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Cytochrome P450: Drug Interactions in Psychiatry

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Cytochrome P450: Drug Interactions in Psychiatry

Post  Admin on Sat Jan 21, 2012 2:27 pm

Cytochrome P450: Drug Interactions in Psychiatry

Cytochrome P450 is a family of isozymes responsible for the biotransformation of several drugs.
Although a majority of the isozymes are located in the liver, extrahepatic metabolism also occurs in the kidneys, skin, gastrointestinal tract, and lungs.

Recognizing whether the drugs involved act as enzyme substrates, inducers, or inhibitors can prevent clinically significant interactions from occurring.

This thread is dedicated to Cytochrome P450 enzymes substrates, inhibitors and inducers.


INDEX:

Page 1:
• CYP450 1A2
• CYP450 2D6
• CYP450 3A4


Regards

Admin



Last edited by Admin on Mon Sep 10, 2012 9:33 pm; edited 3 times in total

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Re: Cytochrome P450: Drug Interactions in Psychiatry

Post  Admin on Sat Jan 21, 2012 2:34 pm

(1) Cytochrome P450 1A2


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Re: Cytochrome P450: Drug Interactions in Psychiatry

Post  Admin on Sat Jan 21, 2012 3:11 pm

(2) Cytochrome P450 2D6


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Re: Cytochrome P450: Drug Interactions in Psychiatry

Post  Admin on Sat Jan 21, 2012 3:42 pm

(3) Cytochrome P450 3A4


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Re: Cytochrome P450: Drug Interactions in Psychiatry

Post  P450 on Sun Jan 22, 2012 6:48 pm

A very nice overview!

I just want to add that the list of substrates for various cyp enzymes can be quite extensive as you have shown in the images above. It is important to keep in mind that in most cases, the drugs which are substrates of ONE cyp enzyme or have a major metabolic cyp enzyme (clozapine - 1A2, olanzapine - 1A2, risperidone - 2D6) are the ones which will cause clinically significant drug-drug interactions.

This may be complicated if drugs are given with substances known as "pan-inducers" like carbamazepine or "pan-inhibitors" like fluoxatine. In that case, even drugs with multiple metabolic pathways can have clinically significant changes in serum concentrations.

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Re: Cytochrome P450: Drug Interactions in Psychiatry

Post  Admin on Sun Jan 22, 2012 6:52 pm

P450 wrote:A very nice overview!

I just want to add that the list of substrates for various cyp enzymes can be quite extensive as you have shown in the images above. It is important to keep in mind that in most cases, the drugs which are substrates of ONE cyp enzyme or have a major metabolic cyp enzyme (clozapine - 1A2, olanzapine - 1A2, risperidone - 2D6) are the ones which will cause clinically significant drug-drug interactions.

This may be complicated if drugs are given with substances known as "pan-inducers" like carbamazepine or "pan-inhibitors" like fluoxatine. In that case, even drugs with multiple metabolic pathways can have clinically significant changes in serum concentrations.

Thanks for clarification. I was about to e-mail you with above confusion of "multiple substrates".

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