A Case Approach to Perioperative Drug-Drug Interactions

ABOUT THIS BOOK

· Fills a great void in the clinical literature
· Synoptic, readable presentations of pharmacokinetic drug interactions most relevant to the perioperative clinician
· Edited and written by leading experts in anesthesiology, surgery, intensive care, nursing, patient safety, and pharmacy
· Extensive case scenarios memorably highlight specific drug-drug interactions

The occurrence of deleterious or even fatal drug-drug interactions (DDIs) in the perioperative period is no longer a theoretical concern but a harrowing reality. A Case Approach to Perioperative Drug-Drug Interactions addresses the complex realm of pharmacokinetic drug interactions in an easy-to-read volume that functions as both a comprehensive clinical reference and a casebook. The book presents a summary of the core concepts of drug interactions; an organized, annotated presentation of the drug interactions most relevant to the perioperative clinician; and approximately 200 case scenarios that highlight specific drug interactions. This book fills a real void in the clinical literature and is invaluable to anesthesiologists and surgeons, and PharmDs, as well as trainees in those specialties; intensive care staff, including physicians, physician assistants, and nurses; and nurse practitioners who staff preoperative evaluation clinics.

Content Level » Professional/practitioner
Keywords » DDIs - P450 system - anesthesia - intensive care - pain medicine - perioperative medicine
Related subjects » Anesthesiology - Critical Care & Emergency Medicine - Pharmacology & Toxicology - Surgery

TABLE OF CONTENTS

Part I. Introduction to Drug-Drug Interactions

1. Let’s Start at the Very Beginning: Overcoming Fear and Gaining Mastery of Drug-Drug Interactions

F. Jacob Seagull, PhD, Catherine Marcucci, MD

2. Pharmacodynamic Interactions: Core Concepts

Erica D. Wittwer, MD, PhD, Wayne T. Nicholson, MD, PharmD, MSc

3. Pharmacokinetic Interactions: Core Concepts

Erica D. Wittwer, MD, PhD, Wayne T. Nicholson, MD, PharmD, MSc

4. A Brief Treatise On The Area Under The Curve

Michael J. Sikora, MD, Barbara Jericho, MD

Part II. Introduction to Drug-Drug Interactions: Brief Review of CYP450 Enzymes, UGTs, and Transporters

5. CYP2D6: Where It All Began

John C. Sanders, MBBS, FRCA, Rachel Koll, MD, Randal O. Dull, MD, PhD

6. CYP2E1: The Anesthesia Enzyme

Benjamin S. Gmelch, MD, Randal O. Dull, MD, PhD

7. CYP3A4: The Workhorse

Jennifer DeCou, MD, Nathaniel Birgenheier, MD, Randal O. Dull, MD, PhD

8. CYP1A2: The Switch-hitter

Danielle Roussel, MD, Emily Hagn, MD, Randal O. Dull, MD, PhD

9. CYP2B: 2B or Not 2B?

Dustin Coyle, MD, Randal O. Dull, MD, PhD

10. CYP2C9: The Support Crew I

Byron Douglas Fergerson, MD, Crystal B. Wallentine, MD, Randal O. Dull, MD, PhD

11. CYP2C19: The Support Crew II

Barbara Jericho, MD, Alfredo Aguiar, MD, Randal O. Dull, MD, PhD

12. UGTs: Conjugating Cousins

Neil B. Sandson, MD

13. The Cytochrome P450 System In Disease States—A Brief Review

Catherine Marcucci, MD

PART III. Drug-Drug Interactions: Paradigms and Core Concepts

14. P-glycoprotein and OATP Transporters

Dustin Coyle MD, Erica D. Wittwer, MD, PhD, Juraj Sprung, MD, PhD

15. The “Fatal” Forty

Neil B. Sandson MD, Michael Hutchens MD, F. Jacob Seagull, PhD, Catherine Marcucci, MD

16. The Six Patterns of Pharmacokinetic Drug-Drug Interactions

Neil B. Sandson, MD, Catherine Marcucci, MD

17. The Problem with the Drug-Drug Interaction Software: A Procrustean Dilemma

Neil B. Sandson, MD, F. Jacob Seagull, PhD, Wayne T. Nicholson, MD, PharmD, MSc, Catherine Marcucci, MD

18. Pharmacogenomics

Chad D. Moore, PhD, William Hartman, MD, PhD, Michael Hutchens, MD, Randal O. Dull, MD, PhD

19. The Pharmacoepidemiology of Drug Interactions: Why and How They Are Important

Joseph A. Lovely, PharmD, BCPS, Stephen Esper, MD, MBA, Michael Hutchens, MD, Wayne T. Nicholson, MD, PharmD, MSc, Catherine Marcucci, MD

20. The Lawyers Can Read, Too: Case Presentations from the Courtroom

Jessica Voge, MD, David K. Miller, JD

Part IV. Drug-Drug Interactions Involving Inhalational Anesthetic Agents

21. Introduction

Catherine Marcucci, MD

22. That Sums It Up

Volatile anesthetics, additive MACs

James A. Jernigan, MD, James W. Ibinson, MD, PhD

23. 1+1+1+1=?

