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Related Concept Videos

Drug toxicity: Drug–Drug Interaction01:30

Drug toxicity: Drug–Drug Interaction

Drug–drug interactions can precipitate toxicity through multiple mechanisms. Absorption interactions alter how drugs enter the body, exemplified when ranitidine increases the absorption of basic drugs, while cholestyramine decreases the levels of propranolol. Protein binding interactions occur when drugs share the same binding sites on plasma proteins. Drugs like aspirin and warfarin, when bound in excess, can lead to increased free drug concentrations, enhancing the potential for...
Agonism and Antagonism: Quantification01:14

Agonism and Antagonism: Quantification

When drugs are administered, they can elicit either an agonist or antagonist effect on the body. Agonism occurs when a drug activates a specific receptor, triggering a biological response. On the other hand, antagonism happens when a drug binds to the same receptors but blocks their activation, thereby preventing a biological response.
To quantify these effects, researchers use a dose-response curve, which provides valuable information about the potency and efficacy of a drug. Potency refers to...
Quantitative Aspects of Drug-Receptor Interaction01:30

Quantitative Aspects of Drug-Receptor Interaction

The receptor occupancy theory connects a drug's response to the number of occupied receptors. With higher drug concentrations, more receptors are occupied, leading to increased responses. The formation of drug-receptor complexes involves association and dissociation rates, which reach equilibrium when the forward and backward reactions are equal. The equilibrium association constant (Ka) and its inverse, the equilibrium dissociation constant (Kd), indicate drug affinity. Higher Ka and lower Kd...
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Drug-receptor interaction describes the binding of receptors by drugs, but not all drug-receptor interactions result in activation and tissue response. For instance, the binding of agonists activates the receptor to generate a cellular reaction, while antagonists bind to receptors without causing their activation.
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Pharmacokinetics: Drug–Drug Interactions01:25

Pharmacokinetics: Drug–Drug Interactions

Drug interactions occur when the pharmacological effect of one drug is altered by another substance, either enhancing or diminishing its activity. The drug whose activity is altered is known as the object drug, and the substance causing the alteration is called the agent drug or the precipitant. The net effects of these interactions are mostly undesirable, leading to decreased effectiveness or increased adverse effects. In rare cases, interactions can be beneficial, such as the enhanced...
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Combined Effects of Drugs: Synergism

Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
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A Data Integration Workflow to Identify Drug Combinations Targeting Synthetic Lethal Interactions
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Published on: May 27, 2021

Proposal for a new tool to evaluate drug interaction cases.

John R Horn1, Philip D Hansten, Lingtak-Neander Chan

  • 1Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA 98195, USA. jrhorn@u.washington.edu

The Annals of Pharmacotherapy
|March 29, 2007
PubMed
Summary

The Naranjo nomogram is unsuitable for assessing drug-drug interactions. The new Drug Interaction Probability Scale (DIPS) offers a structured approach to evaluating drug interaction causation in patients.

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Area of Science:

  • Pharmacology
  • Clinical Pharmacy
  • Drug Safety

Background:

  • Assessing drug interaction causation requires evaluating drug properties, patient factors, and concurrent medications.
  • The Naranjo nomogram, designed for single-drug adverse events, is often inappropriately applied to drug-drug interactions.
  • Existing methods lack a specific framework for evaluating drug interaction causality in individual patients.

Purpose of the Study:

  • To introduce and describe the Drug Interaction Probability Scale (DIPS) as a tool for assessing drug interaction causation.
  • To provide a structured guide for healthcare practitioners in evaluating drug interaction-induced adverse outcomes.
  • To enhance the accuracy of case report preparation and evaluation concerning drug interactions.

Main Methods:

  • Development of the Drug Interaction Probability Scale (DIPS) with a series of targeted questions.
  • The DIPS estimates a probability score for drug interaction causation based on patient-specific data.
  • Requires comprehensive knowledge of the pharmacologic properties of both object and precipitant drugs.

Main Results:

  • The DIPS provides a systematic method for evaluating the likelihood of a drug interaction causing an adverse event.
  • It addresses limitations of the Naranjo nomogram by focusing specifically on drug-drug interactions.
  • The scale aids in differentiating drug interactions from other causes of adverse events.

Conclusions:

  • The DIPS is a valuable tool for clinicians to assess drug interaction causality in patient care.
  • It can improve the quality and consistency of reporting and evaluating drug interaction case studies.
  • Accurate application of DIPS necessitates a strong understanding of drug pharmacology and interaction mechanisms.