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By Domenic A. Ciraulo MD, Richard I. Shader, David J. Greenblatt MD, Wayne L. Creelman MD

ISBN-10: 0781748178

ISBN-13: 9780781748179

Thoroughly up to date for its 3rd variation, this guide offers whole, present, and simply available info on how psychotropic medicinal drugs have interaction with each other and with compounds used to regard non-psychiatric health conditions. The publication is equipped for swift reference, comprises a variety of tables, and gives guidance for handling hostile effects.

The 3rd version contains an hostile drug results desk within the appendix part, tables on receptor binding and dosing, and the newest details on medicinal drugs of abuse and chemical dependence. This version additionally contains drug-food interactions for every drug classification and interactions of psychotropic medicinal drugs with HIV medications.

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For example, caffeine and tacrine are both metabolized almost entirely by CYP1A2. The SSRI antidepressant fluvoxamine (a potent CYP1A2 inhibitor) produces qualitatively similar effects on the oral clearance of both these drugs (80% to 90% impairment). 07) manifests itself as a prolongation of elimination half-life (sixfold) without a significant effect on Cmax. 95), without a significant effect on elimination half-life. In vitro experiments per se, would not predict these differences, unless the resulting data are interpreted within the context of the pharmacokinetic properties of the victim drug.

CYP2C9 is the most abundant human hepatic CYP2C isoform, followed by CYP2C8 and CYP2C19. CYP2C18 is a minor isoform without any demonstrated role of clinical significance in drug metabolism. CYP2C9 and 2C19 show a 91% identity in amino acid sequence. Thus, most substrates of CYP2C9 are metabolized by CYP2C19 as well, albeit with lower values of intrinsic clearance, attributable to a lower affinity and lower level of expression of the latter isoform in human liver. CYP2C8 plays an important role in the metabolism of the antidiabetic agents repaglinide and rosiglitazone and the anticancer agent paclitaxel (Taxol), and contributes to the epoxidation of the anticonvulsant carbamazepine.

Qxd 7/28/05 3:25 PM Page 34 pinnacle Raj01:BooksQuark:GRBQ043-Cirualo:F 34 DRUG INTERACTIONS IN PSYCHIATRY CYP3A mediated, and two-thirds is mediated by AO, the pharmacokinetic consequences of CYP3A inhibition are small for this atypical antipsychotic agent. Carbonyl Reductases Carbonyl reductases comprise of a group of enzymes with ketone and aldehyde reduction properties. They are localized both in the microsomal and cytosolic compartments of cells, distributed not only in the liver but at other extrahepatic sites, including red blood cells and brain and heart tissue.

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Drug interactions in psychiatry by Domenic A. Ciraulo MD, Richard I. Shader, David J. Greenblatt MD, Wayne L. Creelman MD


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