P450 Enzyme System (Inducers, Inhibitors, & Subtypes)

[@DirtyMedicine]

So for some reason my brain kept saying 2E3, but to be clear it’s CYP-2E1 . Note that the mnemonic reflects this and is correct. Just ignore my brain fart

[@karthikeyareddyramasahayam1039]

DirtyUSMLE sir please,can you do a video on AFFINITY,POTENCY,EFFICACY,DOSE and RESPONSE curves...please sir please

[@xinchaoli4930]

very helpful video thx! but when u say that most cardiovascular drugs are 2D6, I see about uptodate . It says that most statin and CCB are 3A4? also nitroprusside and hydralazine CYP is unknown.I only found that propanol and flecanide is 2D6

[@melissajanos1691]

Thank you so much for this! It's hard to find videos that give you the information you need, but are entertaining as well! You remind me of myself. I appreciate you.

[@Vunami]

Can you add the annotation right beside it saying that it's CYP2E1?

[@capstone6045]

Cbd is a stronger inhibitor than grapefruit juice. I’m on methadone maintenance and I learned this the hard way . Please get this info out so that someone else doesn’t go through the same hell I did (am)

[@danieldonascimentoaraujo3221]

Mnemonics for CYP450 Drugs: Inducers (ASMR): Anticonvulsants, St John Warts, Modafinil, Rifampin Inhibitors (ABCDE): Antimicrobials (lots), Belly (Omeprazol, Cimetidine), Cardio (Amiodarone, Calcium channel blockers), Depression (SSRIs), Extra (Grapefruit juice)

[@hippocratesdaterra7652]

This one belongs in the DirtyUSMLE's Greatest Hits album

[@Agoraphobia07]

P-3 student pharmacist in my last semester of curriculum...and this is the best CYP explanation I've seen since being in this program...God (or whoever you believe in) bless you sir!!!

[@markmabazza6439]

I don't listen to any music in my car anymore. I listen to you every day that I go to work. Thank you for sharing your knowledge.

[@wfox6985]

You are a very gifted educator. This is the most simple explanation I've seen and I don't think I've fully understood these concepts until watching this video. Thank you for what you do.

[@greenheadmetalchips6669]

You are not a simple youtuber, you are a messenger of tHE GODS, a messenger with a message that will SAVE the medical students and allow them to ascend into the godlihood status of being a professional in the field ;w; thank you

[@riyasomani101]

I got p450 enzyme questions on Uworld correct today..! Happy tears :) Thankyou so much for relieving the pain of remembering these meds!!!!

[@SA-fz5zj]

I cannot tell you how much this video has helped me get through pharmacy school rotations! May Allaah bless you!

[@bradcallahan3546]

No thanks. People aren't interested in terrorist gods

[@nal-awad7963]

I’ve been trying to remember this throughout medical school and this was just one of those topics that never stuck and all it took was this 13 and a half minute video… This was a lifesaver. Thank you!!!

[@aircavmedic]

Well presented. Prior pharmacy student, changing major to Nursing, i have tried to understand the P 450 enzyme system, since as senior, I need to understand personally & professionally. You did an amazing explanation and presentation thank you

[@jacksample7954]

Wow, I just finished a UWorld Form 1 practice exam and got destroyed by 3 CytP450 questions. Open up KZbin after I finish my exam and see this beautiful new upload. Pharm gods have spoken, bless your soul

[@b4birjupatel]

UWSA 1 for Step 1? I didn't see any questions related to this. Gave it 2 weeks back

[@alhasanmd7305]

Birju D. Patel, MD same

[@mikewest7504]

My mnemonic is CAR GPS and when you think of CAR (carbamazapine), I think of the stick in the middle that says PRNdl = Phenytoin/Phenobarbital, Rifampin, and Nicotine (another enzyme inducer) and then dl isn't anything. GPS is Greiseofulvin, Phenytoin/Phenobarbital, and Sulfonylureas.

