Concise Guide to Drug Interaction Principles for Medical Practice: Cytochrome P450, UGTs, P-glycoproteins

Adverse medication reactions account for up to 7,000 deaths annually in the United States. In today's era of polypharmacy, busy clinicians - especially those who practice in medical/surgical settings - must be able to quickly find and even anticipate psychiatric drug interactions. This book is divided into three parts. Part 1 defines the P450 human oxidase system and its critical importance in metabolizing both endogenous and exogenous compounds, thereby rendering them less active. It also presents an in-depth discussion, tailored for psychiatrists, of pharmacology. Part 2 discusses - complete with case studies and tables - each of the six enzymes (2D6, 3A4, 1A2, 2C9, 2C19 and 2E1) that account for 90 percent of human drug oxidation. Unique to this guide, Part 3 arranges the drugs commonly used in nonpsychiatric medicine that have clinically significant P450 drug interactions by specialty and lists them in tables, with pertinent clinical and research data to support and clarify the issues. Concluding with appendices that offer suggestions about how to prescribe in a polypharmacy environment and monitor for drug interactions and tips on how to sort through the enormous amount of information available in this area, this concise "how-to" guide should prove valuable to students and practitioners in psychiatric (in complicated medical/surgical settings, such as geriatrics) and nonpsychiatric (primary care, family practice, internal medicine and obstetrics/gynaecology) specialties alike.

Table of Contents:
Introduction and Basic Pharmacology of Metabolic Drug Interactions. Introduction to drug interactions and to this concise guide. Definitions and phase I metabolism. Metabolism in depth: phase II. P-Glycoproteins. P450 Enzymes. 2D6. 3A4. 1A2. 2C9. 2C19. 2E1. P450 enzymes: 2A6, 2B6, 2C8. Drug Interactions by Medical Specialty. Gynecology: oral contraceptives. Internal medicine. Infectious diseases. Neurology. Oncology. Pain management I: nonnarcotic analgesics. Pain management II: narcotic analgesics. Psychiatry. Transplant surgery/rheumatology: immunosuppressants. Practical Matters. Guidelines. Medicolegal implications of drug-drug interactions. How to retrieve and review the literature. Appendix: trade and generic names used in this book. Index. Pull-out guide.

About the Author :
Kelly L. Cozza, M.D., is a Psychiatrist at the Infectious Disease Service, Department of Medicine, at the Walter Reed Army Medical Center in Washington, D.C.; Assistant Professor at the Department of Psychiatry, Uniformed Services University of the Health Sciences in Bethesda, Maryland; and Fellow of the Academy of Psychosomatic Medicine. Dr. Cozza is the Med-Psych Drug-Drug Interactions Update co-editor of Psychosomatics. Scott C. Armstrong, M.D., is Co-Medical Director at the Center for Geriatric Psychiatry, Tuality Forest Grove Hospital in Forest Grove, Oregon; Clinical Associate Professor of Psychiatry at Oregon Health and Science University in Portland; and Fellow of the American Psychiatric Association and the Academy of Psychosomatic Medicine. He has published many articles on various psychiatric subjects and is a peer reviewer for Military Medicine and Psychosomatics, as well as the Med-Psych Drug-Drug Interactions Update Editor of Psychosomatics. Jessica R. Oesterheld, M.D., is Medical Director of The Spurwink School in Portland, Maine, and an Instructor in Family Medicine at the University of New England School of Osteopathy in Biddeford, Maine.

Review :
"This book is filled with pearls of wisdom about drug-drug interaction and can assist clinicians in the safe and effective medication management of their patients. I highly recommend it to medical students, residents and fellows, and practicing physicians in psychiatry and other disciplines."- "Sashi K. Bhatia, M.D., Journal of American Child and Adolescent Psychiatry," "June 2005" "This book presents the difficult topic of the P450 system and drug interactions in a practical, straightforward manner. Though it does become complex in some discussions of the chemical interactions, the reader should feel competent and comfortable when dealing with drug interactions of this nature after completing the book. This is an invaluable reference tool to an inpatient or consult psychiatrist, and would be a necessary addition to an outpatient psychiatrist's library. The pocket guide is helpful in providing quick reference tables of metabolizers, inducers, and inhibitors of each enzyme and medication. Finally, this second edition expanded the scope of the book and provides needed updates on new medications and research. Four Stars!"- "Brett Plyler, M.D., Doody's Health Science Book Reviews"