Reversible mechanisms of enzyme inhibition and resulting clinical significance

Methods Mol Biol. 2014:1113:37-56. doi: 10.1007/978-1-62703-758-7_4.

Abstract

Inhibition of a drug-metabolizing enzyme by the reversible interaction of a drug with the enzyme, thus decreasing the metabolism of another drug, is a major cause of clinically significant drug-drug interactions. This chapter defines the four reversible mechanisms of inhibition exhibited by drugs: competitive, noncompetitive, uncompetitive, and mixed competitive/noncompetitive. An in vitro procedure to determine the potential of a drug to be a reversible inhibitor is also provided. Finally, a number of examples of clinically significant drug-drug interactions resulting from reversible inhibition are described.

Publication types

  • Review

MeSH terms

  • Binding, Competitive
  • Drug Evaluation, Preclinical
  • Enzyme Inhibitors / metabolism
  • Enzyme Inhibitors / pharmacology*
  • Enzymes / metabolism*
  • Humans
  • Kinetics
  • Pharmaceutical Preparations / metabolism

Substances

  • Enzyme Inhibitors
  • Enzymes
  • Pharmaceutical Preparations