[@KateEing]

GOD BLESS YOU I HAVE MISSED SO MANY UWORLD QUESTIONS ON THIS

[@Abo7meyd]

Btw on my actual Step 1 exam I was asked about the Cytochrome Subtype that metabolizes a certain drug (which i cant remember which it was) but I HIGHLY recommend learning it from this vid, because I just guessed, because this is way too difficult to memorize without a mnemonic. Other than that this channel is truly great, and on many questions like the inheritance pattern and the cardiovascular loops I used the mnemonics and tips from DIRTYUSMLE. Thank you so much.

[@nelsonsridge]

Studying for the PHMNP exam next week. This was excellent, thank you!

[@dianasalazar4488]

THANK YOU!!! You had me at the enzyme doesn't inhibit. My teacher just flew over this and I was so confused. You are a lifesaver.

[@nubios1983]

VERRRRRY HELPFUL especially for me as a pharmacy student! Please KEEP THEM COMING! Thank you!

[@michellekathryn2902]

I'm so glad I found your channel. Foreign MD here! Studying for the USMLEs... Taking Step 1 in Spring. God bless you!!!

[@andrewmelek8161]

Phenomenal video, your mnemonics are on point as always. For some odd reason, a couple of the Qbanks like to stress out the difference between Chronic vs acute Alcohol. ChRonic Alcohol (CRAp gps) induces and acute inhibits. It has to do with the 0 order kinetics / enzyme saturation bs i think. Regardless, I just wanted to thank you for all the hard work you've put in. Recommended your channel to everyone I know lol.

[@rebeccao5499]

CRAP GPS induces my rage is so freaking good. It’s saving my life right now. I kept getting those questions wrong before!!! Thank you!!!!!!

[@DestinyRowSH]

OMG this was hilarious. My partner and I are Pharmacists and are studying for a Board Certification tomorrow. This made our day. Thanks!!!!

[@donhjoe2162]

Well explained. I'm not any kind of doctor or a professional in bio-chemical or bio-genetic but I like me all about science. Thank you!

[@johanespardede640]

I must say it : the best explanation i have ever heard! Thank you.

[@annalisalopez-madrigal8291]

Thank you for this video! If possible can you please make a video for the lab techniques? (i.e. RT-PCR, FISH)

[@thepangpong]

I am taking my exam in 3 days... and I guarantee these videos are going to come in CLUTCH on test day. Thank you! Binge watching all of them now.

[@AhmedDeyeMD]

Thanks man. You deserve a Nobel prize

[@RubyHall-y4f]

It's not the best but may help on a test in a pinch. My mnemonic for Inhibitors is: IS Grape CAKE Quickly Inhibiting Valorie? Isoniazid Sulfonamides Grapefruit Chloramphenicol Amiodarone Ketoconazole Erythromycin Quinidine Valproate

[@rachelmoloney6592]

Thank you kindly, this was extremely helpful----whatever watching videos and documentaries are for a learning style, that's me. Thanks a million for the help learning these abstract concepts in pharmacology.

[@rishabbiradar5416]

Thanks a lot bro. You made my medlife hell eazy....all of your videos are the best on KZbin, such cool mnemonics - you are genius.

[@monajenks5398]

THANK YOU, THANK YOU, THANK YOU!!! I'm in nursing school and that darn text didn't explain what you just did. Now I know why Grapefruit is an inhibitor to Ca+ channel blockers ❤️

[@greyeyedone_2119]

Thank you so much for this video. You explained in 13 minutes what my 2 hour lecture could not w/o confusion!

[@doctoronduty7044]

Warfarin was one of the awesome memonic. GENIUS bro 😎

[@jourdanjaydubwaddell]

Not that you would ever be asked about what enzyme metabolizes Cyproheptadine, but it is CYP3A4. Where it helps is if you take apart the name of the drug( CYP ro HEPTA dine ) - it can help you remember it works on 5HT-2 and CYP3A4 because HEPTA = 7. In a roundabout way, the 3A portion of the enzyme and Cyproheptadine can be tied to First Aid's reference of the 3As of Serotonin Syndrome, of which Cyproheptadine is a treatment.

