Les interactions médicamenteuses de nature pharmacodynamique sont caractérisées par des additions d’effets notamment sédatifs, hypotenseurs. Carbamazépine et clarithromycine: une interaction médicamenteuse cliniquement significativeCarbamazepine and clarithromycin: a clinically relevant drug. Newly approved drugs expand our therapeutic armamentarium, but augment the potential for drug–drug interactions. These can be broadly categorized into.

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Effects of drug interactions on biotransformation and antiplatelet effect of clopidogrel in vitro. Lack of clinically relevant drug—drug interactions when dalcetrapib is co-administered with ezetimibe. There are many study designs used for this purpose, which include: In this issue of the Journal we publish several papers describing drug—drug interaction studies, and a cadre of papers that highlight the value of careful clinical observation and investigation in a single clinical case, which draws attention to potential, but previously undefined or poorly defined, drug—drug interactions.

Seven of these mdicamenteuse patients were among those who received an intervention. However, the clinical significance of this interaction is unclear.

Importantly a drug—drug interaction that primarily causes a change in PK will consequently cause a secondary alteration in its pharmacodynamics. Personal information regarding our website’s visitors, including their identity, is confidential. A chart review was conducted for patients over 18 years of age who were admitted, from September to September inclusive, to the psychiatry or neurology service at Vancouver General Hospital, Vancouver, British Columbia, and who received concomitant valproic acid and lorazepam therapy.

In vitro characterization of cytochrome P 2D6 inhibition by classic histamine H1 receptor antagonists. To identify site-specific practices and assess clinical responses to the interaction between valproic acid and lorazepam.

Les principales interactions médicamenteuses pharmacodynamiques – EM|consulte

Further clinical and pharmacokinetic studies are required to determine whether concurrent treatment with lorazepam and valproic acid should be considered as causing a major drug interaction.


The Hunter serotonin toxicity criteria: The authors sensibly suggest that in patients who take a combined overdose of dextromethorphan and chlorphenamine, the development of serotonin syndrome should be considered a potential complication.

Pharmacodynamic drug interactions are characterised by the accumulation of effects, notably sedative, hypotensive or hypokalemic, or pharmacological antagonisms, for exemple when a dopaminergic drug is combined with a dopamine antagonist antipsychotic drug. It appears that only a prospective randomized placebo controlled trial will settle this debate.

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Dextromethorphan, chlorphenamine and serotonin toxicity: If you want to subscribe to this journal, see our rates You can purchase this item in Pay Per View: Access to mericamenteuse PDF text. Initially the gastrointestinal symptoms were treated with antacids and then with the proton pump inhibitor pantoprazole intravenously for 2 days and then orally for 5 days. A recent paper in our sister Journal by Zahno et al.

Clearly, further studies are needed to confirm the potential interaction between pantoprazole and erlotinib and to define its dose-dependency. Top of the page – Article Outline.

Most drug—drug interaction studies in humans compare drug substrate D concentrations with and without the interacting drug Ithus intteraction on the pharmacokinetic type of interaction. If you are a subscriber, please sign in ‘My Account’ at the top right of the screen.

Until more data are available, clinicians should remain cognizant of the potential for a drug-drug interaction and should use the lowest effective dose of lorazepam when this drug is administered concomitantly with valproic acid. The owners of this website hereby guarantee to respect the legal confidentiality conditions, applicable in France, and not to disclose this data to third parties.


A literature review revealed three cases of overdoses in which solely dextromethorphan and chlorphenamine including that reported in this paper had been ingested and in which serotonin syndrome developed. Several drug dosing regimen combinations for a drug substrate and interacting drug can be used: The proposed mechanism for this observation is reduced absorption of erlotinib pKa 5.

You can move this window by clicking on the headline. The plasma lipid profile effects were similar for all treatments, except that dalcetripib plus ezetimibe produced a greater reduction in LDL-C.

Melphalan C maxAUC and plasma clearance were the same with aprepitant and placebo. The contribution of clinical cases as a signal for potential drug—drug interactions Monte et al. Please review our privacy policy. The proposed mechanism involves inhibition of lorazepam glucuronidation via direct inhibition of uridine 5′-diphosphate-glucuronosyltransferase enzymes by valproic acid.

Study designs used to determine drug—drug interactions Most drug—drug interaction studies in humans compare drug substrate D concentrations with and without the interacting drug Ithus focusing on the pharmacokinetic type of interaction.

N Engl J Med.

He developed the serotonin syndrome as diagnosed on clinical Hunter criteria [ 6 ] and made a good recovery. Journal page Archives Contents list. The authors also point out that the influenza virus infection can produce cytokines e. Pharmacological profile of antidepressants and related compounds at human monoamine transporters. The pharmacokinetic profiles of each drug were determined on day 7 of each treatment. In vitro studies, particularly for CYPmediated interactions, can be helpful in estimating the likely magnitude of any interaction and understanding its mechanism.

Access to the text HTML. Well documented case reports play a definite role in informing and guiding well-controlled further studies.