drug interaction Flashcards

Question

When can changes in drug distribution occur

Answer 1

One agent alters size of physical compartment in which another drug distributes

Answer 2

Diuretic = reduce total body’ water = increase plasma levels of amino glycosides and lithium = possibly enhancing drug toxic ties = differences in drug absptoptn

Answer 3

Major group enzymes that metabolize = in liver Cytochrome p450 fam of enzymes Drugs/vitamins/supplements or diseases that effect this fam =- have effects on metabolism

Answer 4

Pharmacogenietcis Ppl hav edify expression Many differences - if metabolize faster If give multiple drugs = complex since person already has differences in ability to absorb dru

Answer 5

Absent in 7% Caucasians 1-2% in non csuaisns Hyperactive in up to 30% of East Africans Catalyze primary metabolism of Codiein, many b blockers, many tricyclic antidepressants Inhibited by fluzetine, haloperidol, paroxetinem quinidine

Answer 6

Responsible for metabolism of Most calcium channel blocks Benzos Most hiv pro taste inhibitors =ppl with chronic illness, affects drug they take Present in gi tract and liver

Answer 7

If take any of these drugs = inhibit, need to thin about other drugs that require this enzyme Ketoconazole Itraconazole Fluconazole Cimetidine Calrithromycin Erythromycin Troleandromycin Grape fruit juice

Answer 8

Drugs that reduce hepatic blood flow (eg., propranolol) may reduce the clearance of other drugs metabolized in the liver, especially those subject to flow limited hepatic clearance such as morphine and verapamil. Affects hepatic blood flow = slows it down, reduces ability of body to eliminate other drug Can cause toxicity if not metabolizing proreply = not properly eliminated = effects frequency of drug and will last for longe time

Answer 9

Increase efficacy p450s isozymes Chronic admin of barbiturates, carbamazepine, ethanol, phenytoin, rifampin

Answer 10

Inhibit drug metabolize ezznyems Cimetidine, disulfram, erythromycin, furanocoumarins - in grapefruit juice Ketocaonzaole,quininde, ritonasviry, sulfonamides

Answer 11

Monoamine oxidase inhibitors (MAOIs) were the first type of antidepressant develope not on market anymore since cause cardiac arrhythmias People taking MAOIs generally need to change their diets to limit or avoid foods and beverages containing tyramine, which is found in products such as cheese, soy sauce, and salami. If large amounts of tyramine are consumed, they may suffer a hypertensive crisis, which can be fatal. = limits bodies ability to eliminate tyramine, displaces norepinephrine = can cause vasoconstriction arrhythmia = heat bests faster and affects ability to breathe

Answer 12

Tyramine displaces norepinephrine, epinephrine, and dopamine from pre-synaptic storage vesicles. The release of these neurotransmitters, particularly norepinephrine, is responsible for vasoconstriction, increased heart rate, and a rise in blood pressure. Therefore, tyramine functions as an indirect sympathomimetic by causing the release of presynaptic endogenous neurotransmitters. Tyramine acts as a substrate for monoamine oxidase, further limiting the breakdown of monoamine neurotransmitters.

Answer 13

Can be inhibited = ex = Sentra may inhibit warfarin, increasing risk of toxicity or bleeds Metabolism induced = ex = rifampin may induce warfarin metabolism Competitive substrates = 2 meds metabolized by same enzyme = competes binding, sometimes only 1 drug effect seen or not drug effect = outcompete each other and don’t bind enzyme

Answer 14

Excretion of drugs by the kidney can be changed by drugs that reduce renal blood flow (eg, β blockers) or inhibit specific renal transport mechanisms (eg, the action of aspirin on uric acid secretion in the proximal tubule). Drugs that alter urinary pH can alter the ionization state of drugs that are weak acids or weak bases, leading to changes in renal tubular reabsorption. = affect ability to eliminate Can result in toxic effects from accumulation fo broken down drug

Answer 15

Penicillin and probenecid Penicillins taken every 6 hrs, up to 4 times daily = maintain adequate concentration in body If taken with probenicid = where elimination reducers = can be given once daily and maintain good concentration Bc elimination effected

Answer 16

How drug interacts with receptors

Answer 17

BRONCHODILATING effects of β2 adrenoceptor activators used in asthma is to be anticipated if a β blocker is given for another condition. If taken together = no effect = giv b2 agonist to stop bronchial obstruction, usually inhaled, helps, if have anxiety = give b blockers = will interact with asthma meds - counter effect