Variable effects of combined substances

Anthony T. Silipo, DO, Raymond M. Planinsic, MD, Erica D. Wittwer, MD, PhD, Juraj Sprung MD,PhD, Wayne T. Nicholson, MD, PharmD, MSc

24. A Delayed Surgeon Is A “Dismayed” Surgeon?

Nitrous oxide, dexmedetomidine, somatosensory evoked potentials

Jonathan Anson, MD

25. Relax, It’s Only Gentamicin

Volatile anesthetics, aminoglycoside antibiotics, neuromuscular junction

Brian Gierl, MD, Ferenc E. Gyulai, MD

26. Jaundice After Surgery

Halothane hepatitis, CYP2E1

Jonathon E. Kivela, MD, Toby N. Weingarten, MD, Juraj Sprung, MD, PhD

27. Everybody Clear?

Halothane, epinephrine arrhythmia

Nikhli Patel, MD, Barbara Jericho MD, Randal O. Dull, MD, PhD

28. The Hemodynamic Hole

general anesthetics, ACE-I, ARBs

Arun L. Jayaraman, MD, PhD, Theresa A. Gelzinis, MD

29. Alpha-2 To The Rescue But Beware Bradycardia

volatile anesthetics, alpha-2 agents

Phillip Adams, DO, Nashaant N. Rizk, MD

30. Hot Stuff!

triggering drugs, ryanodine receptor, malignant hyperthermia

Cornelius B. Groenewald, MD, ChB, Juraj Sprung, MD, PhD

Part V. Drug-Drug Interactions Involving Intravenous Anesthetic Agents

31. Introduction

Catherine Marcucci, MD

32. How to Successfully Occlude an Intravenous Line

thiopental, succinylcholine, line precipitation

Helga Komen, MD, Juraj Sprung, MD, PhD, Toby N. Weingarten, MD

33. A Curious Cause of Seizures

ketamine, theophylline

Charles Galaviz, MD, Randal O. Dull, MD, PhD

34. Magnesium Mama And The Mad Dad

magnesium sulfate, propofol, remifentanil, vecuronium

Ana Maria Manrique MD, Catherine Marcucci, MD, Kathirvel Subramaniam, MD

35. Dexy’s Midnight Spinal

dexmedetomidine, bupivaine spinal, multiple mechanisms, CYP3A4, CYP2D6

Michael Hutchens, MD, Edward A. Kahl, MD, Matthias J. Merkel, MD, PhD

Part VI. Drug-Drug Interactions Involving Local Anesthetics

36. Introduction

Catherine Marcucci, MD

37. Comfortably Numb

local anesthetics

Joseph J. Yurigan, DO, Todd M. Oravitz, MD

38. Naturally Occurring And Nasty

cocaine, propranolol

Lauren Partyka, MD, Li Meng, MD, MPH

39. LOL-LOL: Little Old Lady—Lots of Lido

lidocaine, bupivacaine

Kitling M. Lum, RN, BSN, CCRN-CSC, Kelly N. Stafford, BSN, CCRN, CSC

40. The Spinal Countdown

general anesthesia after spinal anesthesia

Audra M. Webber, MD, Franklyn P. Cladis, MD, FAAP

41. Are Drug-Drug Interactions The Smoking Guns of Local Anesthetic Toxicity? Smoking Gun I

Fatal Forty DDI: ropivacaine, fluoxetine, CYP1A2, CYP3A4

L. Michele Noles, MD

42. Are Drug-Drug Interactions The Smoking Guns of Local Anesthetic Toxicity? Smoking Gun II

Fatal Forty DDI: bupivacaine, methocarbamol

L. Michele Noles, MD

43. A Perfect Storm?

Fatal Forty DDI: omeprazole, nicardipine, diltiazem, bupivacaine, CYP3A4, CYP2C19, CYP2D6

J. Andrew Dziewit, MD, Nabil M. Elkassabany, MD

44. Shake Rattle and Roll

Fatal Forty DDI: lidocaine, cimetidine, CYP3A4

Hans P. Sviggum, MD, Juraj Sprung, MD, PhD

45. Hello, We Have A Patient With Acute Delirium and We Need An Urgent Psych Consult

lidocaine, metoprolol

Katarina Bojanic, MD, Juraj Sprung, MD, PhD, Toby N. Weingarten, MD

46. Fatal Pain Relief

local anesthetics, intrathecal morphine

Matthew M. Kumar, MD, Richard Levi Boortz-Marx, MD, MS

47. Lipid Lifesaver

local anesthetic, lipid emulsion

Adrian Pichurko, MD, Guy Weinberg, MD

Part VII. Drug-Drug Interactions Involving Opioids

48. Introduction

Toby N. Weingarten, MD

49. No ‘Subs’titute for Sobriety

buprenorphine, mu agonist opioids

James Hilliard, MSN, CRNA, Kirk Lalwani, MD, FRCA, MCR

50. A Needle And The Damage Done

Fatal Forty DDI: buprenorphine, ritonavir, CYP3A4

James Hilliard, MSN, CRNA, Kirk Lalwani, MD, FRCA, MCR

51. Dad’s Not Having Much Pain

Fatal Forty DDI: methadone, ciprofloxacin, CYP3A4

Rani Chovatiya, MD, Mehmet S. Ozcan, MD, FCCP, Randal O. Dull, MD, PhD

52. Royal Flush

Fatal Forty DDI: methadone, nortriptyline, CYP2D6, CYP3A4

Kimberly Mauer, MD, Catherine Marcucci, MD, Neil B. Sandson, MD

53. The Worry That’s Always With Us: Afternoon Nap

oxycodone, diazepam

Syed M. Quadri, DO, Randal O. Dull, MD, PhD

54. The Bawling Baby

Fatal Forty DDI: rifampin, methadone , CYP3A4, CYP2B6

Angela Kendrick, MD

55. Sleeping Beauty

Fatal Forty DDI: fentanyl, ritonavir, CYP3A4

Hans P. Sviggum, MD, Juraj Sprung, MD, PhD

56. Codeine Can’t Do It

Fatal Forty DDI: codeine, fluoxetine, CYP2D6

Katarina Bojanic, MD, Wayne T. Nicholson MD PharmD, MSc, Erica D. Wittwer MD, PhD, Toby N. Weingarten MD, Juraj Sprung, MD, PhD

