The importance of cytochrome P450 monooxygenase CYP2D6 in palliative medicine.
The enzymes in the cytochrome p450 monooxygenase system (CYP) are the major enzymes responsible for metabolizing medications. The CYP2D6 isomer is responsible for metabolizing certain opioids, neuroleptics, antidepressants and cardiac medications. Owing to CYP2D6's low capacity and high affinity it is easily saturated by substrate and/or inhibited, resulting in pharmacokinetic interactions. Polymorphisms of the structural gene are common, leading to wide inter-individual and ethnic differences in drug metabolism. Clinically important drug interactions, which may be anticipated in the palliative medicine population, are reviewed.
Davis
M P
MP
Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic Foundation, OH 44195, USA. davism6@ccf.org
Homsi
J
J
D002317:Cardiovascular Agents / Q000494:pharmacology; D002491:Central Nervous System Agents / Q000494:pharmacology; D019389:Cytochrome P-450 CYP2D6 / Q000235:genetics / Q000378:metabolism*; D051544:Cytochrome P-450 CYP3A; D003577:Cytochrome P-450 Enzyme System / Q000235:genetics / Q000378:metabolism*; D004347:Drug Interactions; D004790:Enzyme Induction / Q000187:drug effects; D004791:Enzyme Inhibitors / Q000494:pharmacology*; D006801:Humans; D006899:Mixed Function Oxygenases / Q000235:genetics / Q000378:metabolism*; D004366:Nonprescription Drugs / Q000494:pharmacology; D010166:Palliative Care / Q000592:standards; D044469:Racial Groups / Q000235:genetics
D002317:Cardiovascular Agents; D002491:Central Nervous System Agents; D004791:Enzyme Inhibitors; D004366:Nonprescription Drugs; D003577:Cytochrome P-450 Enzyme System; D006899:Mixed Function Oxygenases; C104464:CYP3A protein, human; D019389:Cytochrome P-450 CYP2D6; D051544:Cytochrome P-450 CYP3A