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A group of enzymes located in the endoplasmic reticulum, known as cytochrome P-450, is the most important family of metabolizing enzymes in the liver. Cytochrome P-450 is not a single enzyme, but rather consists of a closely related family of 50 isoforms ; six of them metabolize 90% of drugs.
For example, antibiotics that kill gut bacteria often reduce enterohepatic drug circulation and this requires a temporary increase of the drug's dose until the antibiotic use is discontinued and the gut repopulates with bacteria. This effect of antibiotics on enterohepatic circulation of other drugs is one of several types of drug interactions.
A common antibiotic used to treat liver disease could give rise to an “almost untreatable” superbug, scientists warned in a new study.. The antibiotic, rifaximin, has enabled the global ...
Rifampicin is the most powerful known inducer of the hepatic cytochrome P450 enzyme system, including isoenzymes CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP3A4, CYP3A5, and CYP3A7. [42] It increases metabolism of many drugs [43] and as a consequence, can make them less effective, or even ineffective, by decreasing their levels. [44]
Effects on P450 isozyme activity are a major source of adverse drug interactions, since changes in P450 enzyme activity may affect the metabolism and clearance of various drugs. For example, if one drug inhibits the P450-mediated metabolism of another drug, the second drug may accumulate within the body to toxic levels.
Clarithromycin, sold under the brand name Biaxin among others, is an antibiotic used to treat various bacterial infections. [3] This includes strep throat, pneumonia, skin infections, H. pylori infection, and Lyme disease, among others. [3] Clarithromycin can be taken by mouth as a tablet or liquid or can be infused intravenously. [3]
Pharmacogenomics is a study that analyzes how an individual's genetic makeup affects the response to drugs of this individual. There are many common genetic variations that affect the expression of the CYP2C19 gene, which in turn influences the enzyme activity in the metabolic pathways of those drugs in which this enzyme is involved.
CYP3A4 is an enzyme that metabolizes many drugs in the liver. Macrolides inhibit CYP3A4, which means they reduce its activity and increase the blood levels of the drugs that depend on it for elimination. This can lead to adverse effects or drug-drug interactions. [31] Macrolides have cyclic structure with a lactone ring and sugar moieties. They ...