57. A Shuddering Interaction

meperidine, phenelzine, serotonin toxicity

Christine A. Kenyon Laundre, MD, Randall Flick, MD, Juraj Sprung, MD, PhD

58. Double Indemnity

Fatal Forty DDI: morphine, rifampin, P-glycoprotein

Lisa Chan, MD, Catherine Marcucci, MD, Neil B. Sandson, MD, Kirk Lalwani, MD, FRCA, MCR

59. Breaking the Codeine

Fatal Forty DDI: codeine, quinidine CYP2D6

Clint Christensen, MD, Nathan G. Orgain, MD, Randal O. Dull, MD, PhD

60. The Ultimate Ultram Primer I: My Mood Is Better, But Boy Do I Hurt!

Fatal Forty DDI: tramadol, paroxetine, CYP2D6

Toby N. Weingarten MD, Juraj Sprung, MD, PhD

61. The Ultimate Ultram Primer II: I “Haight” Narcotics But I Hate Seizures Worse

Fatal Forty DDI: tramadol, buproprion, seizures, CYP2D6

Bruce T. Dumser, MD, Neil B. Sandson, MD

62. The Ultimate Ultram Primer III: Tremor-dol Trigger in Serotonin Syndrome

Fatal Forty DDI: tramadol, paroxetine, 2D6 inhibition, serotonin syndrome

Bryan C. Hoelzer, MD, Stephanie Neuman, MD

63. Too Much of A Good Thing

Fatal Forty DDI: codeine, drug-gene interaction, CYP2D6

Erica D. Wittwer, MD, PhD, Juraj Sprung, MD, PhD, Wayne T. Nicholson MD, PharmD, MSc

Part VIII. Drug-Drug Interactions Involving Non-opioid Pain Medications

64. Introduction

Toby N. Weingarten, MD

65. Pining For Pete In The Pain Clinic

Fatal Forty DDI: nortriptyline, paroxetine, CYP2D6

Steven S. Liu, MD, Toby N. Weingarten MD, Catherine Marcucci, MD

66. You Do Not Look Well Today, Mon Ami

Fatal Forty DDI: amitriptyline, amiodarone, QRS widening

Kimberly Mauer, MD, Catherine Marcucci, MD, Neil B. Sandson, MD

67. My Headache is Gone, But My Leg Now Hurts

Fatal Forty DDI: methysergide, erythromycin, CYP3A4

Jessica D. Lorenz, MD, Juraj Sprung, MD, PhD, Wayne T. Nicholson, MD, PharmD, MSc

68. Special ‘K’ase

Oral S-ketamine, ticlopidine

Lisa Chan, MD, Kirk Lalwani, MD, FRCA, MCR

69. Not Manic About NSAIDs

Fatal Forty DDI: ketorolac, lithium, toxicity

Allen N. Gustin, MD, FCCP, Michael J. Bishop, MD

70. Keep It Capped!

acetominophen, ethanol

Christine M. Formea, PharmD, BCPS, Wayne T. Nicholson MD, PharmD, MSc

71. The ACE Is Not Always High

Fatal Forty DDI: ketorolac, lisinopril

Wayne T. Nicholson, MD, PharmD, MSc

72. When The Smoke Clears, Relaxation Disappears

Fatal Forty DDI: cyclobenzaprine, smoked tobacco, CYP1A2

Avinash Ramchandani, MD, Julio A. Gonzalez-Sotomayor, MD

73. Befuddled by Aspirin

Fatal Forty DDI: aspirin, valproic acid, protein binding

Melisa N. Weingarten, RN, MS, Juraj Sprung, MD, PhD, Toby N. Weingarten, MD

74. You Can’t Trick Us!

Fatal Forty DDI: ibuprofen, phenytoin, CYP2C9, protein binding

Catherine Marcucci, MD, Neil B. Sandson, MD

Part IX. Drug-Drug Interactions Involving Benzodiazepines and Other Sedatives

75. Introduction

Catherine Marcucci, MD

76. The Worry That’s Always With Us: Now I’m Depressed

benzodiazepines, opioids, propofol

Kelly T. Peretich, MD, Raymond M. Planinsic, MD

77. The Worry That’s Always With Us: Tragic But Not Rare alprazolam, clonazepam, and buprenorphine

Phillip Adams, DO, Ibtesam A. Hilmi, MB, CHB, FRCA

78. Lack of Sedation

Fatal Forty DDI: midazolam, carbamazepine interaction, CYP3A4

Erica D. Wittwer, MD, PhD, Juraj Sprung, MD, PhD, Wayne T. Nicholson, MD, PharmD, MSc

