tailieunhanh - Essential Cardiac Electrophysiology Self Assessment - Part 9

Omeprazole Ticlopidine Phenytoin Rifampin Ca chẹn kênh diltiazem mibefradil Cimetidin Erythromycin kháng sinh nhóm macrolid và nước ép bưởi Ketoconazole và độc tính thuốc kháng nấm azole với ức chế | Pharmacologic Therapy of Arrhythmias 233 Table Enzymes and Drug interactions Enzyme Substrate Inducer Inhibitor Effect CYP2D6 Codeine Debrisoquine Flecainide Mexiletine Phenformin Propafenone Propranolol Thioridazine Timolol Flecainide Fluoxetine Mibefradil Propafenone Proxetine Quinidine Deficiency results in poor metabolizers CYP2C19 Mephenytoin Omeprazole Omeprazole Ticlopidine CYP3A4 Astemizole Cisapride Cortisol Cyclosporine HMG-CoA reductase inhibitors HN protease inhibitors Lidocaine Nifedipine Quinidine Terfenadine Phenytoin Rifampin Ca channel blockers diltiazem mibefradil Cimetidine Erythromycin and macrolide antibiotics Grapefruit juice Ketoconazole and azole antifungal Drug toxicity with inhibition -acetyltransferase Hydralazine Isoniazid Procainamide Increase drug levels in slow acetylators P-glycoprotein Cortisol Cyclosporine Digoxin HN protease inhibitors Quinidine Verapamil Cyclosporine Quinidine Verapamil Inhibition affects blood brain barrier Thiopurine methyltransferase 6mercaptopurine Azathioprine Sulfasalazine Marrow aplasia paralysis Pseudocholinesterase Succinylcholine P-glycoprotein PG PG acts as a drug efflux pump. Its expression in cancer cells may be responsible for multi-drug resistance MDR . PG is also expressed normally at multiple sites important for drug distribution such as intestinal epithelium hepatocytes renal tubular cells and capillaries of the blood brain barrier. In the intestine PG eliminates the drug by efflux back into the intestinal lumen. In the liver and kidney PG eliminates drugs into bile and urine. In the blood brain barrier it removes the drug from capillary endothelium. PG is an integral 234 Essential Cardiac Electrophysiology part of the blood brain barrier. Inhibition of PG in the brain capillaries results in higher levels of the drugs in cerebral tissues. Cells that express PG also express CYP3A4. Administration of digoxin with quinidine results in doubling of the serum digoxin levels. Digoxin is a .