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It is nowadays well known that grapefruit is a CYP 3A4 enzyme inhibitor. But what about clinical practice? As grapefruit has a significant impact on the pharmacokinetics of some drugs, like felodipine, one can wonder about the ubiquity of this interaction. It is essential for a healthcare professional to be able to advise patients about consumption of this fruit: in which case is it a forbidden fruit, in which case is it a harmless one? This final thesis aims to demystify the underlying mechanisms of pharmacokinetic interactions caused by grapefruit. In this bibliographic research, intrinsic properties of grapefruit will be evaluated to bring out populations most at risk of interaction with grapefruit. Afterwards, an analysis of pharmacokinetic grapefruit interactions mechanisms will follow. Those data will then allow us, with scientific knowledge and case reports, to assess the clinical relevance of grapefruit interactions with important drugs in modern medicine. Finally, clinical perspectives will be suggested, highlighting the potential benefits brought by grapefruit-drug interactions. The main goals of this final thesis are the instruction of the reader about potential interactions caused by grapefruit and sensitization of healthcare professionals about potential effects of food on drugs pharmacokinetics. Il est désormais bien connu que le pamplemousse est un inhibiteur enzymatique du CYP 3A4. Mais qu’en est-il en pratique clinique ? En effet, si le pamplemousse exerce un impact significatif sur la pharmacocinétique de certains médicaments tels que la felodipine, on peut s’interroger quant à l’ubiquité de cette interaction. Il est essentiel pour un professionnel pouvoir conseiller les patients quant à la consommation de ce fruit : dans quel cas est-ce un fruit interdit, dans quel cas est-ce un fruit inoffensif ? C’est pourquoi, ce mémoire vise à démystifier les mécanismes régissant les interactions pharmacocinétiques produites par le pamplemousse. Au cours de ce travail de recherche bibliographique, les propriétés intrinsèques du pamplemousse seront évaluées, afin de mettre en évidence les populations à risque d’interaction avec le pamplemousse. Par la suite, une analyse de mécanismes pharmacocinétiques d’interaction sera réalisée. Ces données permettront ensuite, sur base de données scientifiques et de rapport de cas, d’évaluer la relevance clinique d’interactions avec le pamplemousse et de médicaments importants dans notre médecine moderne. Enfin, il sera proposé quelques perspectives cliniques mettant en avant les bénéfices potentiels que peut apporter l’interaction du pamplemousse avec un principe actif. Les objectifs finaux de ce mémoire sont l’instruction du lecteur sur les interactions potentielles provoquées par le pamplemousse et la sensibilisation des professionnels de la santé sur les effets éventuels de l’alimentation sur la pharmacocinétique d’un traitement médicamenteux.

Citrus paradisi --- Cytochrome P-450 Enzyme System --- Risk Assessment --- Food-Drug Interactions

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Dietary Supplements. --- Drug Interactions. --- Food-drug interactions --- Herbal medicine --- Plants, medicinal

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Food-Drug Interactions. --- Drug Interactions. --- Nutrition --- Diet Therapy. --- Metabolism --- Plants, Medicinal --- Drug-nutrient interactions. --- Interactions médicaments-aliments --- drug effects. --- metabolism.

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Handbook of Drug-Nutrient Interactions, Second Edition is an essential new work that provides a scientific look behind many drug-nutrient interactions, examines their relevance, offers recommendations, and suggests research questions to be explored. In the five years since publication of the first edition of the Handbook of Drug-Nutrient Interactions new perspectives have emerged and new data have been generated on the subject matter. Providing both the scientific basis and clinical relevance with appropriate recommendations for many interactions, the topic of drug-nutrient interactions is significant for clinicians and researchers alike. For clinicians in particular, the book offers a guide for understanding, identifying or predicting, and ultimately preventing or managing drug-nutrient interactions to optimize patient care. Divided into six sections, all chapters have been revised or are new to this edition. Chapters balance the most technical information with practical discussions and include outlines that reflect the content; discussion questions that can guide the reader to the critical areas covered in each chapter, complete definitions of terms with the abbreviation fully defined and consistent use of terms between chapters. The editors have performed an outstanding service to clinical pharmacology and pharmaco-nutrition by bringing together a multi-disciplinary group of authors. Handbook of Drug-Nutrient Interactions, Second Edition is a comprehensive up-to-date text for the total management of patients on drug and/or nutrition therapy but also an insight into the recent developments in drug-nutrition interactions which will act as a reliable reference for clinicians and students for many years to come.

