Pediatrics in Review
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(Pediatrics in Review. 2006;27:315-317.)
© 2006 American Academy of Pediatrics

In Brief

Drug Interactions

The first 300 words of the full text of this article appear below.

Cytochrome P450: New Nomenclature and Clinical Implications. Cupp MJ, Tracy TS. Am Fam Physician. 1998;57 :107 –116[Medline]

Drug-Drug Interactions. Reed MD, Blumer JL. In: Haddad LM, Shannon MW, Winchester JF, eds. Clinical Management of Poisoning and Drug Overdose. 3rd ed. Philadelphia, Pa: WB Saunders Company; 1998

Drug Interactions–A Review. Manzi SF, Shannon M. Clin Ped Emerg Med. 2005;6 :93 –102

Cytochrome P450 Enzymes: Substrates, Inhibitors, and Inducers. In: Taketomo CK, Hodding JH, Kraus DM. Pediatric Dosage Handbook. 12th ed. Hudson, Ohio: Lexi-Comp; 2005

Important Drug Interactions and Reactions in Dermatology. Aria N, Kauffman CL. Dermatol Clin. 2003;21 :207 –215[CrossRef][Medline]

Pediatric Dietary Supplement Use–An Update. Babu KM, McCormick MA, Bird SB. Clin Pediatr Emerg Med. 2005;6 :85 –92[CrossRef]

A drug interaction occurs when one drug alters the effectiveness or toxicity of another. Clinically significant drug interactions, which pose potential harm to the patient, may result from changes in pharmaceutical, pharmacokinetic, or pharmacodynamic properties. Required in vitro studies conducted by drug manufacturers help predict the potential occurrence of a drug interaction, but they do not confirm the clinical relevance for patients, and they are not sufficiently sensitive to identify all potentially serious interactions, especially in the pediatric population.

Patient factors that increase the risk for drug interactions include being critically ill; receiving polypharmacy; having impaired hepatic or renal function, hypoxemia, or metabolic disturbances; and being elderly. Given the paucity of data on drug interactions in pediatric patients, children also should be considered at special risk. Drug characteristics that contribute to interactions include high potency, wide usage, action on vital organ functions, narrow therapeutic index, saturable hepatic metabolism, and extensive protein binding (>90%).

Drug interactions can be used strategically to benefit patients. . . . [Full Text of this Article]


Catherine Tom-Revzon, PharmD
 Arnold & Marie Schwartz College of Pharmacy and Health Sciences
Long Island University
Brooklyn, NY
Children’s Hospital at Montefiore
Bronx, NY

Henry M. Adam, MD
 Editor, In Brief





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