozygotes are unaffected carriers and represent about 4% of the population. GENETIC INFLUENCES ON DRUG DISPOSITION Several g ...

lipoprotein (LDL) is impaired. LDL receptors are needed for hepatic uptake of LDL and individuals with FH consequently have very ...

for Ry1R or undergo muscle biopsy to assess their predisposi- tion to this condition. Muscle from affected individuals is abnorm ...

INHERITEDDISEASES THATPREDISPOSE TODRUGTOXICITY 85 Key points Genetic differences contribute substantially to individual (pharm ...

HISTORY Many years before Christ, humans discovered that certain plants influence the course of disease. Primitive tribes used e ...

CLINICALTRIALS 87 CLINICAL TRIALS Physicians read clinical papers, review articles and pharma- ceutical advertisements describin ...

88 INTRODUCTION OF NEW DRUGS AND CLINICAL TRIALS between diagnosis and treatment, individual differences in determining entry cr ...

CLINICALDRUGDEVELOPMENT 89 differences should be reported as confidence intervals (usu- ally 95% confidence intervals). Such int ...