79. A Cold Isn’t Going to Slow Me Down

midazolam, goldenseal, CYP3A4, CYP3A5, CYP2D6

Leelee Thames, MD, Jessica Miller, MD, BM

80. Her Patients Never Wake Up On Time

Fatal Forty DDI: midazolam, diltiazem, alfentanil, CYP3A4, CYP3A5, CYP3A7

Toby N. Weingarten, MD, Erica D. Wittwer, MD, PhD, Wayne T. Nicholson, MD, PharmD, MSc

81. When Enough Is Now Too Much

Fatal Forty DDI: midazolam, itraconazole, CYP3A4

Erica D. Wittwer, MD, PhD, Juraj Sprung, MD, PhD, Wayne T. Nicholson, MD, PharmD, MSc

82. The Distressed Daughter

Fatal Forty DDI: alprazolam, carbamazepine, CYP3A4

Jennifer Egan, MD, Kirk Lalwani, MD, FRCA, MCR, Catherine Marcucci, MD

83. Check Check and Double Check

Fatal Forty DDI: diazepam, fluvoxamine, CYP3A4, CYP2C19

Catherine Marcucci, MD, Neil B. Sandson, MD

84. Doggone It—The Case is Cancelled

Fatal Forty DDI: midazolam, lopinavir/ritonavir, CYP3A4

Erica D. Wittwer, MD, PhD, Wayne T. Nicholson, MD, PharmD, MSc, Corinne Wisdo, DPM, Catherine Marcucci, MD

85. Noct’ Out

Fatal Forty DDI: chloral hydrate, phenobarbital, furosemide

Michael Wollenberg, MD, Kirk Lalwani, MD, FRCA, MCR

86. Predisposed to Doze

promethazine, CYP2D6 poor metabolizer

Erica D. Wittwer, MD, PhD, Juraj Sprung, MD, PhD, Wayne T. Nicholson MD PharmD, MSc

87. Synergistic Sedation

Fatal Forty DDI: midazolam, clozapine, synergism and clozapine, sertraline, CYP2D6

Michael Hutchens, MD, Paul Schipper, MD, FACS, FACCP, Catherine Marcucci, MD

Part X. Drug-Drug Interactions Involving Neuromuscular Blockade Agents

88. Introduction

David G. Metro, MD

89. Blocked Again

succinylcholine, repeated doses

Matthew Patrick Feuer, MD, Thomas M. Chalifoux, MD

90. Irreversibility Sux

succinylcholine, neostigmine

Joseph C. Shy, MD, David G. Metro, MD

91. Keep An “Ion” The Twitches

magnesium, neuromuscular blockade

Brian Gierl, MD, Ferenc E. Gyulai, MD

92. A Reversal of Misfortune

neostigmine, glycopryrolate,

Thomas N. Talamo, MD, Richard J. Kuwik, MD

93. Stop Moving

Fatal Forty DDI: vecuronium, phenytoin

Michael D. Olson, PA-C, Randall Flick, MD

94. There’s Just Not Enough Roc In The World

Fatal Forty DDI: rocuronium, carbamazepine

Tammara S. Goldschmidt, MD, Randal O. Dull, MD, PhD

95. Slow Sux I: A Lengthy Wake-Up Period After Electroconvulsive Therapy

succinylcholine, atypical plasma cholinesterase

Jennifer A. Rabbitts, MB, ChB, Juraj Sprung, MD, PhD

96. Slow Sux II: I Remember Reviewing This For The Boards

succinylcholine, atypical plasma cholinesterase

Andrew Oken, MD, Scott Richins, MD

97. Slow Sux III: Where Did the Twitches Go?

succinylcholine, donepizil, atypical pseudocholinesterase

Katarina Bojanic, MD, Juraj Sprung, MD, PhD, Toby N. Weingarten, MD

98. Weakened All Weekend

vecuronium, amakacin

Daniel W. Johnson, MD

99. The Patient Who Could Not Raise Her Head

vecuronium, gentamicin

Nicole L. Varela, MD, Toby N. Weingarten, MD, Juraj Sprung, MD, PhD

100. An Unexpected Wait

pancuronium,mivacurium

Michael W. Best, MD, Shawn T. Beaman, MD

101. Diabolical Cough Syrup

rocuronium, pholcodine

Melisa N. Weingarten, RN, MS, Juraj Sprung, MD, PhD, Toby N. Weingarten, MD

Part XI. Drug-Drug Interactions Involving Antibiotics and Antifungals

102. Introduction

Catherine Marcucci, MD

103. Full Stop

ceftriaxone, calcium

Norah Janosy, MD

104. Flummoxed by the FLOX

Fatal Forty DDI: ciprofloxacin, tizanidine, CYP1A2

Janice Kim, MD

105. Tales of Terror

Fatal Forty DDI: ciprofloxacin, simvastatin, CYP3A4

Arun Subramanian, MBBS, Juraj Sprung, MD, PhD

106. Too Low To Go

Fatal Forty DDI: erythromycin, nifedipine, CYP3A4

Catherine Marcucci, MD, Neil B. Sandson, MD

107. A Fungal Story

Fatal Forty DDI: fluconazole, phenytoin, CYP2C9, CYP2C19

Jerusha Taylor, PharmD, BCPS, Ansgar M. Brambrink, MD, PhD

108. Rejection Protection Turned Kidney Killer

Fatal Forty DDI: voriconazole, tacrolimus, CYP3A4, P-glycoprotein

Erica D. Wittwer, MD, PhD, Juraj Sprung, MD, PhD, Christine M. Formea, PharmD, BCPS

