Voigt N, Ort K, Sossalla S
Pneumologie. 2019 May;73(5):306-318. doi: 10.1055/a-0863-6242. Epub 2019 May 13.
Drug-drug interactions (DDI) represent a significant problem in modern medicine. The number of patients with multi-morbidity, who take multiple drugs, is constantly increasing (polypharmacy). The related exponential increase in potential DDI is almost incomprehensible. In this article, we review pharmacodynamic DDI and provide clinically relevant examples. In addition, we extensively review pharmakokinetic DDI (e. g. through the cytochrome P450-system or p-glycoproteins) that can modify the plasma concentration of many compounds, thereby also increasing the likelihood of unwanted side effects. Finally we provide tools, which may help clinicians in their daily practice to identify and avoid potential DDI. In the context of an ageing society receiving polypharmacy, a better awareness of DDI and of strategies to prevent them is expected to reduce mortality and morbidity.
药物相互作用（DDI）是现代医学中的一个重大问题。患有多种疾病且服用多种药物的患者数量（多重用药）持续增加。潜在药物相互作用的相关指数增长几乎难以想象。在本文中，我们回顾了药效学药物相互作用并提供了临床相关实例。此外，我们广泛回顾了药代动力学药物相互作用（例如通过细胞色素P450系统或P-糖蛋白），这些相互作用可改变许多化合物的血浆浓度，从而也增加了出现不良副作用的可能性。最后，我们提供了一些工具，可能有助于临床医生在日常实践中识别和避免潜在的药物相互作用。在接受多重用药的老龄化社会背景下，更好地了解药物相互作用及其预防策略有望降低死亡率和发病率。
