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Dispensing 2 > Drug/Drug interaction > 6 > Flashcards

Drug/Drug interaction > 6 Flashcards

1
Q

Most powerful inducer of CYP 450 enzymes

A

Rifampin

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2
Q

Rifampin

A

Reduces effectiveness of antiretroviral drugs, atorvastatin, clarithromycin, voriconazole, rosiglitazone and lorazepam

Reduces efficacy of birth control pills or hormonal
contraception

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3
Q

Ritonavir

A

Inhibits CYP 1A2 and induces CYP 3A4 / 2D6

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4
Q

Statins

Simvastatin
Atorvastatin
Pravastatin

A

amiodarone, itraconazole, macrolides and protease inhibitors

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5
Q

Sulfonylureas

Gliclazide

A

hypoglycemia with metformin, thiazolidinediones (eg.
Pioglitazone), and insulin

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6
Q

Tetracyclines

Minocycline
Tetracycline
Doxycycline

A

Divalent ions reduce absorption / efficacy.

Reduce anticoagulant effect of warfarin.

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7
Q

Thiamazole
(methimazole)

A

Increased anticoagulant effect of warfarin

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8
Q

Thiazolidinediones
Pioglitazone

A

anti-diabetic drugs.

prednisolone, loop and thiazide diuretics.

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9
Q

Thyroid hormones
Levothyroxine

A

antacids, calcium or iron salts.

Phenytoin / carbamazepine

Levothyroxine enhances the effects of warfarin.

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10
Q

Trimethoprim

A

Potassium-elevating drugs increase the risk of
hyperkalemia.

Folate antagonists (eg. Methotrexate)

Phenytoin

Enhances the anticoagulant effect of warfarin

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11
Q

Vaccines

A

Immunosuppressive drugs, including systemic
corticosteroids,

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12
Q

Valproate

A

Inhibits CYP 450 enzymes

increasing toxicity of warfarin and other antiepileptics.

Risk of seizures

increases when valproate is taken with phenytoin /
carbamazepine / carbapenems.

Adverse effects of valproate increased by macrolides and protease inhibitors.

Aspirin displaces valproate from protein
binding sites.

Efficacy of valproate reduced by drugs that
lower the seizure threshold.

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13
Q

Vancomycin

A

Risk of ototoxicity / nephrotoxicity increases
when vancomycin is taken with loop diuretics,
aminoglycosides or cyclosporine

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14
Q

Risk of ototoxicity / nephrotoxicity increases
when vancomycin is taken with loop diuretics,
aminoglycosides or cyclosporine

A

Vitamin K and warfarin have opposing effects.

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15
Q

Warfarin

A

CYP 450 inhibitors, such as macrolides and
protease inhibitors – increase bleeding risk.

Inducers – such as phenytoin and rifampin

–increase warfarin metabolism

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16
Q

Z-drugs

Zaleplon
Zolpidem
Zopiclone

A

Sedative effects of alcohol, benzodiazepines, opioids
and antihistamines is enhanced.

Hypotensive effect of antihypertensive drugs is
enhanced.P450 inhibitors – like macrolides
– enhance sedative effects of Z rugs.

P450 inducers – like rifampin – impair sedation.

17
Q

5-alpha reductase inhibitors

Finasteride
Dutasteride

A

No clinically significant drug interactions

18
Q

5-HT4 antagonists

Sumatriptan
Zolmitriptan

A

Serotonergic drugs
–
including MAO inhibitors – increase the risk of
serotonin syndrome

Dispensing 2 (10 decks)

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