Enzymes Targeted As Key To Understanding Drug Interactions

You go to one doctor for your back problem. You see another for high blood pressure. Perhaps you consult a third for a nagging sinus infection. As part of your treatment, each writes a prescription or two. The result can be an array of pill bottles on your bathroom counter or breakfast table, perhaps augmenting your usual arsenal of over-the-counter supplements and pain and cold remedies.

How is the patient -- or the health care professional -- to know when the potential exists for a serious, even life-threatening, interaction between medications? Or when one drug may render another ineffective? News stories have highlighted the problem of pharmacists who failed to question prescriptions for dangerous drug combinations, and pharmacists complain of computer programs that fail to give them adequate warning of possible interactions.

A notorious example of a potentially deadly drug duo was Seldane, a popular antihistamine, and erithromycin, a common antibiotic, which when taken together could produce sometimes fatal heart problems. The U.S. Food and Drug Administration (FDA) has recommended that Seldane be withdrawn from the market.

Prevention of drug interactions, say researchers at the University of Washington School of Pharmacy, lies in learning how the human body processes each drug.

The school has recently established a formal Program in Drug Interactions, tapping the expertise of 22 faculty members believed to be the largest group of experts in the world on drug interactions.

The UW investigators are seeking systematic knowledge of how various enzymes -- biochemical catalysts produced by the body -- metabolize drugs. Their research is producing an understanding of the potential for adverse effects among thousands of drug combinations.

"Pharmacists have had to remember hundreds of pairs of drugs that interact," said the program's director, Dr. Rene Levy, professor and chair of pharmaceutics. "But there was a shift in our knowedge

Contact: Laurie McHale
University of Washington

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