Cited by 31Pharmacogenetics and Drug MetabolismDrug-Induced Hepatotoxicity and ProtectionDrug Transport and Resistance Mechanisms

Psychophysiological stress: a significant parameter in drug pharmacokinetics

Konstandi, Maria·2013·Expert Opinion on Drug Metabolism & Toxicology

Abstract

INTRODUCTION: The available evidence suggests that psychophysiological stress regulates a substantial number of factors, which in turn, can alter the pharmacokinetic parameters of a drug. AREAS COVERED: Due to the multi-factorial involvement of stress in the regulation of a drug's pharmacokinetic profile, this review has been limited to and focuses only on the impact of stress on drug metabolism. Specifically, the review presents studies which have indicated that psychophysiological stress can significantly modify the function of the major hepatic drug-metabolizing enzymes belonging to cytochrome P450s (CYP) family in a stress-specific and species-specific manner. Furthermore, the article discusses how stress related changes in CYP regulation appear to be mediated by glucocorticoids and epinephrine/norepinephrine. This can lead to an increased rate of metabolism of the majority of prescribed drugs and chemical pre-carcinogens. EXPERT OPINION: Apparently, psychophysiological stress has a significant impact on some of the major drug-metabolizing enzyme systems. Therefore, stress should be considered as an important factor affecting drug metabolism and pharmacokinetics, with the potential to significantly alter the outcome of drug therapy and toxicity. Despite the fact that the majority of data come from experimental studies, it is conceivable that the elimination of stress is an essential condition in order to ensure the optimal outcome of pharmacotherapy.

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Crossref · 10.1517/17425255.2013.816283

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154 of 154 references verified0 citation errors · 0 not checkable

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  • Stress impacts host xenobiotic metabolism, particularly via induction of hepatic drug-metabolizing enzymes possibly mediated by glucocorticoids or noradrenaline.

    “Stress is known to impact on host xenobiotic metabolism, particularly via induction of hepatic drug-metabolizing enzymes possibly mediated by glucocorticoids or noradrenaline (Konstandi, 2013;Pantelidou et al., 2017).”

    From Gut reactions: Breaking down xenobiotic–microbiome interactions (2019) · cites this paper as Konstandi, 2013

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Authors
Konstandi, M.
Affiliations
University of Ioannina (GR)
Corresponding author
Konstandi, Maria
Venue
Expert Opinion on Drug Metabolism & Toxicology
Published
2013-07-09
Volume
9
Issue
10
Pages
1317-1334
ISSN
  • 1742-5255 (ISSN-L)
  • 1744-7607
OpenAlex
W2013932673
Cited by
31
References
154
Citations by year
2026: 2 · 2025: 4 · 2023: 1 · 2022: 4 · 2021: 4 · 2020: 4 · 2019: 2 · 2018: 3 · 2017: 1 · 2016: 2 · 2015: 1 · 2014: 3
FWCI
0.33
Type
journal article
Language
en
Open access
closed
Locations
  • Expert Opinion on Drug Metabolism & Toxicology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
  • Health Sciences › Medicine › Oncology › Drug Transport and Resistance Mechanisms
Keywords
psychophysiological stress, pharmacokinetics, drug metabolism, cytochrome P450, glucocorticoids, epinephrine, norepinephrine, hepatic drug-metabolizing enzymes, species differences, drug toxicity
MeSH terms
Animals, Cytochrome P-450 Enzyme System, Disease Models, Animal, Drug Interactions, Pharmaceutical Preparations, Humans, Liver, Pharmacokinetics, Stress, Physiological, Stress, Psychological, Down-Regulation, Up-Regulation

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