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Yr1 -S1 - Principles of Disease > Drug-Drug Interactions > Flashcards

Drug-Drug Interactions Flashcards

1
Q

A drug interaction is defined by…

A

The modification of a drugs effect by PRIOR or CONCOMITANT (naturally occurring) administration of another drug, herb, foodstuff drink
OR
A drug interaction has occurred when the pharmalogical effect of two or more drugs given together is not just a direct function of their individual effects

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2
Q

Types of things that can interact with drugs

A

Other drugs, Herbs, Food, Drink, Pharmacogenetic interactions, smoking, alcohol

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3
Q

Object Drug

A

The drug whose activity is effected by an interaction

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4
Q

Precipitant

A

The agent which precipitates such an interaction

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5
Q

Parkinson’s treated with carbidopa and levadopa

A

Carbidopa - dopa decarboxylase inhibitor which prevents the systemic side effects of levadopa

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6
Q

Warfarin

A

Blood thinner. (anticoagulant) Treats blood clots etc

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7
Q

SSRI

A

Selective Serotonin Reuptake inhibitors (anti-depressants)

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8
Q

Erythromycin

A

Treats various bacterial infections. eg chlamydia

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9
Q

Therapeutic drug monitoring is important because

A

A small change in blood levels can induce profound toxicity

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10
Q

SSRI, Lithium, Erythromycin etc

A

All are potent with a narrow therapeutic index

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11
Q

Foods etc that interact with Warfarin

A

Broccoli, Asparagus, Kale, spinach. Green teas etc avocado, fish oils

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12
Q

The more medications taken

A

the higher probability of drug-drug interactions

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13
Q

Susceptible patients include chronic conditions such as

A

Liver disease, Renal Impairment, Diabetes, epilepsy, asthma

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14
Q

Pharmacokinetics

A

Determining the bodies effect on the drug. Absorption, distribution, metabolism, elimination

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15
Q

Pharmacodynamics

A

Determining the drugs effects on the body

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16
Q

Pharmacokinetic interactions ADME

A

Absorption, distribution, metabolism, elimination of another drug

17
Q

Mechanisms of absorption interactions

A

Formation of insoluble complexes, altered pH, altered bacterial flora, altered GIT motility

18
Q

Absorption can be affected by ionisation which is dependent on…

A

pH

19
Q

Change in Bacterial Flora

A

Bacterial flora are usually found in the large bowel. Broad spectrum antibiotics destroy normal gut flora

20
Q

Rate limiting step of absorption

A

Gastric Emptying

21
Q

Most oral medicines are absorbed in the…

A

Small intestine

22
Q

Pharmacologically active drugs are…

A

unbound. The displacement of a drug (by another drug) from plasma protein results in increased bioavailability of the displaced drug.

23
Q

If a drug is 99% bound displacement of only 1% will lead to

A

a doubling of free plasma levels

24
Q

Drugs with protein binding >95%

A

Warfarin, Naproxen, Diazepam, Glyburide, Ibuprofen

25
Q

Drug metabolism

A

Drug interactions involving metabolism occur when one drug induces or inhibits the metabolism of another

26
Q

Metabolism occurs in the liver via the…

A

cytochrome p450 system

27
Q

Inducers of the P450 system

A

Barbiturates, carbamazepine, phenytoin and tobacco smoke

Common example:
Phenytonin –> Warfarin, steroids
Rifampacin –> Warfarin

28
Q

Rifampicin increases metabolism of…

A

Ciclosporin (by inducing CYP3A4)

29
Q

St Johns Wort increases metabolism of

A

ciclosporin (by inducing CYP3A4)

30
Q

Digoxin and Lithium

A

Toxic agents that are eliminated by the kidneys

31
Q

Phamacodynamics interactions

A

Occur when the pharmacodynamics actions of a drug are changed due to the presence of another drug either acting directly on the same receptor or indirectly on different receptors
AGONIST/ANTAGONIST (direct and indirect)

32
Q

Direct antagonism

A

Beta blockers (eg atenolol) will block the actions of agonists (eg salbutamol - bronchodilators)

33
Q

Synergistic interactions (agonists)

A

When two drugs with the same pharmacological effect acting on the same receptor are given concurrently.

34
Q

Indirect agonism

A

CNS depression, nexodiazapines, Warfarin

35
Q

Indirect antagonism

A

NSAIDs and antihypertensive medication or NSAIDs and treatment for heart failure

Yr1 -S1 - Principles of Disease (25 decks)

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