Abstract

Drug interaction occur when the response of one drug is altered by the simultaneous or closely time administration of another drug. Polypharmacy involving the simultaneous use of multiple drugs, raise concern due to unpredictable and potential severe internation. While some drug interactions are intentionally utilized in therapeutics strategies, their severity can vary making prediction challenging. Prescribing multiple medications increases the risk of drug interactions, which can occur with other drugs, foods, beverages, and herbs, both inside and outside the body. Understanding in vitro interactions is crucial to prevent drug activity loss before administration. While not all theoretical drug interactions may occur in practice, they remain a significant cause of adverse events associated with drug administration. Drug-drug interactions (DDIs) represent a significant source of medication errors in developed nations, especially among the elderly who often take multiple medications simultaneously, leading to a prevalence of 20-40%. The complexity of managing therapy increases with poly-therapy, elevating the risk of clinically significant DDIs that can either trigger adverse drug reactions or diminish clinical efficacy. DDIs are typically categorized into two groups: pharmacokinetic and pharmacodynamic. In vivo interactions at pharmacokinetic level affect absorption, distribution, biotransformation or excretion of drugs. Induction or inhibition of cytochrome P450 (CYP450) enzymes forms a major basis of drug interactions. Induction of metabolism of a substrate drug leads to treatment failure.

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