Drug-Drug Interaction Primer: A Compendium of Case Vignettes for the Practicing Clinician / Edition 1

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Overview

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.

American Psychiatric Publishing

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Editorial Reviews

Doody's Review Service
Reviewer: Raj Tummala, MD (Wyeth Pharmaceuticals)
Description: This is a user-friendly review of drug-drug interactions presented in the form of case vignettes. This edition builds on the author's previous book with over 170 case vignettes organized by medical specialty.
Purpose: The purpose is to provide a comprehensive review of psychotropic drug interactions for prescribers.
Audience: It is targeted at anyone dealing with psychotropics such as students, residents, clinicians, nursing staff, and psychopharmacologists.
Features: Drug interactions can lead to potentially fatal complications and can be avoided with some care. The new edition has 29 new cases, organized by medical specialty as opposed to by mechanism of action as in the earlier version. Starting with a brief introduction to the core concepts of drug-drug interactions, each section has case vignettes based on symptoms or other pearls. The cases have a uniform format, with a succinct presentation followed by a discussion and a small, pertinent reference section. The cases are based on clinical evidence with explanations of theoretical mechanisms behind the clinical presentations. Of special interest are the sections on internal medicine and neurology, as psychiatric patients tend to have comorbid medical and neurological disorders. The appendixes are reader friendly and useful for quick reference. The author includes an overview of psychotropic drug-drug interactions based on class and drug. Appendixes cover interactions based on major classes of psychotropics and other drugs. Tables based on the cytochrome P450 system and glucuronidation pathways are also provided. Of special mention is the index, which allows clinicians to navigate through the book either by drug or by case.
Assessment: This reader-friendly book takes a dry topic and makes it more interesting and accessible in the form of vignettes. As the title denotes, this is a primer, not a detailed textbook. However, it does cover all of the major topics and provides a wealth of information.
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Product Details

  • ISBN-13: 9781585623051
  • Publisher: American Psychiatric Publishing, Incorporated
  • Publication date: 6/28/2007
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 408
  • Product dimensions: 6.00 (w) x 9.00 (h) x 0.75 (d)

Meet the Author

Neil B. Sandson, M.D., is Director of the Division of Education and Residency Training at Sheppard Pratt Health System in Towson, Maryland; Associate Director of the University of Maryland/Sheppard Pratt Psychiatry Residence Program in Baltimore, Maryland; and Clinical Assistant Professor in the Department of Psychiatry at the University of Maryland Medical System in Baltimore, Maryland.

American Psychiatric Publishing

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Table of Contents

Acknowledgments. Introduction. Core concepts. Psychiatry case vignettes. Internal medicine case vignettes. Neurology case vignettes. Surgery/anesthesia case vignettes. Gynecology, oncology, and dermatology case vignettes. Appendix A: an overview of psychotropic drug-drug interactions. Appendix B: P450 tables. Appendix C: UGT or Phase II (Glucuronidation) tables. Appendix D: P-glycoprotein table. Case index. Subject index.

American Psychiatric Publishing

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