Relevant CYP450-mediated Drug Interactions in the ICU

Abstract

As multiple drug therapies are often used at the same time, the potential for clinically significant drug interactions in intensive care unit (ICU) patients is large [1]. Moreover, disease-related factors, such as altered drug distribution, renal insufficiency, and hepatic disease or altered protein binding, typically occurring in the critically ill will contribute to the wide interindividual variability in drug exposure and response and to the high risk of drug interactions [2]. The majority of drugs used in the ICU are metabolized by the iso-enzymes of the cytochrome P450 (CYP450) system [3]. This chapter provides a practical overview of CYP450-mediated drug interactions with high relevance to ICU patients.