NEI Podcast E46 - Drug Interactions and Pharmacokinetics with Dr. Patrick Finley
Oct 16, 2019
In this engaging discussion, Dr. Patrick Finley, a Professor of Clinical Pharmacy at UCSF and a board-certified psychiatric pharmacist, dives into the intricate world of drug interactions and pharmacokinetics. He highlights that 20% of hospitalizations are linked to drug interactions, emphasizing their often underestimated risk, particularly for the elderly. Dr. Finley explains key concepts like cytochrome P450 enzymes, discusses the impact of grapefruit juice on drug metabolism, and addresses the importance of pharmacogenetic testing for personalized medicine.
AI Snips
Chapters
Transcript
Episode notes
Prevalence And Risk Of Drug Interactions
- Drug interactions are vastly underappreciated and commonly misunderstood in clinical practice.
- Elderly patients on eight prescriptions face ~25% risk of moderate-to-severe interactions and 1/6 hospital adverse events are interaction-related.
Absorption, Distribution, Elimination Matter
- Pharmacokinetics involves absorption, distribution, and elimination and interactions can occur at any stage.
- Food and blood-brain barrier integrity notably alter absorption and CNS distribution, especially in older adults.
Adjust For Food And Transport Proteins
- Consider food effects when prescribing: some antipsychotics double in plasma concentration with food.
- Account for transport proteins like P-glycoprotein when predicting CNS drug exposure.