Psychosomatics 44:255-258, June 2003
© 2003 The Academy of Psychosomatic Medicine
Six Patterns of Drug-Drug Interactions
Scott C. Armstrong, M.D.,
Kelly L. Cozza, M.D., and
Neil B. Sandson, M.D. (Guest Contributor)
Dr. Armstrong is the Co-Medical Director, Center for Geriatric Psychiatry, Tuality Forest Grove Hospital, Forest Grove, Ore., and Associate Professor of Psychiatry, Oregon Health Sciences University, Portland, Ore. Dr. Cozza is the staff psychiatrist for the Infectious Disease Service, Department of Medicine, Walter Reed Army Medical Center, Washington, D.C., and Assistant Professor of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Md. Dr. Sandson is the Director of the Division of Education and Residency Training for the Sheppard Pratt Health System, Towson, Md., Associate Director of the University of Maryland/Sheppard Pratt Psychiatry Residency Program, Baltimore, and Clinical Assistant Professor in the Department of Psychiatry at the University of Maryland Medical System, Baltimore. Dr. Sandson is the author of Drug Interactions Case Book: The Cytochrome P450 System and Beyond (American Psychiatric Publishing, 2003). Address correspondence to Dr. Armstrong, Tuality Forest Grove Hospital, 1809 Maple St., Forest Grove, OR 97116; scott.armstrong{at}tuality.org (e-mail).
The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.
ABSTRACT
The literature on pharmacokinetic drug-drug interactions usually focuses on various interactions relating to the cytochrome P450 system, phase II glucuronidation, and P-glycoprotein function. However, there has been relatively little examination of how the modes or patterns that govern these interactions can be systematically characterized to better anticipate drug-drug interactions in clinical practice. This article details a schema of six core patterns of pharmacokinetic drug-drug interaction relating to processes of induction and inhibition and the action of substrates. Case examples illustrating each pattern are provided.
Key Words: Drug-Drug Interactions
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