METABOLISM – P450 ENZYMES
P450 ENZYME INDUCERS
P450 ENZYME INHIBITORS
Certain drugs that speed up the process of P450 enzyme
metabolism à makes the P450 enzyme show up faster à
increased drug metabolism à sub-therapeutic effect of drug
Carbamazepine
Rifampin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas
Certain drugs that inhibit P450 enzyme metabolism à
eliminating the P450 enzyme metabolism process à decreased
drug metabolism à TOXICITY!
Valproate
Ketoconazole
Isoniazid
Sulfonamides
Chloramphenicol
Amiodarone
Erythromycin
Quinidine
No need for Mnemonic: if it isn’t one of the inducers – you
know it’s an inhibitor
“CRAP GPS induces my rage”
CYP-1A2
CYP-2E1
CYP-2C9
CYP-2D6
CYP-3A4
P450 ENZYME SUBTYPES
Acetaminophen – “1 word with 2 a’s”
Ethanol – “You have to be 21 to drink Ethanol (alcohol)”
Warfarin / Coumadin – “works on Coumadin factors 2, 7, 9, 10, C, S”
Cardiovascular drugs – test for heart is 2D Echo
Most common; if drug is none of the above – choose this subtype