Cytochrome P450 system MRCPsych course

MRCPsych course

P450 inhibitors

 SICKFACES.COM Group 

(You definitely don’t want to join this group as it inhibit your spirits)

 

 

Sodium valproate/SSRIs (except Escitalopram)

Isoniazide

Cimetdine/CPZ

Ketonazole

Fluconazole

Alcohol  binge-drinking

Chloramphenicol

Erythromycin (macrolides)

Sulfonamides

Ciprofloxacin

Omeprazole

Metronidazole

Grapefruit juice

                                             P450 enzyme

          Substrate + P450 inhibitor --------------------->  Increased levels of substrate in plasma

                                                        1A2 enzyme

E.g.  Clozapine + Fluvoxamine    ---------------------> Increased levels of Clozapine in plasma

P450 inducers

BullShit CRAP GPS (induces my rage!)

Barbiturates

St. John’s wort

Carbamazepine

Rifampicin

Alcohol (chronic)

Phenytoin

Griseofulvin

Phenobarbital

Sulphonylureas/Smoking

                                             P450 enzyme

          Substrate + P450 inducer --------------------->  Reduced levels of substrate in plasma

                                                       1A2 enzyme

E.g.  Clozapine + Smoking      -----------------------> Reduced levels of Clozapine in plasma

 MRCPsych course