Chemistry. --- Drug-nutrient interactions -- Handbooks, manuals, etc. --- Food-Drug Interactions -- Handbooks. --- Nutrition. --- Nutritional Physiological Phenomena -- Handbooks. --- Nutritional Physiological Phenomena. --- Toxicology. --- Drug-nutrient interactions --- Drug Interactions --- Physiological Phenomena --- Food-Drug Interactions --- Nutritional Physiological Phenomena --- Phenomena and Processes --- Pharmacological Processes --- Physiological Processes --- Pharmacological Phenomena --- Health & Biological Sciences --- Biology --- Pharmacy, Therapeutics, & Pharmacology --- Biophysics --- Pharmacology. --- Pharmacology/Toxicology. --- Chemicals --- Medicine --- Pharmacology --- Poisoning --- Poisons --- Alimentation --- Food --- Nutrition --- Health --- Physiology --- Diet --- Dietetics --- Digestion --- Food habits --- Malnutrition --- Toxicology --- Health aspects --- Nutrition   . --- Drug effects --- Medical pharmacology --- Medical sciences --- Chemotherapy --- Drugs --- Pharmacy --- Physiological effect

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Outside back cover : "Stockley's Herbal Medicines Interactions is now in its second edition and remains a unique collaboration between a team of experts in the fields of drug interactions, clinical herbal medicines, phytopharmacovigilance and regulation of herbal medicinal products. It provides an invaluable reference text for all healthcare professionals who require evidence-based information on the interactions of conventional medicines with herbal medicines, dietary supplements and nutraceuticals. Stockley's Herbal Medicines Interactions brings together available data on over 180 of the most commonly used herbal medicines, dietary supplements and nutraceuticals in highly structured, rigorously researched, and fully referenced monographs. Extensively updated for this second edition over 40 new monographs have been added for herbal medicines and dietary supplements, including Blue cohosh, Bergamot, Carnitine derivatives, Goat's rue, Hibiscus, Holy basil, Juniper, Kava and Squill. Substantial updates have been undertaken to the standing content, including revisions of the interactions of St John's wort, Milk thistle, Evening primrose oil, Ginkgo and many others. Key features include: Ease of use - structured format allows user to target key information at-a-glance. Clinically relevant - each monograph contains a concise summary on the available evidence and guidance on how the interaction can be managed. Ratings system - simple and intuitively understood, familiar to users of key drug interactions reference works. Worldwide appeal - as well as commonly used synonyms nomenclature includes approved pharmacopoeial names from Europe and the US. Indexing - full, comprehensive interactions indexing, with lead-ins from appropriate synonyms."

