scholarly journals Dealing with the complex drug-drug interactions: Towards mechanistic models

2015 ◽  
Vol 36 (2) ◽  
pp. 71-92 ◽  
Author(s):  
Manthena V. Varma ◽  
K. Sandy Pang ◽  
Nina Isoherranen ◽  
Ping Zhao
Keyword(s):  
Drug Interactions ◽  
Mechanistic Models ◽  
Complex Drug

scholarly journals Opioids, Polypharmacy, and Drug Interactions: A Technological Paradigm Shift Is Needed to Ameliorate the Ongoing Opioid Epidemic

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 154
Author(s):  
Adriana Matos ◽  
David L. Bankes ◽  
Kevin T. Bain ◽  
Tyler Ballinghoff ◽  
Jacques Turgeon
Keyword(s):  
Drug Interactions ◽  
Paradigm Shift ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Health Records ◽  
Technological Paradigm ◽  
Life Threatening ◽  
Drug Regimens ◽  
Manual Input ◽  
Complex Drug

Polypharmacy is a common phenomenon among adults using opioids, which may influence the frequency, severity, and complexity of drug–drug interactions (DDIs) experienced. Clinicians must be able to easily identify and resolve DDIs since opioid-related DDIs are common and can be life-threatening. Given that clinicians often rely on technological aids—such as clinical decision support systems (CDSS) and drug interaction software—to identify and resolve DDIs in patients with complex drug regimens, this narrative review provides an appraisal of the performance of existing technologies. Opioid-specific CDSS have several system- and content-related limitations that need to be overcome. Specifically, we found that these CDSS often analyze DDIs in a pairwise manner, do not account for relevant pharmacogenomic results, and do not integrate well with electronic health records. In the context of polypharmacy, existing systems may encourage inadvertent serious alert dismissal due to the generation of multiple incoherent alerts. Future technological systems should minimize alert fatigue, limit manual input, allow for simultaneous multidrug interaction assessments, incorporate pharmacogenomic data, conduct iterative risk simulations, and integrate seamlessly with normal workflow.

scholarly journals Fluoxetine- and Norfluoxetine-Mediated Complex Drug–Drug Interactions: In Vitro to In Vivo Correlation of Effects on CYP2D6, CYP2C19, and CYP3A4

2014 ◽  
Vol 95 (6) ◽  
pp. 653-662 ◽  
Author(s):  
J E Sager ◽  
J D Lutz ◽  
R S Foti ◽  
C Davis ◽  
K L Kunze ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Complex Drug

scholarly journals Complex Drug Interactions of the HIV Protease Inhibitors 3: Effect of Simultaneous or Staggered Dosing of Digoxin and Ritonavir, Nelfinavir, Rifampin, or Bupropion

2011 ◽  
Vol 40 (3) ◽  
pp. 610-616 ◽  
Author(s):  
Brian J. Kirby ◽  
Ann C. Collier ◽  
Evan D. Kharasch ◽  
Dale Whittington ◽  
Kenneth E. Thummel ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Protease Inhibitors ◽  
Hiv Protease ◽  
Hiv Protease Inhibitors ◽  
Complex Drug

Drug Interactions Involving Renal Transport Mechanisms: An Overview

DICP ◽  
1989 ◽  
Vol 23 (2) ◽  
pp. 116-122 ◽  
Author(s):  
Teddy Kosoglou ◽  
Peter H. Vlasses
Keyword(s):  
Organic Acids ◽  
Drug Interactions ◽  
Clinical Studies ◽  
Renal Transport ◽  
Transport Mechanisms ◽  
Cellular Mechanisms ◽  
Cationic Drugs ◽  
Tubular Transport ◽  
Underlying Mechanisms ◽  
Complex Drug

The renal anatomy, physiology, and cellular mechanisms involved in tubular transport of organic acids (anions) and bases (cations) are reviewed. Drugs that are renally secreted are prone to significant and complex drug-drug interactions, and knowledge of the underlying mechanisms is important. Several clinical studies involving commonly used cationic drugs (e.g., cimetidine, trimethoprim, and procainamide) are cited as examples of drug interactions involving renal transport mechanisms.

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