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principles of disease > drug-drug interactions > Flashcards

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
Q

where does metabolism of drugs occur and via what system

A

liver, via the cytochrome P450

26
Q

what drugs inhibit the cytochrome system

A

clarithromycin and erythromycin

27
Q

which drugs are potent inducers of cytochrome P450

A

barbiturates, carbamazepine, phenytoin, rifampacin and tobacco smoke

28
Q

what 2 drugs increase metabolism of ciclosporin by inducing CYP 3A4

A

Rifampicin

St john’s wort

29
Q

where are most drugs excreted

A

urine or bile

30
Q

what kind of secretion are changes in GFR

A

tubular

31
Q

when do Pharmacodynamics interactions occur

A

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
Q

what are pharmacodynamic interactions

A

direct, indirect, antagonistic and synergistic/ agonist

33
Q

what is direct antagonism

A

beta-blockers such as atenolol will block the actions of agonists e.g. bronchodilators such as salbutamol

34
Q

what are synergistic interactions

A

When two drugs with the same pharma-cological effect acting on the same receptor are give concurrently

principles of disease (39 decks)

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