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Enzyme induction is a process in which a molecule (e.g. a drug) induces (i.e. initiates or enhances) the expression of an enzyme. Enzyme inhibition can refer to the inhibition of the expression of the enzyme by another molecule; interference at the enzyme-level, basically with how the enzyme works.
An enzyme inducer is a type of drug that increases the metabolic activity of an enzyme either by binding to the enzyme and activating it, or by increasing the expression of the gene coding for the enzyme. [1] [page needed] It is the opposite of an enzyme repressor.
"Indiana University Department of Medicine Clinical Pharmacology Drug Interactions Flockhart Table ™". "INHIBITORS, INDUCERS AND SUBSTRATES OF CYTOCHROME P450 ISOZYMES". "The Life Raft Group: Long List of Inhibitors and Inducers of CYP3A4 and CYP2D6". "DRUGBANK Online: Cytochrome P-450 Enzyme Inhibitors".
Many drugs may increase or decrease the activity of various P450 isozymes either by inducing the biosynthesis of an isozyme (enzyme induction) or by directly inhibiting the activity of the P450 (enzyme inhibition). A classical example includes anti-epileptic drugs, such as phenytoin, which induces CYP1A2, CYP2C9, CYP2C19, and CYP3A4.
The majority of the enzymes are also involved in the metabolism of endogenous substances, such as steroids or sex hormones, which is also important should there be interference with these substances. The function of the enzymes can either be stimulated (enzyme induction) or inhibited (enzyme inhibition).
Primidone, carbamazepine, phenobarbital, and phenytoin are among the most potent hepatic enzyme-inducing drugs in existence, which occurs at therapeutic doses. In fact, people taking these drugs have displayed the highest degree of hepatic-enzyme induction on record. [ 66 ]
Index inducer or just inducer predictably induce metabolism via a given pathway and are commonly used in prospective clinical drug-drug interaction studies. [ 4 ] Strong, moderate, and weak inducers are drugs that decreases the AUC of sensitive index substrates of a given metabolic pathway by ≥80%, ≥50% to <80%, and ≥20% to <50% ...
As this drug resembles the peptide that is the substrate of the HIV protease, it competes with the substrate in the enzyme's active site. [45] Enzyme inhibitors are often designed to mimic the transition state or intermediate of an enzyme-catalysed reaction. [46]