Drug interactions have become a significant iatrogenic complication, with as many as 5% of hospitalizations and 7,000 deaths annually attributable to drug-drug interactions in the United States. There are several reasons these numbers have increased. First, many new medications have been brought to market in recent years. Second, advances in medical care have resulted in increased longevity and more elderly patients than ever before -- patients who are more likely to be following polypharmacy regimens. Population patterns in the U.S. have amplified this trend, with aging baby boomers swelling the patient pool and demanding treatment with medications advertised on television and in print.

Fortunately, drug interactions can be prevented with access to current, comprehensive, reliable information, and the Clinical Manual of Drug Interaction Principles for Medical Practice provides just that in a user-friendly format psychiatry clinicians (including residents and nurses) and forensics experts will find indispensable. With this new edition, the book has evolved from "Concise Guide" to "Clinical Manual" and offers the expanded coverage and features healthcare providers need to keep up with this critical field.

The book is well organized, with major sections on metabolism; cytochrome P450 enzymes; drug interactions by medical specialty; and practical matters, such as the medicolegal implications of drug-drug interactions and how to retrieve and review the literature. In the section on P450 enzymes, each chapter addresses what the individual enzyme does and where, its polymorphisms, and drugs that inhibit or induce activity. Each chapter also includes extensive references and study cases to help the reader understand and contextualize the information. A number of additional features enhance the book's scope and utility: The book boasts the very latest information in the area of drug metabolism, transport, and interaction. The chapter on P-glycoprotein (a drug transporter) was expanded from the last edition to include a broader array of transport mechanisms. The highest ethical standard was adhered to in the development of this volume, which was not supported in any way by pharmaceutical makers or distributors.

All eight contributors to this excellent resource are experts in the fields they have addressed, and clinicians can trust that the information contained in the Manual reflects the very latest research. This exceptionally practical manual is essential to maintaining the highest standard of care.

Autorentext

Gary H. Wynn, M.D., Jessica R. Oesterheld, M.D., Kelly L. Cozza, M.D., and Scott C. Armstrong, M.D.

Inhalt

ContributorsPrefaceAcknowledgmentsPART I: Introduction and Basic Pharmacology of Metabolic Drug InteractionsChapter 1. Introduction to Drug Interactions and to This Clinical ManualChapter 2. Definitions and Phase I MetabolismChapter 3. Metabolism in Depth: Phase IIChapter 4. TransportersPART II: P450 EnzymesIntroduction to Part IIChapter 5. 2D6Chapter 6. 3A4Chapter 7. 1A2Chapter 8. 2C9Chapter 9. 2C19Chapter 10. 2E1Chapter 11. 2A6, 2B6, and 2C8PART III: Drug Interactions by Medical SpecialtyChapter 12. Gynecology: Oral Contraceptives Chapter 13. Internal MedicineChapter 14. Infectious DiseasesChapter 15. NeurologyChapter 16. OncologyChapter 17. Pain Management I: Nonnarcotic AnalgesicsChapter 18. Pain Management II: Narcotic AnalgesicsChapter 19. PsychiatryChapter 20. Transplant Surgery and Rheumatology: ImmunosuppressantsPART IV: Practical MattersChapter 21. GuidelinesChapter 22. Medicolegal Implications of Drug-Drug InteractionsChapter 23. How to Retrieve and Review the LiteratureAppendix: Tables of Drug Interaction PharmacokineticsIndex