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Drug interaction

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This article may be expanded with text translated from the corresponding
article in Spanish Wikipedia. (December 2009)
After translating, {{Translated|es|Interacción farmacológica}} must be added to
the talk page to ensure copyright compliance.
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A drug interaction is a situation in which a substance affects the activity of a drug, i.e. the
effects are increased or decreased, or they produce a new effect that neither produces on its
own. Typically, interaction between drugs come to mind (drug-drug interaction). However,
interactions may also exist between drugs & foods (drug-food interactions), as well as drugs
& herbs (drug-herb interactions). These may occur out of accidental misuse or due toof
knowledge about the active ingredients involved in the relevant substances.[1]
Generally speaking, drug interactions are to be avoided, due to the possibility of poor or
unexpected outcomes. However, drug interactions have been deliberately used, such as co-
administering probenecid with penicillin prior to mass production of penicillin. Because
penicillin was difficult to manufacture, it was worthwhile to find a way to reduce the amount
required. Probenecid retards the excretion of penicillin, so a dose of penicillin persists longer
when taken with it, and it allowed patients to take less penicillin over a course of therapy.
A contemporary example of a drug interaction used as an advantage is the co-administration
of carbidopa with levodopa (available as Carbidopa/levodopa). Levodopa is used in the
management of Parkinson's disease and must reach the brain in an un-metabolized state to be
beneficial. When given by itself, levodopa is metabolized in the peripheral tissues outside the
brain, which decreases the effectiveness of the drug and increases the risk of adverse effects.
However, since carbidopa inhibits the peripheral metabolism of levodopa, the co-
administration of carbidopa with levodopa allows more levodopa to reach the brain un-
metabolized and also reduces the risk of side effects.
Drug interactions may be the result of various processes. These processes may include
alterations in the pharmacokinetics of the drug, such as alterations in the Absorption,
Distribution, Metabolism, and Excretion (ADME) of a drug. Alternatively, drug interactions
may be the result of the pharmacodynamic properties of the drug, e.g. the co-administration
of a receptor antagonist and an agonist for the same receptor.

Contents
[hide]
• 1 Metabolic drug interactions
• 2 Epidemiology
• 3 See also
• 4 References
• 5 External links

[edit] Metabolic drug interactions


Many drug interactions are due to alterations in drug metabolism.[2] Further, human drug-
metabolizing enzymes are typically activated through engagement of nuclear receptors.[2]
One notable system involved in metabolic drug interactions is the enzyme system comprising
the cytochrome P450 oxidases. This system may be affected by either enzyme induction or
enzyme inhibition, as discussed in the examples below.
• Enzyme induction - drug A induces the body to produce more of an enzyme which
metabolises drug B. This reduces the effective concentration of drug B, which may
lead to loss of effectiveness of drug B. Drug A effectiveness is not altered.
• Enzyme inhibition - drug A inhibits the production of the enzyme metabolising drug
B, thus an elevation of drug B occurs possibly leading to an overdose.
• Bioavailability - drug A influences the absorption of drug B.
The examples described above may have different outcomes depending on the nature of the
drugs. For example, if Drug B is a prodrug, then enzyme activation is required for the drug to
reach its active form. Hence, enzyme induction by Drug A would increase the effectiveness
of the drug B by increasing its metabolism to its active form. Enzyme inhibition by Drug A
would decrease the effectiveness of Drug B.
Additionally, Drug A and Drug B may affect each other's metabolism.
[edit] Epidemiology
Among US adults older than 55, 4% are taking medication and or supplements that put them
at risk of a major drug interaction.[3]
[edit] See also
• Classification of Pharmaco-Therapeutic Referrals
• List of drug interactions
[edit] References
1. ^ "Forget the colour, shape or brand: It's the active ingredient which counts". National
Prescribing Service, 2009. Available at
http://nps.org.au/news_and_media/media_releases/repository/Forget_the_colour_shape_or_br
and__its
2. ^ a b Elizabeth Lipp (2008-06-15). "Tackling Drug-Interaction Issues Early On". Genetic
Engineering & Biotechnology News (Mary Ann Liebert, Inc.): pp. 14, 16, 18, 20.
http://www.genengnews.com/articles/chitem.aspx?aid=2509. Retrieved 2008-07-06.
"(subtitle) Researchers explore a number of strategies to better predict drug responses in the
clinic"
3. ^ "JAMA -- Abstract: Use of Prescription and Over-the-counter Medications and Dietary
Supplements Among Older Adults in the United States, December 24/31, 2008, Qato et al.
300 (24): 2867". http://jama.ama-assn.org/cgi/content/short/300/24/2867.

[edit] External links


• Drug Interactions: What You Should Know. U.S. Food and Drug Administration,
Center for Drug Evaluation and Research
• Medfacts Pocket guide for Drug Interaction Published by Nephrology pharmacy
associates NPA Second Edition
• Cytochome P450 table maintained by the Indiana University School of Medicine
• Free Drug Interaction Checker
Retrieved from "http://en.wikipedia.org/wiki/Drug_interaction"
Categories: Pharmacology | Drugs
Hidden categories: Articles to be expanded from December 2009 | All articles to be expanded
| Science articles needing translation from Spanish Wikipedia
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