[@MelanieGraham-r9i]

Hi, your video is really helpful. I wanted to point out that psych medication’s have been left off of these lists. They may not be on your boards, however, it would be beneficial for providers to know which psych medication’s are affecting the medication that they prescribe.

[@Areebanm4]

Oh dirty! I wish I had found you sooner! Thank you for making my life easier!

[@SG333_]

The P450 subtype mnemonics are absolute FIRE - thank you so much!!!

[@ezatullaha.3502]

Thanks sir, I love the way u teach and makes big topics like nothing 🙏

[@titustp]

This video makes it so easy to understand the concept.

[@dk28355]

Great explanation of the enzymes - you've demystified it for me. Thanks

[@aamirihsan7236]

dear sir, not only this one every one is super super ...easy to understand and super easy to remember...bundles of thanks ..keep it on sir

[@Vunami]

I love that you don't have filters

[@JenniferShuartAPRN]

So wickedly helpful! Thank you!

[@sangbarafavour4039]

thank you so much sir This video has really helped me Your mnemonics are very good Favour from nigeria

[@gym196444]

I thank you for your teaching. You make learning enjoyable and stress free.

[@meghan1529]

CYP-3A4: Think “free-for-all” 3 (free) 4 (for) A (all), and rearrange the letters. “Free-for-all”, as 3A4 metabolizes most drugs.

[@aircavmedic]

This is just an interesting & informative video. So many subtypes.This video brings it down to my educational level. Pneumonics , I use so this was invaluable. Thank you Dr

[@ahmedjadoon2840]

For those of you who are looking for First Aid reference, it's FA19 p.251, FA20 p.252

[@mawiley2493]

Holy shit, this is exactly what I needed. No one else's videos or mnemonics are as good as yours.

[@LiviaGrigorie]

Thank you for this. I'm now heading towards the year 2 of my Mpharm degree with a little less anxiety!

[@thirteenbee3890]

You can also say Ace2minophen (CYP-1A2 --- Acetaminophen)

[@wileenalexis8187]

Short, sweet and the to point!! Thanks a million 🙏

[@AcceleratedCurriculum]

Just thought of something helpful and wanted to share: for the statins (except pravastatin) remember that Apolipoproteins include ApoE. Then ApoE is Apo3 and has 4 letters and Apo starts with A. So now 3A4. Alternatively, there are also 4 Apos: A,B,C,E. So now you have 3A4 as well. I know it's in the catchall but since statins are so important it might be helpful.

[@a22258461]

Thanks I learn the new thing, I am working on P450 enzyme.

[@preetijoshi5594]

This is amazing! You are a genius, Dirty!!

[@colleenhanson1840]

It finally makes sense! THANK YOU!!!!

[@bradgibson9430]

What a great way to simplify this concept! Really helped me put it all together. Thank you!

[@dogbert1234567]

You are the common man's Dr. Sattar.

[@MLife1000]

I like the way you explain things so easy!

[@liyanelaasar6802]

the best video i have seen in my life

[@davidperry1018]

Great video and expanded on a few more items than other videos. I was hoping for more of an explanation and details. What about fluvoxamine, fluoxetine, celebrex???

[@King_Cyn]

For CYP450 inhibs, you can use G-PACMAN: G - grapefruit juice P - Protease inhibitors A - antifungals (I believe azoles specifically) C - cyclosporine/cimetidine M - Macrolides A - amiodarone N - non-DHP CCBs (dilt & verapamil)

[@paolozabat3200]

Really helpful! I understand P450 enzyme better. Thanks for making this video!

[@JuliaRachel_2022]

Thank you so much for this video!!! I always had trouble understanding P450 system, and now I totally get it!

[@rozzarozza3250]

I struggled with this for a while but your video saved me so thank you!!!!

[@jeandivine3]

Sometimes an inducer increases the break down a drug into it’s active metabolite, so it’s incorrect and dangerous to teach that inducers do not cause toxicity.

