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Clinical Manual of Drug Interaction Principles for Medical Practice

Gary H. Wynn, M.D., Jessica R. Oesterheld, M.D., Kelly L. Cozza, M.D., and Scott C. Armstrong, M.D.

  • ISBN 978-1-58562-296-2
  • Item #62296


Drug interactions have become a significant iatrogenic complication, with as many as 5% of hospitalizations and 7,000 deaths annually attributable to drug-drug interactions in the United States. There are several reasons these numbers have increased. First, many new medications have been brought to market in recent years. Second, advances in medical care have resulted in increased longevity and more elderly patients than ever before—patients who are more likely to be following polypharmacy regimens. Population patterns in the U.S. have amplified this trend, with aging baby boomers swelling the patient pool and demanding treatment with medications advertised on television and in print.

Fortunately, drug interactions can be prevented with access to current, comprehensive, reliable information, and the Clinical Manual of Drug Interaction Principles for Medical Practice provides just that in a user-friendly format psychiatry clinicians (including residents and nurses) and forensics experts will find indispensable. With this new edition, the book has evolved from “Concise Guide” to “Clinical Manual” and offers the expanded coverage and features healthcare providers need to keep up with this critical field.

The book is well organized, with major sections on metabolism; cytochrome P450 enzymes; drug interactions by medical specialty; and practical matters, such as the medicolegal implications of drug-drug interactions and how to retrieve and review the literature. In the section on P450 enzymes, each chapter addresses what the individual enzyme does and where, its polymorphisms, and drugs that inhibit or induce activity. Each chapter also includes extensive references and study cases to help the reader understand and contextualize the information. A number of additional features enhance the book’s scope and utility:

  • The book boasts the very latest information in the area of drug metabolism, transport, and interaction.
  • The chapter on P-glycoprotein (a drug transporter) was expanded from the last edition to include a broader array of transport mechanisms.
  • The highest ethical standard was adhered to in the development of this volume, which was not supported in any way by pharmaceutical makers or distributors.

All eight contributors to this excellent resource are experts in the fields they have addressed, and clinicians can trust that the information contained in the Manual reflects the very latest research. This exceptionally practical manual is essential to maintaining the highest standard of care.


PART I: Introduction and Basic Pharmacology of Metabolic Drug Interactions
Chapter 1. Introduction to Drug Interactions and to This Clinical Manual
Chapter 2. Definitions and Phase I Metabolism
Chapter 3. Metabolism in Depth: Phase II
Chapter 4. Transporters
PART II: P450 Enzymes
Introduction to Part II
Chapter 5. 2D6
Chapter 6. 3A4
Chapter 7. 1A2
Chapter 8. 2C9
Chapter 9. 2C19
Chapter 10. 2E1
Chapter 11. 2A6, 2B6, and 2C8
PART III: Drug Interactions by Medical Specialty
Chapter 12. Gynecology: Oral Contraceptives
Chapter 13. Internal Medicine
Chapter 14. Infectious Diseases
Chapter 15. Neurology
Chapter 16. Oncology
Chapter 17. Pain Management I: Nonnarcotic Analgesics
Chapter 18. Pain Management II: Narcotic Analgesics
Chapter 19. Psychiatry
Chapter 20. Transplant Surgery and Rheumatology: Immunosuppressants
PART IV: Practical Matters
Chapter 21. Guidelines
Chapter 22. Medicolegal Implications of Drug-Drug Interactions
Chapter 23. How to Retrieve and Review the Literature
Appendix: Tables of Drug Interaction Pharmacokinetics

About the Authors

Gary H. Wynn, M.D., is Staff Psychiatrist at the Walter Reed Army Medical Center, in Washington, D.C., and Assistant Professor, Uniformed Services University School of Medicine in Bethesda, Maryland.

Jessica R. Oesterheld, M.D., is Acting Director of the Spurwink Department of Psychiatry, at the Maine Medical Center, and Clinical Associate Professor at the University of Vermont College of Medicine in Burlington, Vermont.

Kelly L. Cozza, M.D., FAPM, FAPA, is Associate Professor at Uniformed Services University School of Medicine in Bethesda, Maryland, and Consultant in the Department of Psychiatry at Walter Reed Army Medical Center in Washington, D.C.

Scott C. Armstrong, M.D., DFAPA, FAPM, is Medical Director of Tuality Center for Geriatric Psychiatry, and Associate Clinical Professor of Psychiatry at Oregon Health and Science University in Forest Grove, Oregon.

The wrong mixture of over the counter drugs can be fetal, and doctors and pharmacists must be aware of these lethal combos. “Clinical Manual of Drug Interaction Principles for Medical Practice” is a scholarly work discussing this very real possibility that can be prevented with the right research and foresight. With the hundreds upon hundreds of new drugs entering the market every year, the research into this subject is now invaluable, as it could save thousands of lives. Filled with complete and comprehensive and up to date research on drug interaction, “Clinical Manual of Drug Interaction Principles” is strongly recommended for community and college library medicine collections.—the Midwest book review, 2/1/2009

As a resident physician in a combined internal medicine/psychiatry residency program, I found this book extremely helpful. It serves as a great source when caring for patients with multiple medical problems coupled with mental illness.The large amount of information in this book justifies its change from a concise guide to a clinical manual.—Doddy Enterprises, 2/1/2009

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