Concise Guide to Drug Interaction Principles for Medical Practice: Cytochrome P450s, Ugts, P-Glycoproteins (Concise Guides) [Paperback]

Kelly L. Cozza (Author), Scott C. Armstrong (Author), Jessica R. Oesterheld (Author)

Book Description

Publication Date: January 2003 | ISBN-10: 1585621110 | ISBN-13: 978-1585621118 | Edition: 2

An understanding of drug interactions has become essential to the practice of medicine. Since publication of the first edition of this Concise Guide in 2001, our increasing pharmacopoeia?A?A?A?A?A?A?A?Acoupled with prolonged human life spans?A?A?A?A?A?A?A?Ahas made polypharmacy commonplace. Like the first edition of this unique pocket reference, the Second Edition is written expressly for clinicians. With four new contributors, this bestseller includes expanded sections on both phase I and phase II metabolism, updates of existing chapters and tables, new graphics, and extensive Web site references. Brand-new chapters discuss P-glycoproteins, "minor" cytochrome P450 enzymes, pain management with narcotic and nonnarcotic analgesics, prescribing guidelines, and medicolegal issues. This exceptionally practical guide is divided into four parts: 1. An easy-to-read, succinct review of pharmacology, written with clinicians in mind, explaining the importance of understanding our metabolic system and pharmacokinetics and P-glycoprotein drug interactions. 2. Thorough, carefully referenced reviews of the most clinically relevant phase I and phase II metabolic enzymes highlighted with newly expanded tables and study cases. 3. A section unique to this book on drug interactions by medical specialty, with drug tables arranged by how they are used in specialties such as gynecology, infectious diseases, internal medicine, neurology, oncology, psychiatry, and pain medicine. 4. Chapters on practical matters: prescribing guidelines, how to identify drug interaction patterns, strategies for reviewing the current literature, and medicolegal concerns. Enhanced by detailed descriptions and clinically based explanations, and complemented by a unique pocket guide to the most common and potent inhibitors and inducers of drug metabolism, this updated concise "how-to" guide will prove indispensable for busy students, teachers, and practitioners in all medically specialties.

Editorial Reviews

Review

"This book presents the difficult topic of the P450 system and drug interactions in a practical, straightforward manner. Though it does become complex in some discussions of the chemical interactions, the reader should feel competent and comfortable when dealing with drug interactions of this nature after completing the book. This is an invaluable reference tool to an inpatient or consult psychiatrist, and would be a necessary addition to an outpatient psychiatrist's library. The pocket guide is helpful in providing quick reference tables of metabolizers, inducers, and inhibitors of each enzyme and medication. Finally, this second edition expanded the scope of the book and provides needed updates on new medications and research. Four Stars!"- "Brett Plyler, M.D., Doody's Health Science Book Reviews"

About the Author

Kelly L. Cozza, M.D., is a Psychiatrist at the Infectious Disease Service, Department of Medicine, at the Walter Reed Army Medical Center in Washington, D.C.; Assistant Professor at the Department of Psychiatry, Uniformed Services University of the Health Sciences in Bethesda, Maryland; and Fellow of the Academy of Psychosomatic Medicine. Dr. Cozza is the Med-Psych Drug-Drug Interactions Update co-editor of Psychosomatics. Scott C. Armstrong, M.D., is Co-Medical Director at the Center for Geriatric Psychiatry, Tuality Forest Grove Hospital in Forest Grove, Oregon; Clinical Associate Professor of Psychiatry at Oregon Health and Science University in Portland; and Fellow of the American Psychiatric Association and the Academy of Psychosomatic Medicine. He has published many articles on various psychiatric subjects and is a peer reviewer for Military Medicine and Psychosomatics, as well as the Med-Psych Drug-Drug Interactions Update Editor of Psychosomatics. Jessica R. Oesterheld, M.D., is Medical Director of The Spurwink School in Portland, Maine, and an Instructor in Family Medicine at the University of New England School of Osteopathy in Biddeford, Maine.

Product Details

• Paperback: 644 pages
• Publisher: American Psychiatric Publishing, Inc.; 2 edition (January 2003)
• Language: English
• ISBN-10: 1585621110
• ISBN-13: 978-1585621118
• Product Dimensions: 6.4 x 4.3 x 1.3 inches
• Shipping Weight: 1.2 pounds
• Average Customer Review: 5.0 out of 5 stars  See all reviews (1 customer review)
• Amazon Best Sellers Rank: #1,278,778 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

3 of 3 people found the following review helpful:

5.0 out of 5 stars Hard to believe there are no reviews, January 6, 2007

By 

George Dawson (St. Paul, MN USA) - See all my reviews
(REAL NAME)   

This review is from: Concise Guide to Drug Interaction Principles for Medical Practice: Cytochrome P450s, Ugts, P-Glycoproteins (Concise Guides) (Paperback)

I wrote a review for the first edition of this book and thought it was excellent. This edition is even better and as far as I can tell is state of the art even today in researching drug interactions.

The authors provide excellent summaries of drug metabolism in general and specific chapters on cytochromes, phase II metabolism, and P-glycoproteins. The chapters are logically organized and contain many case examples. As an example the cytochrome chapters describe the function, localization, inhibitors and inducers of each enzyme.

Rather than detail the specifics - I can tell you how a clinician treating complex problems might use this book. Medical care has become increasingly complex. It is common to treat people who are taking various combinations of maintenance medications like antihypertensives and cholesterol lowering drugs. Those drugs may be combined with medications to treat diabetes or other chronic medical disorders. The introduction of one or more psychiatric medications can lead to problems at the pharmacokinetic level.

A rapid check using computerized drug interaction programs or lists for specific conditions like prolonged QT syndrome usually yields rare interactions based on case reports in the literature. Reading the specific case reports or program results often gives conflicting results and no theoretical basis. This guide allows the reader to look up specific drugs across chapters and read relevant case illustrations. Chapters also include well organized tables showing specific compounds from the drug classes under discussion with the metabolizing sites and inhibitors. These tables are footnoted with whether the inhibitory effects are mild, moderate or potent.

Using the drug metoprolol as an example - the index shows four pages referenced with three of those pages containing the drug in tables. The pages describe that it is hepatically metabolized by 2D6 and 3A4. The authors provide an analysis of pharmacokinetic drug interactions that illustrate what can happen if the enzymes metabolizing metoprolol are affected by other agents.

The title of this book is somewhat of a misnomer. The authors have done an excellent job of balancing the theoretical and practical aspects of drug interaction in a book that is clinically useful. Any physician prescribing multiple medications or single medication to a patient who is already taking several will find this book extremely useful. The level of scholarship in this book is very high and it has a unique niche in the drug interaction literature. If there is a better book out there on drug interactions - I haven't found it. If you have - send the reference to me and I will review it and compare it to this book.

George Dawson, MD