109. Can’t Get Well

Fatal Forty DDI: itraconazole, budesonide, CYP3A4

Michael J. Sikora, MD, Barbara Jericho, MD, Randal O. Dull, MD, PhD

110. Linezolid (I): Be VREy Careful

Fatal Forty DDI: linezolid, buproprion

Bruce T. Dumser, MD

111. Linezolid (II): Hyper and Hot

linezolid, meperidine, serotonin syndrome

Erica D. Wittwer, MD, PhD, Toby N. Weingarten, MD, Juraj Sprung, MD, PhD

112. Not Sweet At All

Fatal Forty DDI: trimethoprim/sulfamethoxazole, glipizide, CYP2C9

Mayumi Horibe, MD, Michael J. Bishop, MD

113. Where Did All The Sugar Go?

Fatal Forty DDI: levofloxacine, glyburide, complex interaction

Nicole L. Varela, MD, Federica Scavonetto, MD, Toby N. Weingarten, MD, Juraj Sprung, MD, PhD

114. Exposed! (Part 1)

Fatal Forty DDI: rifampin, buspirone, CYP3A4

L. Michele Noles, MD, Catherine Marcucci, MD

115. Exposed! (Part 2)

Fatal Forty DDI: rifampin, ondansetron, CYP3A4

L. Michele Noles, MD, Catherine Marcucci, MD

116. Seizures on 5 West

carbapenem, valproic acid, P-glycoprotein, UGT

Elizabeth Duggan, MD, Nabil M. Elkassabany, MD

Part XII. Drug-Drug Interactions Involving Cardiovascular Medications

117. Introduction

Michael Hutchens, MD

118. Riding The Rollercoaster

nitroglycerine, sodium nitroprusside, propofol,

Catherine Marcucci, MD, Erica D. Wittwer, MD, PhD, Juraj Sprung, MD, PhD

119. A Pressing Need For Vasopressin!

ACE-Is, general anesthesia

Erin B. Payne, MD, Anna Dubovoy, MD

120. Too Young To Die

Fatal Forty DDI: bupropion, pseudoephedrine, pharmacodynamic interaction

Catherine Marcucci, MD

121. A Widening Gyre

epinephrine, phosphorus, insulin

Edward A. Kahl, MD, Michael Hutchens, MD

122. Misusing Mom’s Meds

chronic amphetamine, indirect acting sympathomimetics

Pulsar Li, DO, Steven L. Orebaugh, MD

123. If the Patient Has No Renal Failure, Why is Her Potassium So High?

candesartan, spironolactone,

Jennifer A. Rabbitts, MB, ChB, Wayne T. Nicholson, MD, PharmD, MSc, Juraj Sprung, MD, PhD

124. Prazosin and the PTSD Paratrooper

prazosin, tadalafil,

Allen N. Gustin, MD, FCCP, Michael J. Bishop, MD

125. Nicardipine Notes

Fatal Forty DDI: nicardipine, tacrolimus, CYP3A4

Nenna Nwazota, MD, Randal O. Dull, MD, PhD

126. Hypotension Harry

Fatal Forty DDI: nicardipine, clarithromycin, CYP3A4

Matthew Hart, MSN, CRNA, Bryan J. Read, MSN,CRNA, Wayne T. Nicholson, MD, PharmD, MSc, Toby N. Weingarten, MD

127. Too Slow to Flow

Fatal Forty DDI: CYP2D6 ultraslow metabolism of metoprolol

Scott W. Cantwell, MD, Toby N. Weingarten, MD, Juraj Sprung, MD, PhD

128. Better Sleep But Slower Heart

metoprolol, diphenhydramine, CYP2D6

Erica D. Wittwer, MD, PhD, Juraj Sprung, MD, PhD

129. Extreme Blood Pressure After Ephedrine: Should We Rule Out Pheochromocytoma?

ephedrine, selegiline

Erica D. Wittwer, MD, PhD, Juraj Sprung, MD, PhD, Wayne T. Nicholson, MD, PharmD, MSc

130. Heart-Stopping Treatment

Fatal Forty DDI: verapamil, erythromycin, CYP3A4

Erica D. Wittwer, MD, PhD, Toby N. Weingarten, MD, Juraj Sprung, MD, PhD

131. Induction Crashes: Are There Clues In the Ashes?

Fatal Forty DDI: theophylline, smoked tobacco, CYP1A2

Dawn L. Baker, MD, MS, L. Lazarre Ogden, MD

132. The Wakeup Call: 2AM Trauma

beta blockers, cocaine

Devin C. Tang, MD, Nabil M. Elkassabany, MD

133. Falling Down

Fatal Forty DDI: nifedipine, fluoxetine, CYP3A4

Scott Kennedy, MD, Norman A. Cohen, MD

134. A Hidden Drug

Fatal Forty DDI: diltiazem, sildenafil, CYP3A4 and sildenafil, nitroglycerin

Helga Komen, MD, Toby N. Weingarten, MD, Juraj Sprung, MD, PhD

135. I’m Listening, I’m Listening

Fatal Forty DDI: diltiazem, carbamazepine, CYP3A4

Catherine Marcucci, MD, Jerusha Taylor, PharmD, BCPS, Ansgar M. Brambrink, MD, PhD, Neil B. Sandson, MD

