Interactions: Next steps in learning...

Last updated: Sunday, July 05, 2015

You may have questions about the role that cytochrome p450 enzymes play in drug metabolism. A review that may answer a number of these was published in Pharmacology & Therapeutics in 2013. This is a lengthy and complex scientific paper, not really a clinical one. But if you are prepared to browse through it, you will find answers to questions like: Which isoenzymes are most important for drug clearance? Does gender or age affect enzyme activity? etc.

There are two potential patient outcomes of drug interactions that pharmacists are often asked about because a wide range of medicines are implicated in causing them. You may like to read more about these:

1. Prolonged QT interval. Here are two example online reviews that you may find helpful: Australian Prescriber (2015) and Therapeutic Advances in Drug Safety (2012). These are quite technical papers so you may prefer to browse them, rather than reading right through. There is also a helpful Drug and Therapeutics Bulletin on the topic if you have access.

2. Serotonin syndrome. The journal American Family Physician (2010) has a helpful review article that may assist you.

Continuing professional development

Some CPD activities you could undertake include:

★  Have you ever found it difficult to talk to a doctor about an interaction? If so, reflect on why this was the case. How might you do it better next time?
★  Write up an account of an interaction that you managed in practice and present it as a case study at your work journal club, or as part of your diploma.
★  Sit down with a pharmacist colleague to discuss an interaction that you prevented or managed on your ward. Did your colleague agree with your approach? What did you learn from sharing your experiences?
★  Are there any aspects of this topic that make you feel uncertain, or where you know you need a better understanding? If so, then find a relevant review to read, and write up what you learn as a CPD exercise.