PSYCHOTROPIC-DRUG METABOLISM IN THE CANCER-PATIENT - CLINICAL ASPECTSOF MANAGEMENT OF POTENTIAL-DRUG INTERACTIONS

An overview of drug metabolism, with particular focus on the cytochrom e p450 system, is provided in this review. To date, there has been a g rowing body of literature concerning the cytochrome p450 enzyme, drug- drug interactions and the role of psychotropic medications when co-adm inistered with medications prescribed in the medically ill population. The article provides an ability to cross-reference commonly prescribe d medications to their known involvement as substrates, inhibitors or inducers of p450 enzymes. This information will permit the clinician w orking in an oncologic setting to better predict potential interaction s based on available in vitro and in vivo data and choose psychotropic s analytically when confronted with a situation of polypharmacy. A kno wledge of drug interactions will decrease the uncertainty in prescript ion of multidrug therapies and minimize the likelihood of diminished d rug efficacy or toxic reactions. (C) 1998 John Wiley & Sons, Ltd.