Tutorial

Step 4: Building the Acronyms

Okay, now that we have established how easy it is to list the different isoenzymes from the 5 families (sports), it's time to start to associate some medications with them.
In this case, medications come in 3 varieties:

a) Substrates
b) Inhibitors
c) Inducers

Let's use Cytochrome P450 (CYP) 3A4 from the previous table. We created acronyms for the a) substrates, b) inhibitors, and c) inducers of the 3A4 isoenzyme.

Table 4. Summing the Numbers for ~~Cytochrome A~~ the NY Yankees
Instead of remembering this isoenzyme...	Remember this...	Yankee Player
3A4	7 (3+4)	"The Mick" Charles Mantle
Substrates	Chemotherapeutic agents and Cisapride Opiates Sedative-hypnotics & anxiolytics Trazodone Anti-arrhythmic agents Nelfinavir Zaleplon, Zolpidem, and Zopiclone Antipsychotics Steroids and OCPs Finasteride Erythromycin SSRIs Terfenadine Imipramine Valproic Acid Uppers (cocaine, caffeine, TMU) Statins
Inhibitors	Ciprofloxacin (and Norfloxacin) and Chloramphenicol HIV medications Azoles RU-486 (Mifepristone) and Gestodene Leukemia medication (Imantinib) Erythromycin and other macrolide antibiotics Serzone (Nefazodone) Minute Maid (grapefruit juice) and star fruit Anti-arrhythmic medication Neoral (Cyclosporine) Tagamet (Cimetidine) Luvox (Fluvoxamine) and Norfluoxetine Emend (Aprepitant)
Inducers	Thiazolidinediones (pioglitazone) HIV medications Endogenous steroids (glucocorticoids) Modafinil (Alertec) INH-Rifampin (Rifabutin) Carbamazepine, oxcarbazepine, and other anti-epileptic drugs Kira (St. John's Wort)

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