{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:45:42Z","timestamp":1761007542607,"version":"build-2065373602"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,6,18]],"date-time":"2020-06-18T00:00:00Z","timestamp":1592438400000},"content-version":"vor","delay-in-days":78,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T00:00:00Z","timestamp":1585699200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["OTO Open"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the frequency of potential drug\u2010drug interactions affecting cytochrome P450 (CYP)\u2013mediated metabolism of opioids among adult and adolescent patients who underwent adenotonsillectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary care university hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>A retrospective review was conducted of 279 patients who underwent adenotonsillectomy at the University of Rochester. The discharge medication list was reviewed for all patients, and their postoperative medications were compared with a reference list published by the Food and Drug Administration and the University of Indiana\u2019s Department of Clinical Pharmacology (Flockhart Table) to determine whether CYP\u2010inducing or CYP\u2010inhibiting medication was present.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 279 patients, 197 different medications were taken postoperatively. Approximately 70% of patients were taking 2\u00a0medications in addition to the standard postoperative analgesics (acetaminophen, hydrocodone, oxycodone, morphine, and\/or ibuprofen). The 5\u00a0most commonly prescribed medications excluding the posttonsillectomy medications were oral contraceptives, ondansetron, amoxicillin, albuterol, and methylprednisolone. Four percent of patients were taking a medication that inhibits CYP3A4; &lt;1% were taking a medication that induces CYP3A4; and 15% were taking a medication that inhibits CYP2D6.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Nearly 20% of the patients in this cohort were taking a medication that may alter opioid metabolism through induction or inhibition of CYP3A4 or CYP2D6. Some of these interactions have the potential to be more clinically relevant than others, particularly interactions that can lead to enhanced toxicity of opioids due to accumulation of active metabolites.<\/jats:p><\/jats:sec>","DOI":"10.1177\/2473974x20932503","type":"journal-article","created":{"date-parts":[[2020,6,18]],"date-time":"2020-06-18T11:48:41Z","timestamp":1592480921000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Potential Cytochrome P450 Drug\u2010Drug Interaction Among Adult and Adolescent Patients Undergoing Tonsillectomy"],"prefix":"10.1002","volume":"4","author":[{"given":"Sai","family":"Nimmagadda","sequence":"first","affiliation":[{"name":"University of Rochester Rochester New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie Jung\u2010ying","family":"Wong","sequence":"additional","affiliation":[{"name":"University of Rochester Rochester New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madlin","family":"Faria","sequence":"additional","affiliation":[{"name":"Independent Rochester New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Allen","sequence":"additional","affiliation":[{"name":"University of Rochester Rochester New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Faria","sequence":"additional","affiliation":[{"name":"University of Rochester Rochester New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,6,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-019-0352-9"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-2538"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-1907"},{"key":"e_1_2_8_5_1","unstructured":"Center for Drug Evaluation and Research.FDA drug safety communication: FDA requires labeling changes for prescription opioid cough and cold medicines to limit their use to adults 18 years and older. PublishedNovember 3 2018.http:\/\/www.fda.gov\/drugs\/drug\u2010safety\u2010and\u2010availability\/fda\u2010drug\u2010safety\u2010communication\u2010fda\u2010requires\u2010labeling\u2010changes\u2010prescription\u2010opioid\u2010cough\u2010and\u2010cold"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5876(97)00107-9"},{"volume-title":"Health, United States, 2016: With Chartbook on Long\u2010term Trends in Health","year":"2017","author":"National Center for Health Statistics","key":"e_1_2_8_7_1"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1R621"},{"issue":"11","key":"e_1_2_8_9_1","first-page":"S276","article-title":"Opioid pharmacokinetic drug\u2010drug interactions","author":"Overholser BR","journal-title":"Am J Manag Care"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818793850"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/sdata.2017.167"},{"key":"e_1_2_8_12_1","unstructured":"Center for Drug Evaluation and Research. Drug development and drug interactions: table of substrates inhibitors and inducers. PublishedFebruary 9 2019.http:\/\/www.fda.gov\/drugs\/drug\u2010interactions\u2010labeling\/drug\u2010development\u2010and\u2010drug\u2010interactions\u2010table\u2010substrates\u2010inhibitors\u2010and\u2010inducers"},{"key":"e_1_2_8_13_1","unstructured":"Flockhart table: drug interactions. Accessed July 17 2019.https:\/\/drug\u2010interactions.medicine.iu.edu\/Main\u2010Table.aspx"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.2165\/11539950-000000000-00000"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-2015"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-1907"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(11)60750-7"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-010-0893-3"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0009-9236(98)90051-0"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12431"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1533-2500.2007.00153.x"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000000265"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.tpj.6500406"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819866823"},{"issue":"2","key":"e_1_2_8_25_1","first-page":"101","article-title":"Common herbal dietary supplement\u2013drug interactions","volume":"96","author":"Asher GN","year":"2017","journal-title":"Am Fam Physician"},{"key":"e_1_2_8_26_1","first-page":"347","article-title":"Cytochrome P450 enzyme mediated herbal drug interactions (part 1)","volume":"13","author":"Wanwimolruk S","year":"2014","journal-title":"EXCLI J"},{"key":"e_1_2_8_27_1","unstructured":"HerbPedia. Cytochrome P450. Accessed March 28 2020.http:\/\/herbpedia.wikidot.com\/cytochrome\u2010p450"}],"container-title":["OTO Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/2473974X20932503","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/2473974X20932503","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/2473974X20932503","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T14:11:32Z","timestamp":1760969492000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/2473974X20932503"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.1177\/2473974X20932503"],"URL":"https:\/\/doi.org\/10.1177\/2473974x20932503","archive":["Portico"],"relation":{},"ISSN":["2473-974X","2473-974X"],"issn-type":[{"type":"print","value":"2473-974X"},{"type":"electronic","value":"2473-974X"}],"subject":[],"published":{"date-parts":[[2020,4]]},"article-number":"2473974X20932503"}}