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Titolo:
Selection of drugs to treat gastro-oesophageal reflux disease - The role of drug interactions
Autore:
Flockhart, DA; Desta, Z; Mahal, SK;
Indirizzi:
Georgetown Univ, Med Ctr, Dept Med, Div Clin Pharmacol, Washington, DC 20007 USA Georgetown Univ Washington DC USA 20007 armacol, Washington, DC 20007 USA Georgetown Univ, Med Ctr, Dept Pharmacol, Div Clin Pharmacol, Washington, DC 20007 USA Georgetown Univ Washington DC USA 20007 armacol, Washington, DC 20007 USA
Titolo Testata:
CLINICAL PHARMACOKINETICS
fascicolo: 4, volume: 39, anno: 2000,
pagine: 295 - 309
SICI:
0312-5963(200010)39:4<295:SODTTG>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
MEPHENYTOIN 4'-HYDROXYLATION PHENOTYPE; HELICOBACTER-PYLORI GASTRITIS; STEADY-STATE PHARMACOKINETICS; SERUM CARBAMAZEPINE LEVELS; PROTON PUMP INHIBITORS; PLASMA-CONCENTRATIONS; ELECTROCARDIOGRAPHIC PHARMACODYNAMICS; THEOPHYLLINE PHARMACOKINETICS; TERFENADINE PHARMACOKINETICS; CYTOCHROME-P450 ISOFORMS;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
125
Recensione:
Indirizzi per estratti:
Indirizzo: Flockhart, DA Georgetown Univ, Med Ctr, Dept Med, Div Clin Pharmacol, 3900Reservoir Rd NW, Washington, DC 20007 USA Georgetown Univ 3900 Reservoir Rd NW Washington DC USA 20007
Citazione:
D.A. Flockhart et al., "Selection of drugs to treat gastro-oesophageal reflux disease - The role of drug interactions", CLIN PHARMA, 39(4), 2000, pp. 295-309

Abstract

Gastro-oesophageal reflux disease is probably the most common acid-peptic disease in Western countries, and the successful treatment of mild to moderate disease with pharmacotherapy has become commonplace. A large number of effective drugs are now available, and so the decision-making process for physicians increasingly relies on considerations other than pure efficacy, Cost, adverse effects and drug interactions have therefore become important,particularly in the most vulnerable patients - children, the elderly and patients who are ill and are taking medications that may influence the efficacy of antireflux therapy. Important drug interactions with antacids include the prevention of the absorption of antibacterials such as tetracycline, azithromycin and quinolones. H-2 antagonists, proton pump inhibitors and prokinetic agents undergo metabolism by the cytochrome P450 (CYP) system present in the liver and gastrointestinal tract, Cimetidine is an inhibitor of CYP3A and it may cause significant interactions with drugs of narrow therapeutic range and low bioavailability that are metabolised by these enzymes. The gastroparietal proton pump inhibitors lansoprazole, omeprazole and pantoprazole are all primarilymetabolised by a genetically polymorphic enzyme, CYP2C19, that is absent from approximately 3% of Caucasians and 20% of Asians. These drugs may also interact with CYP3A, but to a lesser extent. Interactions with prokinetic agents carry the greatest potential fur harm. Metoclopramide is a dopamine antagonist that may cause extrapyramidal effects when administered alone at high concentrations, or when coadministered with antipsychotic agents such as haloperidol or phenothiazines. Cisapride is clearly able to prolong the electrocardiographic QT interval and cause lethal ventricular arrhythmias when its metabolism is slowed by interaction with inhibitors of CYP3A, such as erythromycin, ketoconazole or itraconazole.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/01/20 alle ore 18:54:34