Adverse drug interactions in anesthesia

Anesthesia often involves the administration of several drugs belonging to different classes. In addition, many patients will be taking a number of drugs related to their surgical condition or for other medical diseases. Thus, there is a considerable potential for drug interactions in the perioperative period, some of which may be potentially harmful to patients. The most common interactions involve changes in the pharmacokinetics or pharmacodynamics of one drug caused by induction or inhibition of the cytochrome P450 enzyme system by another drug. Other important interactions involve monoamine oxidase inhibitors, some antibiotics, and the tricyclic and tetracyclic antidepressants. These adverse interactions are the subject of this review.