Herbs --- Dietary supplements --- Materia medica, Vegetable --- Herb-Drug Interactions --- Herbal Medicine --- Dietary Supplements --- Food-Drug Interactions --- Therapeutic use --- Pharmaceutical Preparations --- Pharmaceutic Preparations --- Pharmaceutical Products --- Pharmaceuticals --- Preparations, Pharmaceutical --- Drugs --- Preparations, Pharmaceutic --- Products, Pharmaceutical --- Pharmacology --- Drug Dosage Calculations --- Dietary Supplementations --- Food Supplementations --- Herbal Supplements --- Nutraceuticals --- Nutriceuticals --- Food Supplements --- Neutraceuticals --- Dietary Supplement --- Food Supplement --- Herbal Supplement --- Neutraceutical --- Nutraceutical --- Nutriceutical --- Supplement, Food --- Supplement, Herbal --- Supplementations, Dietary --- Supplements, Dietary --- Supplements, Food --- Supplements, Herbal --- Functional Food --- Drug-Food Interactions --- Food Interactions --- Drug Food Interactions --- Drug-Food Interaction --- Food Drug Interactions --- Food Interaction --- Food-Drug Interaction --- Interaction, Drug-Food --- Interaction, Food --- Interaction, Food-Drug --- Interactions, Drug-Food --- Interactions, Food --- Interactions, Food-Drug --- Metabolic Side Effects of Drugs and Substances --- Drug-Herb Interactions --- Drug-Plant Interactions --- Herbal Drug Interactions --- Plant-Drug Interactions --- Drug Herb Interactions --- Drug Interaction, Herbal --- Drug Interactions, Herbal --- Drug Plant Interactions --- Drug-Herb Interaction --- Drug-Plant Interaction --- Herb Drug Interactions --- Herb-Drug Interaction --- Herbal Drug Interaction --- Interaction, Drug-Herb --- Interaction, Drug-Plant --- Interaction, Herb-Drug --- Interaction, Herbal Drug --- Interaction, Plant-Drug --- Interactions, Drug-Herb --- Interactions, Drug-Plant --- Interactions, Herb-Drug --- Interactions, Herbal Drug --- Interactions, Plant-Drug --- Plant Drug Interactions --- Plant-Drug Interaction --- Botanical drugs --- Drugs from plants --- Medicinal plants --- Phytotherapy --- Plant drugs --- Vegetable drugs --- Materia medica --- Botanical drug industry --- Botany, Medical --- Diet supplements --- Food supplements --- Nutrient supplements --- Nutritional supplements --- Supplements, Nutritional --- Food additives --- Nutrition --- Vitamins --- Herb remedies --- Herbal medicine --- Medicinal herbs --- Adverse Herb-Drug Interactions --- Beneficial Herb-Drug Interactions --- Adverse Herb Drug Interactions --- Adverse Herb-Drug Interaction --- Beneficial Herb Drug Interactions --- Beneficial Herb-Drug Interaction --- Herb-Drug Interaction, Adverse --- Herb-Drug Interaction, Beneficial --- Herb-Drug Interactions, Adverse --- Herb-Drug Interactions, Beneficial --- Interaction, Adverse Herb-Drug --- Interaction, Beneficial Herb-Drug --- Interactions, Adverse Herb-Drug --- Interactions, Beneficial Herb-Drug --- Drug-herb interactions. --- Therapeutic use. --- Plantes médicinales --- Interactions médicamenteuses --- Compléments alimentaires --- Drug --- Pharmaceutical --- Pharmaceutical Preparation --- Pharmaceutical Product --- Preparation, Pharmaceutical --- Product, Pharmaceutical --- Herbs - Therapeutic use --- Herb-Drug Interactions. --- Dietary Supplements. --- Pharmaceutical Preparations. --- Drug-Related Side Effects and Adverse Reactions --- Drugs, Chinese Herbal --- Chinese Drugs, Plant --- Chinese Herbal Drugs --- Plant Extracts, Chinese --- Chinese Plant Extracts --- Extracts, Chinese Plant --- Herbal Drugs, Chinese --- Medicine, Chinese Traditional --- Reishi --- Adverse Drug Event --- Adverse Drug Reaction --- Drug Side Effects --- Drug Toxicity --- Side Effects of Drugs --- Toxicity, Drug --- Adverse Drug Events --- Adverse Drug Reactions --- Drug Event, Adverse --- Drug Events, Adverse --- Drug Reaction, Adverse --- Drug Reactions, Adverse --- Drug Related Side Effects and Adverse Reactions --- Drug Side Effect --- Drug Toxicities --- Effects, Drug Side --- Reactions, Adverse Drug --- Side Effect, Drug --- Side Effects, Drug --- Toxicities, Drug --- Drug Therapy --- Contraindications, Drug --- Drug Interactions --- Clinical Trials, Phase IV as Topic --- adverse effects --- toxicity