๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
CONCLUSION
Dealing with drug interactions is a challenge in clinical practice. Although no one can be expected to know all drug interactions, useful resources are available. One of the best pocket reference guides is The Top 100 Drug Interactions by Hansten and Horn (www.hanstenยญ andhorn.com). This handbook is concise, up-to-date and, unlike most desk references, it is not limited by class-related statements that may falsely and unnecessarily restrict therapeutic options. A helpful website that contains comprehensive information regarding drug interactions related to CYP isoenzymes is The Flockhart Tableโข (drug-interactions. medicine.iu.edu).
More research during the early stages of drug development is required to identify new interactions, define mechanisms of older interactions,
and examine the safety of new drugs from classes that are known to cause interactions. We also need more sensitive post-marketing surveillance tools to identify important drug interactions that become evident over time in diseased hosts and that were not seen in pre-marketing studies of healthy volunteers. Physicians need better tools, but, in the meantime, understanding the nuances of the cytochrome P450s will help take the fear out of prescribing.
Because the best evidence for clinically relevant drug interactions comes from case reports, prescribing physicians can have a major impact. Observations of drug interactions should be confirmed, if possible, by serum drug concentrations. Then they should be reported to regulatory bodies and submitted to journals. By understanding the mechanisms behind drug interactions and staying alert for toxicities, we can help make drug therapy safer and reduce the fear of drug interactions.
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