[@shuvoislam8104]

This is excellent... Looking forward to more of u

[@cynthiachavez25]

Best explanation Yet!!!! Thank you!!! 🙏💕

[@oliviabunbury7025]

I'm literally so happy I found your channel! I feel like a doctor already and Im only in first year med LOLLL

[@hi-this-is-stephen]

You save my time for revision.

[@usa9872001]

This might be the most beautiful thing ever

[@lalita180]

Im a nursing student and your videos and explanations are great and helpful ! Thanks a lot!

[@poly121]

So smart. Well, you thought you were teaching about CYP450 alone but I also learned that echo heart uses just 2D, that I need to be 21 to be allowed to drink and that 60% of drugs are metabolized by CPY3A4. I will just relax now.

[@caseyandtoryshalloween1236]

Cyp-1a2 also metabolizes caffeine anc theobromine (chocolate)

[@amaranathl9864]

Very nice way of explaing ,tough subject to remember 👌

[@just_shaeee]

I'm getting ready to take my PMHNP boards! This video is extremely helpful!

[@avrilhylton6397]

This was very helpful, thanks a million.

[@subashthapa8066]

What u are doing is amazing sir...

[@sharonsheltermoyo1667]

Easy to understand well explained ❤❤❤👏👏👏

[@really4473]

You the REAL MVP for this video.

[@theconquistador8862]

MVP = Mitral Valve Prolapse " When you spend too much time studying for the Boards"

[@avilashmandal151]

The Conquistador MVP likes FAME Fragile X ARPKD Marfan Ehler Danlos

[@hanstsahnang4533]

Thanks for this marvelous explanation. Are inducers also substrates ?

[@giovaniaguiar8672]

Good morning...I just want to clarify something...I know that tobacco (cigarette smoking) is an inducer of CYP 1A2, but I cant fin the information about Acetaminophen being an inducer of 1A2 as well. Please guide :-) Thank you!

[@aircavmedic]

It is informative as well as inducers & reducers

[@JatinSingh-hk8ts]

This was a very good video👌🏻 loved it. You made it so easy to learn p450 subtypes

[@shaantanu1012]

Thank you so much! The FA mnemonic for this is unnecessarily hella long! :) Very much appreciated!

[@Frickkenn]

How would someone who isn’t affected by THC edibles go about making them work? Do I need to induce myself first? Ex: I consistently drink alcohol until the edible kicks in. Or do I need to inhibit first?

[@JeanJackson-v9j]

This was amazing!!!! Great mind! Will totally help.....

[@dianthejoa]

OMG Thanks for the video. It made it really easy to remember. Great video!

[@mrudulakiran6474]

This video was really very helpful. Thank you!!

[@liliyaa_md]

absolutely brilliant! love your videos and your sense of humor!!!!

[@wildestdreams2383]

Can you explain why enzyme induction is considered non-specific and and has a slow onset whereas enzyme inhibition is faster and more selective?

[@carlettagoodrichmann1513]

Excellent loved your Numonics

[@johnwierzbicki1739]

I love this video. How do you relate these pneumonics to the rest of the drugs metabolized by the subtypes?? Or just different pneumonics to relate to those certain drugs?

[@andrewchill9794]

Dear Dirty, which Sulfonylureas should I assume are CYP450 inducers? 1st gen, 2nd gen, or both? I do not see it listed in first aid. I believe you, and this is a fantastic video. I'm just curious as I have not come across this drug for inducing cyp450 in a question yet

[@argumentumadbaculum]

Your subtype mnemonics are the best

[@irmasanchez5274]

Are Statins cytochome p450 inhibitors? Also, what is the correlation with long term use of statins elevating liver function levels of AST and ALT? I remember when statins first came put liver function tests were done, but now patients are just put on them without careful monitoring.

[@sageknows]

Helpful video! I have a question. Do the inducers and inhibitors work globally on all of these subtypes?

[@sukanyaroy6773]

You are such a lifesaver. THANK YOU THANK YOU THANK YOU I always mixed these up

[@femiomolere4137]

Wonderful explanation. Thanks so much

[@drsabirkakar]

The best explanation ever...♥️👍

[@meganflowers9505]

Your videos are amazing! Thanks for the help!