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Pharmacology 2 > Drug-Drug Interactions > Flashcards

Drug-Drug Interactions Flashcards

1
Q

Lag time for IV drug

A

None

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2
Q

3 Areas of concern when thinking about drug-drug interactions

A

Coagulation, Heart, CNS

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3
Q

Action of Deferasirox

A

Chelating Agent

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4
Q

Adverse effects of Warfarin

A

Hemorrhage

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5
Q

AE’s of Cyclosporine

A

Renal, HTN, Hyperlipidemia

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6
Q

AE’s of Digoxin

A

Cardiac Tachyarrhythmias, AV block

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7
Q

AE’s of Doxepin

A

Excessive sedation, Tachyarrhythmias

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8
Q

AE’s of Methotrexate

A

Pancytopenia, Liver

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9
Q

AE’s of Theophylline

A

CNS Tox

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10
Q

Agonist of Histamine H2 receptor would affect GI pH how

A

Raise GI pH –> Increase absoprtion of basic drugs

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11
Q

Antibiotics generally __ the effects of Warfarin

A

Increase

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12
Q

Anticoagulant w/ Narrow TI

A

Warfarin –> Hemorrhage

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13
Q

Antidepressant w/ Narrow TI

A

Doxepin –> Sedation, Tachyarrhythmias

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14
Q

Azole with no effect on CYP3A4

A

Fluconazole

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15
Q

Azole with strong inhibition of CYP3A4

A

Voriconazole

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16
Q

Bile sequestrant –> Bind drugs (eg Propanolo) –> Decrease absorption

A

Cholestyramine

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17
Q

Both irreversible and Quasi-Irreversible CYP inhibitor are caused by

A

Formation of Reactive Metabolites

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18
Q

Both irreversible and Quasi-Irreversible CYP inhibitor require

A

At least 1 cycle of CYP catalytic process

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19
Q

Bronchodilator w/ Narrow TI

A

Theophylline –> CNS toxicity

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20
Q

Cisplatin + Cyclophosphamide both

A

form DNA adducts at diff sites

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21
Q

CYP effect of Fluoxetine, Paroxetine

A

CYP2D6 strong inhibition

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22
Q

CYP inhibitor potency determined by

A

Lipophilicity and Strength of bonds

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23
Q

Ergotamine + Caffeine =

A

Increased Ergotamine uptake

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24
Q

Erythromycin effect on CYP

A

Strong inhibitor of 3A4 and 1A2

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25
Q

Function of Chelating Agent

A

Administered to bind serum iron and heavy metals to facilitate renal elimination

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26
Q

Immunosuppressives w/ Narrow TI

A

Cyclosporine –> Renal, HTN; MTX –> Panctyopenia, Liver tox

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27
Q

Importance of Atorvastatin

A

Binds PXR and RXR –> Upregulate CYP3A4

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28
Q

Important PXR target

A

CPY3A4

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29
Q

Inotropic Agents w/ Narrow TI

A

Digoxin –> Tachyarrythmias, AV Block

30
Q

Macrolide with no inhibition of CYP3A4

A

Azithromycin

31
Q

Macrolide with strong CYP inhibition

A

Erythromycin

32
Q

Many potent reversible CYP inhibitors contain

A

Nitrogen

33
Q

Methotrexate + Fluorouracil =

A

5-FU solidifies action of MTX

34
Q

Most common herbal products have effects on __ activity

A

CYP

35
Q

Most common type of CYP inhibition

A

Reversible

36
Q

Niacin + Simvastatin =

A

Decrease LDL cholesterol

37
Q

Non-specific beta-adrenergic blocker used to treat HTN

A

Propanolol

38
Q

Peak drug effect usually occurs when

A

Drug level in plasma reaches highest point

39
Q

Propanolo and Salmeterol both act on

A

Beta-2 Adrenergic receptors, but in diff organs

40
Q

Propanolol + Salmeterol =

A

Antagonism

41
Q

Propanolol is used to treat

A

HTN (non-specific beta-adrenergic blocker)

42
Q

Raising GI pH increases absorption of

A

basic drugs

43
Q

Result of Rifampin added to Cyclosporine

A

Cyclo levels decline due to CYP induction –> Loss of transplant

44
Q

Result of Rifampin added to Hormonal Contraceptives

A

HC levels decline due to CYP induction –> Preg

45
Q

Result of Rifampin added to Tacrolimus

A

Tacro levels decline due to CYP induction –> Loss of transplant

46
Q

Result of Rifampin added to Warfarin

A

Warfarin levels decline due to CYP induction –> Thrombosis

47
Q

Reversible CYP inhibition is result of

A

Competition at active site, probably only involves first step

48
Q

Role of Cholestyramine in Drug Drug Interactions

A

Bile sequestrant –> Bind drugs (eg Propanolo) –> Decrease absorption

49
Q

Role of Clarithromycin in Drug Drug Interaxn

A

Weak CYP3A4 inhibitor

50
Q

Role of Erythromycin in Drug Drug Interactions

A

Strong CYP3A4 and 1A2 inhibitor

51
Q

Role of Fluoxetine/Paroxetine in Drug Drug Interaction

A

Strong 2D6 inhibitor

52
Q

Role of Itraconazole in Drug Drug Interaxn

A

Weak CYP3A4 inhibitor

53
Q

Role of Ranitidine in Drug Drug Interactions

A

Agonist of Histamine H2 receptors –> Raises GI pH –> Increase absoprtion of basic drugs

54
Q

Role of Voriconazole in Drug Drug Interaction

A

Strong CYP3A4 inhibitor

55
Q

Salmeterol + Fluticasone =

A

Synergistic T cell activation and Apoptosis induction

56
Q

Salmeterol is used to produce

A

bronchodilation by activating beta-2 adrenergic receptors in bronchial SM of lung

57
Q

SSIR + Triptans =

A

Serotonin Syndrome

58
Q

SSRI + Tramadol =

A

Serotonin Syndrome, Seizures

59
Q

SSRI with strong inhibition of CYP2D6

A

Fluoxetine, Paroxetine

60
Q

Statin drugs in high concentrations cause

A

Breakdown of muscle (Rhabdomyolysis) –> Pain, Renal Failure

61
Q

Statins that are CYP3A4 substrates

A

Atorvastatin, Lovastatin, Simvastatin

62
Q

Sulfamethoxazole + Trimethoprim both target the

A

DHFR pathway

63
Q

The effects of the body on a drug

A

Pharmacokinetic

64
Q

The effects of the drug on the body

A

Pharmacodynamic

65
Q

Three examples of drugs affected by Rifampin CYP3A4 induction

A

Warfarin, HC’s, Cyclosporine/Tacrolimus

66
Q

Voriconazole effect on CYP3A4

A

Strong inhibitor

67
Q

What do Aspirin, Barbituates, Phenytoin, Sulfonamides, Valproic Acid, and Warfarin have in commone

A

Highly protein-bound in plasma

68
Q

What drug would reduce absoprtion of Propanolol

A

Cholestyramine (bile sequestrant)

69
Q

What would increase Triazoloam absorption

A

Increase stomach pH (Ranitidine)

70
Q

Who are especially susceptible to effects of drug-drug interaction

A

Women, old, young

Pharmacology 2 (8 decks)

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