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Titolo:
Pharmacokinetic interactions of antimalarial agents
Autore:
Giao, PT; de Vries, PJ;
Indirizzi:
Univ Amsterdam, Acad Med Ctr, Div Infect Dis Trop Med & AIDS, NL-1100 DE Amsterdam, Netherlands Univ Amsterdam Amsterdam Netherlands NL-1100 DE E Amsterdam, Netherlands Cho Ray Hosp, Trop Dis Clin Res Ctr, Ho Chi Minh City, Vietnam Cho Ray Hosp Ho Chi Minh City Vietnam es Ctr, Ho Chi Minh City, Vietnam
Titolo Testata:
CLINICAL PHARMACOKINETICS
fascicolo: 5, volume: 40, anno: 2001,
pagine: 343 - 373
SICI:
0312-5963(2001)40:5<343:PIOAA>2.0.ZU;2-C
Fonte:
ISI
Lingua:
ENG
Soggetto:
UNCOMPLICATED FALCIPARUM-MALARIA; HUMAN LIVER-MICROSOMES; PERFUSED-RAT-LIVER; MULTIPLE-DOSE PHARMACOKINETICS; HEALTHY VIETNAMESE SUBJECTS; DAPSONE N-HYDROXYLATION; PLASMA-PROTEIN BINDING; PLASMODIUM-FALCIPARUM; IN-VITRO; CLINICAL PHARMACOKINETICS;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
179
Recensione:
Indirizzi per estratti:
Indirizzo: de Vries, PJ Univ Amsterdam, Acad Med Ctr, Div Infect Dis Trop Med & AIDS,POB 22700, NL-1100 DE Amsterdam, Netherlands Univ Amsterdam POB 22700 Amsterdam Netherlands NL-1100 DE ds
Citazione:
P.T. Giao e P.J. de Vries, "Pharmacokinetic interactions of antimalarial agents", CLIN PHARMA, 40(5), 2001, pp. 343-373

Abstract

Combination of antimalarial agents has been introduced as a response to widespread drug resistance. The higher number of mutations required to express complete resistance against combinations may retard the further development of resistance. Combination of drugs, especially with the artemisinin drugs, may also offer complete and rapid eradication of the parasite load in symptomatic patients and thus reduce the chance of survival of resistant strains. The advantages of combination therapy should be balanced against the increased chance of drug interactions. During the last decade, much of the pharmacokinetics and metabolic pathways of antimalarial drugs have been elucidated, including the role of the cytochrome P450 (CYP) enzyme complex. Change in protein binding is not a significant cause of interactions between antimalarial agents. CYP3A4 and CYP2C19 are frequently involved in the metabolism of antimalarial agents. Quinidine is a potent inhibitor of CYP2D6, but itappears that this enzyme does not mediate the metabolism of any other antimalarial agent. The new combinations proguanil-atovaquone and chlorproguanil-dapsone do not show significant interactions. CYP2B6 and CYP3A4 are involved in the metabolism of artemisinin and derivatives, but further studies may reveal involvement of more enzymes. Artemisinin may induce CYP2C19. Several artemisinin drugs suffer from autoinductionof the first-pass effect, resulting in a decline of bioavailability after repeated doses. The mechanism of this effect is not yet clear, but induction by other agents cannot be excluded. The combination of artemisinin drugs with mefloquine and the fixed combination artemether-lumefantrine have beenstudied widely, and no significant drug interactions have been found. The artemisinin drugs will be used at an increasing rate, particularly in combination with other agents. Although clinical studies have so far not shown any significant interactions, drug interactions should be given appropriate attention when other combinations are used.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/03/20 alle ore 13:30:35