Journal article
Pharmacokinetic and Pharmacodynamic Drug Interactions with Antiarrhythmic Agents
Cardiology in review, Vol.5(6), pp.292-304
11/1997
DOI: 10.1097/00045415-199711000-00007
Abstract
The clinical use of antiarrhythmic agents is often confounded by both pharmacokinetic and pharmacodynamic drug interactions. Pharmacokinetic drug interactions result from alterations in the biologic disposition of one or more of the drugs used in combination. The cytochrome P450 enzyme system plays an important role in the metabolism of many of the antiarrhythmic drugs. Therefore, inhibition of these enzymes can result in enhanced therapeutic effects or even toxicity, whereas enzyme induction can cause increased clearance of the antiarrhythmic agent and subsequent subtherapeutic effects. Furthermore, the pharmacokinetic profiles, plasma concentrations, and therapeutic responses of several of the antiarrhythmic agents can vary markedly between individuals because of genetic differences in their metabolic capabilities. Pharmacodynamic drug interactions between antiarrhythmic agents, on the other hand, result from alterations in pharmacologic activity. By interfering with the transmembrane movement of ions, antiarrhythmic combination therapy can produce additive or antagonistic effects on conduction, thereby serving to enhance effectiveness or reverse toxicity. Additionally, because many antiarrhythmic drugs block the delayed rectifier current responsible for cellular repolarization, concurrent administration with other agents that interfere with potassium conductance should be avoided to prevent the development of QT prolongation and possibly torsades de pointes. Increased knowledge of the basic mechanisms and genetic variations in the metabolism of antiarrhythmics, along with an understanding of the ion channel receptor targets of these agents can allow practitioners to more easily predict and potentially avoid drug interactions.
Details
- Title: Subtitle
- Pharmacokinetic and Pharmacodynamic Drug Interactions with Antiarrhythmic Agents
- Creators
- JERRY Bauman - Dean CollegeCYNTHIA Sanoski - University of Illinois at ChicagoLINGTAK-NEANDER Chan
- Resource Type
- Journal article
- Publication Details
- Cardiology in review, Vol.5(6), pp.292-304
- Publisher
- Williams & Wilkins
- DOI
- 10.1097/00045415-199711000-00007
- ISSN
- 1061-5377
- eISSN
- 1538-4683
- Number of pages
- 13
- Language
- English
- Date published
- 11/1997
- Academic Unit
- Pharmacy; Pharmacy Practice and Science
- Record Identifier
- 9984721230102771
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