A huge number of mixtures and substances: How to deal with them?

Abstract

It is of great importance that the effects of any potentially interacting factors, such as food supplements, nutraceuticals, and dietary products, folk herbal and medicinal plants with general chemotherapy are identified and assessed. A survey of the main molecules from such products available need to be assessed to help in the understanding of the possible risk involved.Nevertheless in all these products a huge number of mixtures and substances are present, the more suggested situations in literature which cause herbal–drug interactions, are regarding both phases of the metabolizing process. Phase-I (functionalization, mainly involving CYP450 iso-enzymes as 2C6 and 3A4) and Phase-II (conjugation, mainly sulpho- and glucuron-) reactions are the more important.Variable factors such as age-dependent variations and changes caused by physiological conditions and diseases, as well as on drug–drug, food–drug or herbal–drug interactions may lead to variations in drug metabolism. Diversity in the genome is the main source for differences in drug metabolism between animal species including humans and leads to variations between individuals of a particular species. A broad range of relevant polymorphic enzymes and examples of affected drugs are published. A profound knowledge on frequent variations in drug metabolizing enzymes and their consequences is indispensable for personalized pharmacotherapy (Kramer and Testa, 2008). In a near future approaches for therapy optimization with regard to genetic polymorphisms in drug metabolism will be available.In mean time it is important to have the most reports possible in this issue that will help us to understand this complex mechanism and create easy ways to help the patients and the knowledge to educate the population in general with the warnings that need to be proven for future advice.