136. Jump Start My Heart

metoprolol, amiodarone , CYP2D6, CYP1A2

Katarina Bojanic, MD, Juraj Sprung, MD, PhD, Toby N. Weingarten, MD

137. The Statin Trilogy (I): ‘Statin’ From The Beginning

Fatal Forty DDI: simvastatin, cimetidine, diltiazem, CYP3A4

Brian Mitchell, MD

138. The Statin Trilogy (II): Tripped And Fell At The Train ‘Statin’

Fatal Forty DDI: simavastatin, itraconazole, CYP3A4

Brian Mitchell, MD

139. The Statin Trilogy (III): Welcome To The United ‘Statins’ Of America

Fatal Forty DDI: atorvastatin, phenytoin, CYP3A4

Brian Mitchell, MD

140. Be Still, My Beating Heart

Fatal Forty DDI: amiodarone, digoxin, P-glycoprotein

Branka Polic, MD, MSc, Julije Meštrovic, MD, PhD, Toby N. Weingarten, MD, Juraj Sprung, MD, PhD

141. The Nice Niece

digoxin, St. John’s wort, CYP3A4, P-glycoprotein

Michael Hutchens, MD, Catherine Marcucci, MD

142. Cyclo Killer: Qu’est-ce que c’est?

carvedilol, cyclosporine, P-glycoprotein

Jeff Chen, MD, Michael Hutchens, MD, Wayne T. Nicholson MD, PharmD, MSc

143. Blurry-Eyed With Rapid Heart Beats

Fatal Forty DDI: digoxin, hydrochlorothiazide,

William A. Shakespeare, MD, Juraj Sprung, MD, PhD

Part XIII. Drug-Drug Interactions Involving Coagulation Modifiers

144. Introduction

Catherine Marcucci, MD

145. Seize the Day

Fatal Forty DDI: tranexamic acid, furosemide, ibuprofen

Roman M. Sniecinski, MD, Erica D. Wittwer, MD, PhD, Kenichi Tanaka, MD, MSc, James Zaidan, MD

146. The Third and Final Complication

Fatal Forty DDI: warfarin, nafcillin

Daniel W. Johnson, MD

147. An Interaction With the Furniture

Fatal Forty DDI: warfarin, metronidazole, ciprofloxacin, CYP2C9, CYP1A2

Heather Norvelle, PharmD, BCPS, Ines P. Koerner, MD, PhD

148. Macrolide Mishap for Little Miss Muffett

Fatal Forty DDI: warfarin, clarithromycin, CYP2C9

Elizabeth Pedigo, MD

149. From Asymptomatic to Symptomatic: a Cause of Nosebleed

Fatal Forty DDI: warfarin, amiodarone, CYP2C9

Joško Markic, MD, MSc, Julije Meštrovic, MD, PhD, Juraj Sprung, MD, PhD

150. The Consequences of Not Following A Cardiac Diet

Fatal Forty DDI: clopidogrel, omeprazole, CYP2C19

Kristen B. McCullough, PharmD, BCPS, BCOP, Wayne T. Nicholson, MD, PharmD, MSc

151. Clopidogrel (I): Bagel Brunch

Fatal Forty DDI: clopidogrel, omeprazole, CYP2C19

Ann Marie Canelas, MD, Randal O. Dull, MD, PhD

152. Clopidogrel (II): Conferring Over The Kung Pao

clopidogrel, proton pump inhibitors, calcium channel blockers, CYP2C19, CYP3A4

Catherine Marcucci, MD, Neil B. Sandson, MD

Part XIV. Drug-Drug Interactions Involving Immunosuppressants, Antiemetics, and Chemotherapy

153. Introduction

Catherine Marcucci, MD

154. Beaned

Fatal Forty DDI: diltiazem, tacrolimus, CYP3A4, P-glycoprotein

Matthew Hart, MSN, CRNA, Michael Hutchens, MD

155. Addisonian Adjustment

Fatal Forty DDI: prednisone, fluconazole, CYP3A4

Catherine Marcucci, MD, Neil B. Sandson, MD

156. Tea Time

Fatal Forty DDI: St. John’s Wort, tacrolimus, cyclosporine, CYP3A4, P-glycoprotein

Nikki Jaworski, MD

157. No Fits at Uffizi

Fatal Forty DDI: phenytoin, cyclosporine, CYP3A4

Michael Hutchens, MD, Christine M. Formea, PharmD, BCPS

158. Quit Steroids Quit Kidneys

steroid, tacrolimus, CYP3A, P-glycoprotein

Toby N. Weingarten, MD, Wayne T. Nicholson, MD, PharmD, MSc, Christine M. Formea, PharmD, BCPS

159. The Fall Guy (I)

Fatal Forty DDI: tamoxifen, metoclopramide, CYP2D6

Catherine Marcucci, MD, Neil B. Sandson, MD

160. The Fall Guy (2)

Fatal Forty DDI: tamoxifen, diphenhydramine, CYP2D6

Catherine Marcucci, MD, Neil B. Sandson, MD

161. The Topic of the Day

Fatal Forty DDI: cimetidine, lidocaine, CYP1A2, CYP3A4

Catherine Marcucci, MD

162. Bounce Back

ondansetron, CYP2D6 ultrarapid metabolism

Erica D. Wittwer, MD, PhD, Wayne T. Nicholson, MD, PharmD, MSc, Juraj Sprung, MD, PhD

163. Call The Cath Lab!

Fatal Forty DDI: omeprazole, clopidogrel, CYP2C19

Anna Dubovoy, MD, Erin B. Payne, MD

164. The Imatinib Inquiry: A Theoretical Case (For Now)

imatinib, metoprolol, midazolam, fentanyl, CYP3A4

Stephen J. Gleich, MD, Erica D. Wittwer, MD, PhD, Juraj Sprung, MD, PhD, Nicole Henwood, MD

