P450 enzyme system

Induction usually requires prolonged exposure to the inducing drug, as opposed to P450 inhibitors, where effects are often seen rapidly

Inducers of the P450 system include "CRAP GPS"

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CRAP GPS induces my rage!

Carbamazepine Rifampicin Alcohol (chronic) Phenytoin, topiramate

Griseofulvin Phenobarbitone St. John’s Wort, Sulfonylurea, smoking

my RAage (topiRAmate)

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smoking affects CYP1A2, reason why smokers require more aminophylline)

Inhibitors of the P450 system “SICKFACES.COM”

This is the "gold standard" mnemonic for inhibitors. If you inhibit the liver, the patient gets "sick" because drug levels rise to toxic levels.

• S – Sodium Valproate
• I – Isoniazid
• C – Cimetidine / Ciprofloxacin
• K – Ketoconazole (and other azoles like Fluconazole)
• F – Fluoxetine (and other SSRIs)
• A – Alcohol (Binge drinking/Acute use), Amiodarone
• C – Clarithromycin (and Erythromycin)
• E – Erythromycin
• S – Sulphonamides
• .COM – Cranberry Juice / Omeprazole / Metronidazole

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Stop and CACH’A MOVIE!

Clarithromycin Alcohol (Binge) Cimetidine Allopurinol, Azole antifungals, Amiodarone

Metronidazole Omeprazole Valproate, Verapamil Isoniazid Erythromycin

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