A Holy Grail of clinical pharmacology: prediction of drug pharmacokinetics and pharmacodynamics in the individual patient.
Predicting drug kinetics and dynamics in an individual patient is a worthy goal and has some chance of success for drugs subject to marked pharmacogenetic differences. However, one should not expect any prediction success for drugs primarily metabolized by the major cytochrome P450 enzyme, CYP3A4, whether one uses an exogenous drug or an endogenous metabolic process, such as the oxidation of cortisol.
Benet
L Z
LZ
Biopharmaceutical Sciences, University of California-San Francisco, San Francisco, California, USA. leslie.benet@ucsf.edu
D015065:17-Hydroxycorticosteroids / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D051544:Cytochrome P-450 CYP3A / Q000378:metabolism; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism*; D006801:Humans; D006854:Hydrocortisone / Q000031:analogs & derivatives / Q000378:metabolism; D010084:Oxidation-Reduction; D010599:Pharmacokinetics
D015065:17-Hydroxycorticosteroids; D015415:Biomarkers; C001380:6 beta-hydroxycortisol; D003577:Cytochrome P-450 Enzyme System; C104464:CYP3A protein, human; D051544:Cytochrome P-450 CYP3A; C510163:CYP3A4 protein, human; D006854:Hydrocortisone