Answer 18

action of a catecholamine on heart rate (via βadrenoceptor activation) is antagonized by an inhibitor of acetylcholinesterase that acts through acetylcholine (via muscarinic receptors). Drug that inhibits muscarinin = helps airway constritrcition but if taking another drug at hot turns on muscarinicn = counter each other

Answer 19

Antagonism by mixed agonistant agonist drugs (eg, pentazocine) or by partial agonists (eg, pindolol) is not as easily predicted but should be expected when such drugs are used with pure agonists. Some drug antagonisms do not appear to be based on receptor interactions. For example, nonsteroidal anti- inflammatory drugs (NSAIDs) may decrease the antihypertensive action of angiotensin converting enzyme (ACE) inhibitors by reducing renal elimination of sodium. When given with another drug = can go ether way, complex to uderstsnd, must do studies

Answer 20

Additive interaction describes 2 drugs may or may not act on same receptor to produce such effects

Answer 21

The combination of tricyclic antidepressants with diphenhydramine or promethazine (anti-histamines) predictably causes excessive atropine like effects: These include dryness of the mouth, blurred vision, dry eyes, photophobia, confusion, headache, dizziness, fatigue. * becausethesedrugshavesignificant muscarinic receptor blocking actions Drugs work on diff receptor but have similar additive effect - negative together

Answer 22

Additive effects of anticoagulant drugs can lead to bleeding complications. In the case of warfarin, the potential for such adverse effects is enhanced by aspirin (via an antiplatelet action), thrombolytics (via plasminogen activation), and the thyroid hormones (via enhanced clotting factor catabolism). Aspirin and warfare = can have both anticoagulant effects but work through diff mechanism and pathways but same outcome

Answer 23

Supraadditive (Synergistic) interactions and potentiation appear to be much less common than antagonism and the simple additive interactions described previously. * result of interaction is greater than the sum of the drugs used alone

Answer 24

the best example is the therapeutic synergism of certain antibiotic combinations such as sulfonamides and dihydrofolic acid reductase inhibitors such as trimethoprim. Potentiation is said to occur when a drug’s effect is increased by another agent that has no such effect. Each works bit on own but when combine = works v well

Answer 25

Because of the marked increase in use of herbal medications, more interactions of these agents with purified drugs are being reported. Several herbals listed are known to enhance the actions of anticoagulants. Many other herbs, or edible plants, also contain compounds with anticoagulant or antiplatelet potential, including anise, arnica, capsicum, celery, chamomile, clove, feverfew, garlic, ginger, horseradish, meadowsweet, onion, passion flower, turmeric, and wild lettuce. Can cause excessive bleeding

Answer 26

Ingested, topic, eye drops inhibits the growth and replication of a bacterium or kills it outright can be called an antibiotic. Antibiotics are a type of antimicrobial designed to target bacterial infections within (or on) the body.

Answer 27

Antiseptics are used to sterilise surfaces of living tissue when the risk of infection is high, such as during surgery. * Disinfectants are non-selective antimicrobials, killing a wide range of micro-organisms including bacteria. They are used on non-living surfaces, for example in hospitals. Usually have alcohol = does not inject antiseptics

Answer 28

term antibiotic was used to refer to substances produced by microorganisms that suppress the growth of other microorganisms Antibacterial was more encompassing and used to describe not only natural antibiotics produced by microorganisms but also drugs synthesized in the laboratory. The distinction between these compounds is somewhat blurred today, and both terms are often used interchangeably to refer to any synthetic, semisynthetic, or natural compound used in medicine to eradicate or injure bacteria.

Answer 29

Bacteria are single celled microorganism. * The cell structure is simpler than that of other organisms as there is no nucleus or membrane bound organelles. Can see without microscope Replicated by asexual reproduction - male or female

Answer 30

five groups according to their basic shapes: spherical (cocci), rod (bacilli), spiral (spirilla), comma (vibrios) or corkscrew (spirochaetes). They can exist as single cells, in pairs, chains or clusters. Also classified by cell structure When sick = look kinds of bacteria under microscope = morphology, shape hints at type of bacteria

Answer 31

In gut = live in symbiosis and help you metabolize and energy and protect from infections Most antibiotics also clear good bacteria = bad

Answer 32

* Escherichia coli and Salmonella cause food poisoning. * Helicobacter pylori cause gastritis and ulcers. * Neisseria gonorrhoeae causes the sexually transmitted disease gonorrhea. * Neisseria meningitidis causes meningitis. * Staphylococcus aureus causes a variety of infections in the body, including boils, cellulitis, abscesses, wound infections, toxic shock syndrome, pneumonia, and food poisoning. * Streptococcal bacteria cause a variety of infections in the body, including pneumonia, meningitis, ear infections, and strep throat.

