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Board Study Topics > 00 Drug Interactions > Flashcards

00 Drug Interactions Flashcards

1
Q

Which enzyme is Warfarin metabolized by?

A

CYP 2C9

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2
Q

What is one of the strongest and broadest enzyme inducers?

A

Rifampin (many medications given with this will have to have higher doses)

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3
Q

Which enzymes do many pain and psychiatric drugs go through?

A

CYP 2D6

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4
Q

What are some of the strong P-gp INHIBITORS?

A

Azoles (keto-, itraconazole), Verapamil, Macrolides (Clarithro-, erythromycin)

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5
Q

What are some of the strong P-gp INDUCERS?

A

Rifampin, Carbamazepine, Phenytoin, St. Johns Wort

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6
Q

Quick Study Tool: PS PORCS (Big CYP Inducers)

A

Phenytoin, Smoking, Phenobarbital, Oxcarbazepine, Rifampin, Carbamazepine, St. Johns Wort

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7
Q

Quick Study Tool: G <3 PACMAN (Big Inhibitors)

A

Grapefruit, Protease Inhibitors (ritonavir, etc.), Azoles (fluconazole, itraconazole, ketoconazole, etc.), Cyclosporine & Cimetidine, Macrolides (clarithromycin, erythromycin, but not azithromycin), Amiodarone, Non-DHP CCBs (Diltiazem and Verapamil)

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8
Q

What are some significant drug interactions that can be seen with Amiodarone?

A

Digoxin and Warfarin (likely to be given with amiodarone d/t heart failure/arrhythmia). Digoxin and Warfarin dose will need to be decreased

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9
Q

What can happen if Warfarin is given with Ginseng?

A

May decrease the effectiveness of Warfarin (seng, like sink: drains warfarin)

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10
Q

What can happen if Warfarin is given with Thyroid Hormones?

A

Altered INR (incr or decr) - usually increases warfarin effects - Monitor INR

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11
Q

What can happen if Bactrim is given with Phenytoin or Methotrexate?

A

Can increase the Phenytoin/MTX concentrations, increasing toxicity

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12
Q

What can happen if Digoxin is given with Cholestyramine or Colestipol?

A

Decrease levels of digoxin (decreased GI absorption d/t binding and also interruption of enterohepatic recycling of digoxin)

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13
Q

What can happen if ACE-Is are given with Potassium-sparing diuretics or Potassium supplements?

A

May increase serum potassium concentration, especially in renal impaired patients

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14
Q

What can happen if ACE-Is are given with Lithium?

A

Increase levels of lithium by 200-300% (dose-related)

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15
Q

What drugs can increase Lithium levels?

A

STAND: decreased Sodium intake, Thiazides, ACE-I, NSAIDs, Dehydration

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16
Q

What can happen if Valproic Acid is given with Phenobarbital or Lamotrigine?

A

Increases Phenobarbital or Lamotrigine levels

17
Q

What can happen if TCAs are given with MAO-Is?

A

May lead to hypertensive crisis

18
Q

What can happen is Azole antifungals are given with Cola and other acidic drinks and foods?

A

May increase absorption and levels of the azole antifungals

Board Study Topics (38 decks)

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