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ELECTRONIC CONTINUING EDUCATION FOR
SPECIALISTS IN POISON INFORMATION
Module IV - Cytochrome P450 Update
INTRODUCTION
Welcome to Module IV of the American Association of Poison Control Center’s electronic
continuing education program for Specialists in Poison Information. This module will provide a basic knowledge
of the cytochrome P-450 (CYP-450) system and drug interactions likely to be encountered by SPIs. The format
for this module will consist of five general questions / discussions, followed by 9 case histories / questions
/ discussions. The case histories presented are real and represent situations in which knowledge of the CYP450
system can enhance the practice of SPIs. Tables of common CYP-450 substrates, inducers, and inhibitors are
included in this module for the participant’s convenience. It is suggested that participants become familiar
with these tables, as they represent a useful tool when deciphering CYP-450 mediated drug interactions. Additional
references are provided for SPIs who wish to further their knowledge of the CYP-450 system.
LEARNING OBJECTIVES
Upon completion of this module, participants will:
1. Understand the terminology associated with the CYP-450 system.
2. Recognize common substrates, inhibitors, and inducers of the CYP-450 system.
3. Describe CYP-450 enzyme inhibition and induction.
4. Relate changes in metabolism of drugs to clinical signs and symptoms.
5. Describe factors that affect CYP-450 mediated metabolism.
6. Recognize potential CYP-450 mediated drug interactions.
7. Utilize references for assessing clinically significant CYP-450 drug interactions.
DEFINITIONS
Enzyme: protein molecule that catalyzes chemical reactions of other substances without itself being altered or destroyed upon completion of the reactions
Substrate: substance upon which an enzyme acts
Inhibitor: any substance that interferes with a chemical reaction
Inducer: any substance that causes an accelerated
synthesis of enzymes
AUTHOR
Peter Ciancaglini, PharmD
REVIEW PANEL
Daniel Cobaugh, PharmD
Prashant Joshi, MD
Ruth Lawrence, MD
Christine Stork, PharmD
Desiree Voorhies, RN, MEd
Paul Wax, MD
SELECTED REFERENCES
1. Pharmacotherapy. 1998;18(1):84-112.
2. American Family Physician. 1998;57(1):107-16.
3. American Journal of Psychiatry. 1996;153(3):311-20.
4. Journal of Clinical Psychopharmacology. 1995;15(6)387-398.
Please print these tables to
use for reference during this module.