Ch 3 - Drug Interactions and Adverse Events

Question 1

Acidity, Adsorptions, GI motility, Rate of absorption, GI flora

Answer 1

Drug Interactions involving Absorption

Question 2

Multiple drugs may compete for a single protein binding site when administered simultaneously. One drug may displace the other and cause higher concentrations of free drug, leading to increased drug effect.

Answer 2

Drug Interactions involving Distribution

Question 3

Inducers decrease the effect of the object drug. One drug (inducer) stimulates the metabolism of an object drug (substrate). Increased hepatic blood flow or increase hepatic enzymes cause increased drug metabolism and decreased concentration in the bloodstream

Answer 3

Drug Interactions involving Induction

Question 4

Inhibitors increase the effect of the object drug. When two drugs are metabolized by the same isoenzyme, they compete for the same binding site. This causes more free (unbound) drug and increased drug effect.

Answer 4

Drug Interactions involving Inhibition

Question 5

Renal excretion or reabsorption may be affected by acidic or alkaline urine.

Drugs that depend on enterohepatic recirculation need to be reabsorbed through the GI tract.

Answer 5

Drug Interactions involving Elimination

Question 6

Responses or effects produced by a drug’s actions

Answer 6

Pharmacodynamic Profile

Question 7

Drugs that have similar characteristics in their pharmacodynamic profile may produce exaggerated response. Drugs with opposing pharmacodynamic profile may diminish the other’s effects.

Answer 7

Drug Interactions involving Pharmacodynamics

Question 8

MAO inhibitors react with foods containing ____.

Answer 8

Tyramine

Question 9

Warfarin reacts with foods containing _____.

Answer 9

Vitamin K

Question 10

Herb that can impair absorption of amoxicillin

Answer 10

Acacia

Question 11

Herb that reduces effectiveness of quinolones

Answer 11

Dandelion

Question 12

Two herbs that displace highly protein-bound drugs

Answer 12

Meadowsweet and Black Willow

Question 13

Herb that potentiate effects of CNS depressants such as barbiturates or narcotics

Answer 13

Kava, Lavender and Valerian

Question 14

Herb that may interfere with effects of dopamine or dopamine antagonists. Potentially hepatotoxic.

Answer 14

Kava

Question 15

Herb that may cause hypoglycemia in patients taking glibenclamide.

Answer 15

Aloe

Question 16

Herb that may interfere with action of MAO inhibitors

Answer 16

Bitter Orange

Question 17

Burns, bone fracture, acute infection, inflammatory disease, liver disease, malnutrution, renal disease

Answer 17

Conditions that DECREASE plasma albumin levels

Question 18

Benign tumors, gynecologic disorders, myalgia, surgical procedures

Answer 18

Conditions that INCREASE plasma albumin levels

Question 19

Metabolism of drugs can be altered by diseases that affect liver function (cirrhosis and CHF)

Answer 19

Effect of disease on drug Metabolism

Question 20

Glomerulonephritis, interstitial nephritis, uncontrolled diabetes, HTN

Answer 20

Diseases that effect drug Excretion

Question 21

Examples of drugs that require dose adjustments for patients with renal insufficiency

Answer 21

H2 receptor antagonists and fluoroquinolone antibiotics

Question 22

Exaggeration of the principal pharmacological action of the drug

Answer 22

Type A adverse drug reaction

Question 23

Unrelated to the principal pharmacologic action of the drug itself; precipitated by the secondary pharmacologic actions of the drug

Answer 23

Type B adverse drug reaction

Question 24

Program for tracking adverse events in drugs and medical products after they are marketed and used in clinical practice

Answer 24

MedWatch Program

Question 25

Group of enzymes that are major catalysts for metabolism

Answer 25

Cytochrome P-450

Question 26

Two types of metabolic drug interactions involving CYP isoenzymes.

Answer 26

Inhibition and Induction