Answer 33

Gram neg = usually rods, pink Gram pos = positive for stain, usually cocci= purple

Answer 34

Can have antibiotics v good at killing gram neg or pos = good since only clearing that type fo bacteria, not all bacteria from gut microbiome Broad spectrum = can kill both gram neg and pos

Answer 35

Drug resistance can be defined as the ability of bacteria to withstand the effects of an antibacterial agent. * Each year in the U.S., at least 2.8 million people are infected with antibiotic- resistant bacteria, and more than 35,000 people die as a result. Many antibiotics not effective anymore Many drug developments = stopped for antibiotics but bad since resistance now

Answer 36

Asexual and no nuclei = spread antibiotic resistance genes very effective

Answer 37

No one can completely avoid the risk of resistant infections, but some people are at greater risk than others (for example, people with chronic illnesses). Usually bc these ppl t get eprscribed antibiotics frequently = bacteria developers more resistance genes, the more they are exposed to antibiotics

Answer 38

* If antibiotics lose their effectiveness, then we lose the ability to treat infections and control public health threats. * Many medical advances are dependent on the ability to fight infections using antibiotics, including joint replacements, organ transplants, cancer therapy, and treatment of chronic diseases like diabetes, asthma, and rheumatoid arthritis.

Answer 39

Some bacteria in human body drug resistant- usually just one bacteria having resistant then spread to colon and replicate fast and can also spread to other species bacteria = cocci to rods

Answer 40

Use multiple to help clear infection Initiate through t = provide coverage of mutiple causative organisms Prevent anti optics resistance Achieve Synergy Permit use of lower doses drugs If clear them out = cannot spread ability of antibiotic resistance gene

Answer 41

Same state goes = synergistic, antagonistic, additive effects

Answer 42

Synergism is present if the activity of the combined antimicrobial agents is greater than the sum of the independent activities.

Answer 43

Indifferent effects are present if the combined activity of the antimicrobial agents is similar to the greatest effect produced by an individual drug alone.

Answer 44

Antagonism is present when the activity of the combination is less than what could have been achieved by using the agents separately. Not better than individual one alone

Answer 45

Penicillin = cell wall inhibitor, inhibits ability of bacteria o make cell way = destroys integrity of cell bacterial die Aminoglycosisdes = protein synthesis inhibitor, must reach ribosomes, affect ability fo drug to replicate, bacterial wont produce enzymes that stope penicilin Works synergsitcial = can use 1/2 dose each

Answer 46

* Gram-negative opportunistic pathogen= rod * Pneumoniainventilatedpatients = skin infection, eye infections too * ESKAPE * Multi-drugresistant -= to many antibiotics available

Answer 47

Ways for it to grow in body * Type 3 “Injectisome” : Injects multiple virulence factors into host cells. * Used for pore formation in the host cell Allows syringe to inject toxin into body

Answer 48

Highly expressed, polysaccharide expressed on surface *Abundant, serotype independent exopolysaccharide. *Promotes bacterial aggregation & tissue adherence (colonization) *Component in biofilm formation & maintenance (persistence) *Implicated in immune evasion

Answer 49

Anti - per v = blocks t3s function Anti psl = blocks exopopolysaccraride psl function = targets secretion system and polysaccharide and blocks function of the. 2 molecules Inject mouse with antibody = attaché and helps phagocytosis cell like macrophages or neutrohpiels to recognize pseudomonas and clear it

Answer 50

Meropenem (MEM) is a broad- spectrum carbapenem antibiotic. It is active against Gram-positive and Gram- negative bacteria. Meropenem exerts its action by penetrating bacterial cells readily and interfering with the synthesis of vital cell wall components, which leads to cell death.

Answer 51

Pseudomonas = resistant to almost all classes antibiotic Control = no treatment Mem - most very sick BiS4alPHA P = 0.2pk = antibiotic = gave sub therapeutic dose If combine = BiS4alPHA Mem = mouse survives Combo of 2= works