CYP 450 interactions

Question 1

3A4 inhibitors

Answer 1

Nefaozodone
Fluvoxaine
Fluoxetine
grapefruit juice
Antiretrovirals
antibiotics (macrolide like erythromycin)
Antifungals (like ketoconazole)
CCB

Question 2

3A4 inducers

Answer 2

carbamazepine
phenytoin
barbiturates
modafinil
rifampicin
efavirenz
st John's wort

Question 3

3A4 substrates

Answer 3

Benzos
many antipsychotics
Carbamazepine
OCP
statins
antiretrovirals
immunosuppressants
antineoplastic
cortecosteroids
CCB

Question 4

1A2 inhibitors

Answer 4

fluvoxamine
caffiene
ciprofloxacin
estrogen
cimetidine Atazanavir

Question 5

1A2 inducers

Answer 5

carbamazepine
?phenytoin
barbiturates
rifampicin
primidone
smoking
(not St.John's wort which induces 3A4, 2C9, 2C19)

Question 6

1A2 substrates

Answer 6

Clozapine
Olanzapine
Mirtazapine
Ropinirole
Warfarin
Theophyline
caffiene

Question 7

2D6 inhibitors

Answer 7

Paroxetine
Fluoxetine
Sertraline
Duloxetine
Buproprion

Terbenafine (antifungal)
Imatinib (anti-leukemia)
Quinidine (antiarrythmic)
Amiodarone (antiarrythmic)

there are poor metabolizers

Question 8

2D6 inducers

Answer 8

none!

but there are ultra-rapid metabolizers

Question 9

2 D6 Substrates

Answer 9

antidepressants:
TCA
SSRI
SNRI
Trazodone

AA:
Risperidone
Abilify

FGA: 
Haldol
chlorpromazoine
perphenazine
zuclopenthixole

betablockers
propranolol
metoprolol

anti-arrythmic:
flecainide
mexiletine

Question 10

activation by 2D6

inhibitors of 2 D6 prevent drug from working

Answer 10

codeine
tramadolhydrocodone
tamoxifen

Question 11

2C9 inhibitors

Answer 11

Valproate
Disulfiram
Fluoxetine

Clopidogrel (also 2C19-)
Amiodarone (also 2d6-)
Fluconazole (also 2C19-)
metronidazole

Question 12

2C9 inducers

Answer 12

carbamazepine
phenytoin
barbiturates
rifampicin
Efavirenz (also 3A4 +)
St.John's wort (also  3A4+)

all of these are 3A4 inducers

Question 13

2C9 substrates

Answer 13

phenytoin
barbiturates
Warfarin**
Glyburide (DM)
Glipizide (DM)
NSAIDs
ARB

Question 14

2C19 inhibitors

Answer 14

Fluoxetine
Fluvoxaine
Moclobemide
Modafinil (also a 3A4 inducer)
Oxcarbazepine

Clopidogrel (2C9-)
Efavirenz (+ of 2C9 and 3A4)
Omeprazole
Fluconazole (2C9 -)

Question 15

2C19 inducers

Answer 15

carbamazepine
phenytoin
barbiturates
rifampicin
st Johns wort

same as 3A4 and 2C9 inducer list (minus modafinil and efavirenz)

Question 16

2C19 substrates

Answer 16

sertraline
escitalopram
citalopram
moclobemide
diazepam
pantoprazole
omeprazle

Question 17

St.John’s wort?

Answer 17

inducer of:
3A4
2C9
2C19

Question 18

Efavirenz?

Answer 18

inducer of
3A4
2C9

inhibitor of 2C19

no effect on 1A2

Question 19

inducers of 1A2, 3A4, 2C9, 2C19

Answer 19

carbamazepie
barbiturates
rifampicin
phenytoin (?1A2)

Question 20

polymorphism

Answer 20

2D6: 10% of caucasians, 1% of asians are poor
2C19: 20% of asians and blacks, 2% of caucasians are poor

Question 21

Paxil and phenytoin?

Answer 21

phenytoin goes up

2012

Question 22

least protein binding SSRIS?

most?

Answer 22

celexa and luvox

sertraline

Question 23

luvox plus celexa?

Answer 23

celexa goes up. 2C19

Question 24

Efavirenz and St.John’s wort have:
an effect on which enzymes (3)
no effect on which enzymes? (2)

Answer 24

effect on3A4, 2c9, 2c19

no effect on 2D6, 1A2

Question 25

what 2 enzymes do both fluoxetine and fluvoxamine strongly inhibit?

Answer 25

2C19

3A4

Question 26

which 2 enzymes are not affected by fluvoxamine?

Answer 26

2D6, 2C9

Question 27

which enzyme is not affected by fluoxetine?

Answer 27

1A2

Question 28

Enzymes inhibited by Fluoxetine from most to negligible?

Answer 28

2D6, 2C9
2C19
3A4
1A2

Question 29

Enzymes inhibited by Fluvoxamine from most to negligible?

Answer 29

1A2, 2C19
3A4
2D6
2C9