World Journal of Pharmacology and Toxicology
Open Access

Drug-drug interactions are one of the foremost frequent causes of adverse events throughout polypharmacy, outlined because the chronic co-prescription of many medicines. Indeed, it’s calculable that 6–30% of all side effects are caused by a pharmacological interaction. This may vary from 3-5% in subjects taking solely few medicines, increasing to 20% in subjects treated with over 10 medicines. A drug–drug interaction may be a amendment during a drug’s impact, occurring once two or a more of medicine are administered throughout a similar period. This impact is synergistic (when the drug’s impact is increased), antagonistic (when the drug’s impact is decreased) or a brand-new impact could seem, that doesn’t rely on individual drug outcomes. Various mechanisms are involved in a drug–drug interaction, and these are sometimes classified as “pharmacokinetic” or “pharmacodynamic” [1].

Pharmacokinetic interactions are the foremost frequent and have interaction all the stages of drug pharmacokinetics (absorption, distribution through the tissues, metabolism and elimination). The interactions that involve the metabolism stage are the foremost relevant; they’re extraordinarily various and sometimes cause a decrease or a rise within the blood concentrations of the medicine. The system of hepatic cytochromes is mostly concerned, however alternative enzymes, like those catalysing glucuronidation reactions, is concerned. Pharmacodynamic interactions, on the other hand, concern the effect of the medicine and their mechanism of action. Due to these reasons, the therapeutic impact of a drug could also be reduced, or the drug’s influence could be stronger. However, not all interactions are clinically relevant. Some are simply interesting facts and have no influence on the pharmacological treatment, while, in alternative cases, they’ll even be used for therapeutic functions [2]. Drug-drug interactions are usually predictably supported previous reports and clinical studies, likewise because the data of medicine principles, however clinicians don’t usually understand the result.

In this study, we have focused our attention on alcohol use disorder (AUD), one in all the foremost common and undertreated mental disorders and within the most severe forms, less than 15% of patients receive appropriate treatment. Every year, 3.3 million deaths and 5.1% of the world burden of disease are due to alcohol consumption. The quality treatment for AUD includes psychological and sociorehabilitation therapies, related to many several pharmacological therapies. The latter are headed to manage alcohol withdrawal, the relapse prevention and therefore the reduction of alcohol consumption. Despite the considerable progress regarding neurotransmission mechanisms, there’s still no definitive medical care that satisfies the various and heterogeneous phenotypes concerned in alcoholism. Many medicines are tested in pre-clinical and clinical studies, the U.S.

Food and Drug Administration (FDA) has approved narcotic antagonist (oral and long injectable), acamprosate and disulfiram. In the European Union, nalmefene has conjointly been approved for the reduction of alcohol consumption in alcoholic patients with a high drinking risk level, outlined as > 60 g/day for men and > 40 g/day for ladies of alcohol intake [3]. Additionally, sodium oxybate is approved in European nation and Italia, while in France baclofen is allowed as “temporary recommendation for use”. Unfortunately, the prescription of those medications is tough, due to the lack of knowledge of their availability, prescription guidelines and dosage. The clinical attitude towards the medications conjointly affects prescription, and therefore the off-label use is high (topiramate, gabapentin, antidepressant drug and ondansetron). The presence of comorbid conditions and associated polypharmacy additional complicate the framework: most patients with AUD have tried are actively mistreatment alternative medicine and over 33% of them present a drug use disorder. Thus, the drug– drug interaction is a vital and underestimated concern in patients with AUD, applying for pharmacological treatment. So far, the aim of this review is to recapitulate the pharmacological interactions reported in literature of the medications approved for the treatment of AUD in U.S. and in some European states (benzodiazepines, acamprosate, baclofen, disulfiram, naltrexone, nalmefene and metal oxybate) [4].

Disulfiram is one in all the foremost normally used medicine in alcohol dependence and, during this category of drugs; it’s the best risk of medical specialty interactions. It’s characterized by serious pharmacodynamic interactions that concern each medication containing alcohol and specific medicines related to the onset of psychiatrical events. Even so, it’s going to move with numerous liver enzymes, together with CYP2E1, CYP2C9 and CYP3A4. Baclofen and metal oxybate area unit comparatively safer medicine for coadministration, likewise as nalmefene and narcotic antagonist, while not forgetting that the opioid withdrawal syndrome thanks to their association with AN opioid could also be fatal. On the opposite hand, [5] acamprosate is empty medical specialty interactions, being with success prescribed in association with antidepressants, BDZ, nonopiate analgesics, narcotic antagonist and Disulfiram.

Acknowledgement

I would like to thank Macquarie Medicine School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia for giving me an opportunity to do research.

Conflict of Interest

No potential conflicts of interest relevant to this article were reported.

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