Drug-Drug Interaction Primer: A Compendium of Case Vignettes for the Practicing Clinician

by Neil B. Sandson

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Author: Neil B. Sandson

Publisher: American Psychiatric Publishing

Paperback:
ISBN 10: 1585623059
ISBN 13: 978-1585623051

This user-friendly resource offers complete and comprehensive coverage of the difficult challenges posed by drug-drug interactions. Over 170 case vignettes illustrate a variety of interactions (DDIs) to provide an unintimidating even entertaining approach to understanding these issues. Drug-Drug Interaction Primer builds on the author's earlier work, Drug Interactions Casebook: The Cytochrome P450 System and Beyond, and features updated references throughout and 29 new cases that provide such clinical examples as: a patient diagnosed with schizoaffective disorder transitions from haloperidol to aripiprazole with disastrous results; an AIDS patient's trimethoprim-sulfamethoxazole is replaced with warfarin following atrial fibrillation, resulting in ischemic stroke; and a delusional patient on risperidone is placed on phenytoin following seizures, and delusions return. Previous cases have been revised to enhance clarity.

An introduction to core concepts, which includes brief reviews of each enzyme system, brings the reader up to speed on how to think about DDIs and begin to grapple with what might seem like an imposing subject. The vignettes that follow each include a case presentation and an explanation of the mechanism by which the interaction(s) occurred, and each derives from sound clinical evidence not merely extrapolations from drug characteristics to offer a more realistic understanding of DDIs. Most of the interactions described involve the cytochrome P450 enzyme system; others involve alterations in phase II metabolism and P-glycoprotein functioning, as well as plasma protein displacement effects. The appendices detail most drug-drug interactions between psychotropic agents and contain metabolic pathways and inhibitory and inductive profiles for antidepressants, antipsychotics, and mood stabilizing agents as well as tables that detail all known and clinically significant DDIs between pairings of any two agents from these drug classes. An extensive index allows quick reference. Among the book's other features:

Reorganization by medical subspecialty psychiatry, internal medicine, neurology, surgery/anesthesia, and gynecology, oncology, and dermatology better facilitates clinical application.
Comprehensive tables detail substrates, inhibitors, and inducers for P450, phase II, and P-glycoprotein.
DDIs involving select nonpsychotropic agents such as tobacco, ethinylestradiol, and statins.
Exploration of the paradigm of plasma protein binding mediated DDIs in detail, with cases conveniently indexed.

These cases bring DDIs alive in a way that drier descriptions cannot, and this volume introduces more original material than will be found in other sources. Drug-Drug Interaction Primer is brimming with material that can be put to immediate use, offering insights that will improve any practitioner's skills.

Review

"After a succinct introduction to the 'core concepts' of drug-drug interactions, Dr. Sandson presents scores of engaging clinical vignettes that vividly demonstrate specific principles. Coverage of drug interactions in neurology and general medicine, including those involving herbal agents, is most welcome. Dr. Sandson's book is clearly-written, up-to-date, and of great practical benefit to the busy clinician, who will enjoy puzzling out these challenging cases."-- "Ronald Pies, M.D., Clinical Professor of Psychiatry, Tufts University School of Medicine, Boston, Massachusetts"

"Every practicing clinician should read this lively and interesting work that combines science with the real world of clinical practice. There is a wealth of clinical 'pearls' backed by modern understanding of P450 systems, substrates, inhibitors, inducers, and transporters. The case material is truly fascinating."-- "Steven S. Sharfstein, M.D., President and Chief Executive Officer, Sheppard Pratt Health System, Baltimore, Maryland"

"Comprehensive, authoritative and interesting, Dr. Sandson is skilled in communicating essential knowledge on drug-drug interactions to the clinician. This book covers what every patient needs every doctor to know."-- "William T. Carpenter Jr., M.D., Professor of Psychiatry and Pharmacology, University of Maryland School of Medicine; Director, Maryland Psychiatric Research Center, Baltimore, Maryland"

From the Inside Flap

This user-friendly resource offers complete and comprehensive coverage of the difficult challenges posed by drug-drug interactions. Over 170 case vignettes illustrate a variety of interactions to provide an unintimidating -- even entertaining -- approach to understanding these issues. Drug-Drug Interaction Primer builds on the author's earlier Drug Interactions Casebook: The Cytochrome P450 System and Beyond and features 29 new cases and updated references throughout. Previous cases have been revised to enhance clarity and the entire book has been reorganized by medical subspecialty -- psychiatry, internal medicine, neurology, surgery/anesthesia, and gynecology, oncology, and dermatology -- to better facilitate clinical application.

These cases bring the material alive in a way that drier descriptions cannot, offering insight that will improve any practitioner's skills. An introduction to core concepts includes brief reviews of each enzyme system and brings the reader up to speed on how to think about drug-drug interactions. The case vignettes that follow each include a case presentation and a thorough explanation of the mechanism by which the drug interaction(s) occurred. Appendix A details most drug-drug interactions between psychotropic agents and contains metabolic pathways and inhibitory and inductive profiles for antidepressants, antipsychotics, and mood stabilizing agents, and the remaining appendices detail substrates, inhibitors, and inducers for P450, phase II, and P-glycoprotein.

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Drug-Drug Interaction Primer: A Compendium of Case Vignettes for the Practicing Clinician