165. A HAART-Breaking Tale

metformin, tenofovir

Dean Laochamroonvorapongse, MD, Kirk Lalwani, MD, FRCA, MCR

Part XV. Drug-Drug Interactions Involving Neuropsychiatric Drugs

166. Introduction

Neil B. Sandson, MD

167. Phenytoin (I): Going Crazy!

Fatal Forty DDI: phenytoin, quetiapine, CYP3A4

Sara M. Skrlin, MD, Ansgar M. Brambrink, MD, PhD

168. Phenytoin (II): The Wrong Drug for the Schizophrenic

Fatal Forty DDI: phenytoin, quetiapine, CYP3A4

Melisa N. Weingarten, RN, MS, Juraj Sprung, MD, PhD, Toby N. Weingarten, MD

169. Dizzy and Depressed

Fatal Forty DDI: nefazodone, carbamazepine, CYP3A4

William A. Shakespeare, MD, Juraj Sprung, MD, PhD

170. The Funeral Is On Monday

Fatal Forty DDI: phenytoin, valproic acid, CYP2C9

Elizabeth Macri, MD, Ansgar M. Brambrink, MD, PhD, Neil B. Sandson, MD

171. This Antacid Is Making Me Sick!

Fatal Forty DDI: phenytoin, cimetidine, CYP2C9, CYP2C19

Arun Subramanian, MBBS, Toby N. Weingarten MD, Juraj Sprung, MD, PhD

172. Young at Heart

Fatal Forty DDI: pimozide, nefazodone, CYP3A4

Catherine Marcucci, MD

173. Shiver Yes, Die No –

selegiline patch, meperidine, serotonin syndrome

Ahmed F. Zaky, MD, MPH, Michael J. Bishop, MD

174. Clip and Dip

Fatal Forty DDI: carbamazepine, felodipine, CYP3A4

David W. Barbara, MD, Randall Flick, MD, Juraj Sprung, MD, PhD

175. Blue Fog

citalopram, methylene blue, serotonin syndrome

Toby N. Weingarten, MD, Wayne T. Nicholson, MD, PharmD, MSc, Juraj Sprung, MD, PhD

176. Confiscated Contraceptives

Fatal Forty DDI: lamotrigene, ethinylestradiol, UGT1A4

Erica D. Wittwer, MD, PhD, Juraj Sprung, MD, PhD, Wayne T. Nicholson, MD PharmD, MSc

177. Gotta Love Derm

Fatal Forty DDI: lamotrigine, valproic acid, UGT1A4

Jonathan Anson, MD, Richard C. Month, MD

178. Desperate for A Drink

Fatal Forty DDI: amitriptyline, CYP2D6 poor metabolizer

Erica D. Wittwer, MD, PhD, Juraj Sprung, MD, PhD, Wayne T. Nicholson, MD, PharmD, MSc

Part XVI. Drug-Drug Interactions Involving QT Prolonging DDIs

179. Introduction

Matthew DeCaro, MD, FACC, FACP

180. Delusion At Heart

Fatal Forty DDI: thioridazine, ondanestron, QT-prolongation

Arun Subramanian, MBBS, Toby N. Weingarten, MD, Juraj Sprung, MD, PhD

181. At Long Last

Fatal Forty DDI: ziprasidone, moxifloxacin, CYP3A4, CYP2D6, QT-prolongation,

Kristen B. McCullough, PharmD, BCPS, BCOP, Wayne T. Nicholson, MD, PharmD, MSc

182. Metha-don’t!

Fatal Forty DDI: methadone, amitriptyline, levofloxacin, CYP2D6 , QT-prolongation

