drug-drug interactions Flashcards

1
Q

define the term drug interaction

A

modification of a drugs effect by prior or concomitant administration of another Drug, Herb, Foodstuff, Drink

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2
Q

when has a drug interaction occured

A

pharmacological effect of two or more drugs given together is not just a direct function of their individual effects

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3
Q

what are the types of drugs

A

drug, herbal, food, drink, pharmacogenetics

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4
Q

whats an object drug

A

The Drug whose Activity is effected by such an Interaction

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5
Q

what is the precipitant

A

The agent which precipitates such an interaction

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6
Q

what are the factors that modify its action

A

food, smoking, alcohol, herbs

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7
Q

are the interactions of drugs always detrimental? if not give examples

A

no and treatment of hypertension and parkinsons

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8
Q

what does a small therapeutic index mean

A

small change in blood levels can induce profound toxicity

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9
Q

what are the mechanisms of drug interactions

A

Absorption
Distribution
Metabolism
Elimination

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10
Q

what is pharmacodynamic interactions

A

Antagonistic Interactions
Additive or synergistic interactions
Interactions due to changes in drug transport
Interactions due to fluid and electrolyte disturbances
Indirect pharmacodynamic interactions

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11
Q

what are pharmacokinetic interactions

A

Absorption
Distribution
Metabolism
Elimination of another drug

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12
Q

what are absorption interaction mechanisms

A

Formation of insoluble complexes
Altered PH.
Altered bacterial flora..
Altered GIT motility.

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13
Q

why is the GI tract complex

A

Most of this type of interactions result in changes in absorption rate rather than the extent of absorption

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14
Q

when is delayed absorption important

A

when a drug has a short half life or when we want high plasma levels rapidly

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15
Q

what happens to drugs in the GI tract

A

drugs bind to eachother

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16
Q

what is absorption affected by

A

ionisation which is dependent on pH

17
Q

where is bacterial flora usually found?

A

large bowel

18
Q

what does broad spectrum antibiotics destroy?

A

normal gut flora

19
Q

where are most oral medicines absorbed?

A

small intestines

20
Q

where are the sites of action for distrubution of drugs

A

protein-protein displacement

21
Q

when does Protein-binding displacement occur?

A

when there is a reduction in the extent of plasma protein binding of a drug caused by the presence of another drug

22
Q

what does The displacement of a drug from plasma protein results in

A

increased bioavailability of the displaced drug

23
Q

what are the two most important proteins?

A

albumin and alpha glycoprotein

24
Q

when does drug interactions involving metabolism happen

A

when one drug induces or inhibits the metabolism of another

25
where does metabolism of drugs occur and via what system
liver, via the cytochrome P450
26
what drugs inhibit the cytochrome system
clarithromycin and erythromycin
27
which drugs are potent inducers of cytochrome P450
barbiturates, carbamazepine, phenytoin, rifampacin and tobacco smoke
28
what 2 drugs increase metabolism of ciclosporin by inducing CYP 3A4
Rifampicin | St john's wort
29
where are most drugs excreted
urine or bile
30
what kind of secretion are changes in GFR
tubular
31
when do Pharmacodynamics interactions occur
when the pharmacodynamic actions of a drug are changed due to presence of another drug either acting directly on the same receptor) or indirectly on different receptors.
32
what are pharmacodynamic interactions
direct, indirect, antagonistic and synergistic/ agonist
33
what is direct antagonism
beta-blockers such as atenolol will block the actions of agonists e.g. bronchodilators such as salbutamol
34
what are synergistic interactions
When two drugs with the same pharma-cological effect acting on the same receptor are give concurrently