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Paper I — 2024 March (Supplementary) (2019 Scheme) — Q8

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Paper I
2024 March (Supplementary) (2019 Scheme) · 100 marks · 180 min

Question

Briefly describe enzyme induction and enzyme inhibition with suitable examples.

Q84 marksShort Answers

Answer

Enzyme induction: certain drugs (Rifampicin, Phenytoin, Carbamazepine, Phenobarbitone, chronic alcohol) increase the synthesis of microsomal (CYP450) enzymes, accelerating metabolism of themselves and co-administered drugs. Onset takes days (requires new protein synthesis); reversal after stopping the inducer takes 1-3 weeks. Consequence example: rifampicin causing oral contraceptive failure by accelerating estrogen metabolism.

Enzyme inhibition: drugs such as Cimetidine, Ciprofloxacin, Erythromycin, and Ketoconazole inhibit hepatic CYP450 enzymes, reducing metabolism of co-administered drugs. Faster in onset than induction, since it acts directly on existing enzyme rather than requiring new synthesis. Consequence example: warfarin bleeding risk rises sharply when combined with erythromycin or ciprofloxacin, due to reduced warfarin clearance.

  1. 1Pharmacokinetics

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