Bryan C. Hoelzer, MD, Juraj Sprung, MD, PhD, Wayne T. Nicholson, MD, PharmD, MSc

183. Flash Fire

amiodarone, haloperidol, CYP1A2, CYP3A4, CYP2D6, QT-prolongation,

Michael Hutchens, MD, Catherine Marcucci, MD, Neil B. Sandson, MD

184. I Am Dizzy When I Stand Up

Fatal Forty DDI: thioridazine, propranolol, CYP2D6, QT-prolongation,

Tasha L. Welch, MD, Toby N. Weingarten, MD, Juraj Sprung MD, PhD

Part XVII. Drug-Drug Interactions Involving Foods and Nutrition

185. Introduction

Kevin W. Cleveland, PharmD, David G. Metro, MD

186. High Fat Diet (I): No Juice For The Ketotic Kid

ketosis, carbohydrates, seizures

Denise M. Hall Burton, MD, Miya Asato, MD, Charles Boucek, MD

187. Protein Huffing and Puffing

theophylline, dietary protein, CYP1A2

Brian C. Bane, MD, James Gordon Cain, MD, MBA, FAAP

188. Salty Sam

high salt diet, nitroprusside

Robert Scott Lang, MD, Li Meng, MD, MPH

189. A Peak Potassium Problem

salt substitute, spironolactone, lisinopril

Justin McCray, MD, Steven L. Orebaugh, MD

190. Awake?

vitamin C, general anesthetics

Nicole Scouras, MD, David G. Metro, MD

191. Tropical Punch Packing a Real Knockout

Fatal Forty DDI: grapefruit juice, midazolam, CYP3A4

Brian Blasiole, MD, PhD, Shawn T. Beaman, MD

192. When The Fire Won’t Go Out

pomegranate juice, sildenafil, CYP3A4

Thomas P. Pontinen, MD, Randal O. Dull, MD, PhD

193. Peppermint Patty

Fatal Forty DDI: peppermint, felodipine, CYP3A4

Ryan D. Ball, MD, Karen Boretsky, MD

194. From Bleeding Gums to Green Thumbs- A True Story

Fatal Forty DDI: warfarin, green vegetables

Audra M. Webber, MD, Patricia L. Dalby, MD

195. Delicious but Malicious

licorice, spironolactone, hypokalemia

Eric Fox, BA, Kirk Lalwani, MD, FRCA, MCR

196. I Just Can’t Lick This Problem

Fatal Forty DDI: licorice, electrolytes, digoxin

Koshy M. Mathai, MD, Michael Hutchens, MD, Robert G. Krohner, MD

197. Sommelier’s Surprise

tyramine rich foods, MAO-i drugs, monoamine oxidase

Charles Lin, MD, Joseph F. Talarico, DO

198. Dairy Carefully

Fatal Forty DDI: dairy, fluoroquinolone

Kristin Ondecko Ligda, MD, Erin A. Sullivan, MD

199. Cold And Sick, Sick And Cold

fiber, thyroxine replacement, malabsorption

A. Murat Kaynar, MD, MPH, Nikhil K. Bhatnagar, MD

200. TPN (I): A Review and Two Interactions

TPN basics and complications

Lavinia Kolarcyzk, MD, Patrick J. Forte, MD

201. TPN (II): A Traumatic Case of Increased Metabolism

TPN, valproic acid

Erica D. Wittwer, MD, PhD, Wayne T. Nicholson, MD, Pharm D, MSc, Juraj Sprung, MD, PhD

202. Skin and Bones

starvation, perioperative drugs

Mariam M. El-Baghdadi, MD, Ibtesam A. Hilmi, MB, CHB, FRCA

203. Enough to Make You Sick

syrup of ipecac, general anesthesia

John Hache, MD, Thomas M. Chalifoux, MD

204. Determined and Desperate to Diet

Fatal Forty DDI: Orlistat, warfarin

Lisa Chan, MD, Kirk Lalwani, MD, FRCA, MCR

Part XVIII. Drug-Drug Interactions Involving Spices and Supplements

205. Introduction

Kirk Lalwani, MD, FRCA, MCR

206. Caffeine Crash

Fatal Forty DDI: caffeine, ethinylestradiol, ciprofloxacin, CYP1A2

Brian Gierl, MD, Ryan Romeo, MD

207. Sad Sequelae

Fatal Forty DDI: Dong quai, warfarin

Stacy L. Fairbanks, MD

208. The Scary Side of Ginkgo Biloba Is No Match For An Anesthesia Superstar: Seizures

Ginkgo biloba, phenytoin, CYP2C19

Shreya Patel, MD, Kirk Lalwani, MD, FRCA, MCR

209. The Scary Side of Ginkgo Biloba Is No Match For An Anesthesia Superstar: Sugar

Ginkgo biloba, tolbutamide, CYP2C9

Shreya Patel, MD, Kirk Lalwani, MD, FRCA, MCR

210. The Scary Side of Ginkgo Biloba Is No Match For An Anesthesia Superstar: Subdural

Ginkgo biloba

Shreya Patel, MD, Kirk Lalwani, MD, FRCA, MCR

211. “Khat” Unawares

depletion of central and peripheral endogenous catecholamines

Brian D. Tompkins, MD, Kirk Lalwani, MD, FRCA, MCR

212. Pain on the Plane

Fatal Forty DDI: ginseng, warfarin, CYP2C9

Lei Wu, MD, Kirk Lalwani, MD, FRCA, MCR

213. Ca va, c’est Kava

kava,carbidopa-levodopa, dopamine receptors

Solina Tith, MD, Kirk Lalwani, MD, FRCA, MCR

214. Summertime and the Herbals are Hot

Fatal Forty DDI: goldenseal, amitriptyline CYP2D6, CYP3A4

Jessica Miller, MD, BM, Leelee Thames, MD

215. Garlic I: More Than Just Bad Breath

Fatal Forty DDI: garlic, ritonavir, CYP3A4, P-glycoprotein

Vincent Lew, MD, Kirk Lalwani, MD, FRCA, MCR

216. Garlic II: A Girl Named Allicin

garlic, inhibition of clotting cascade

Vincent Lew, MD, Kirk Lalwani, MD, FRCA, MCR

217. “Danshen” the Night Away

Fatal Forty DDI: Salvia miltiorrhiza, warfarin, CYP2C9, CYP1A2

Tara C. Carey, BA, MD, Kirk Lalwani, MD, FRCA, MCR

218. Caught Yellow-Handed

Fatal Forty DDI: tumeric, warfarin, CYP1A2, CYP2C9

Giorgio Veneziano, MD, Michael Mangione, MD

219. St. John: Not Such A Saint

Fatal Forty DDI: St. John’s Wort, cyclosporine, CYP3A4, P-glycoprotein

Heather Norvelle, PharmD, BCPS, Ines P. Koerner, MD, PhD

220. Hearing the News

Fatal Forty DDI: St. John’s Wort, oral contraceptives, CYP3A4, P-glycoprotein

Nikki Jaworski, MD