Drug Interactions

Question 1

what happens when you give Indinavir and St. John’s Wort?

Answer 1

Decrease AUC and Decr Cmax of indinavir

Question 2

Indinavir is a ____
SJW induces what?

Answer 2

cyp3A substrate
-CYP3A

Question 3

A clinically signif DI is when the ___ or ___ of a drug is changed to such an extent that a ___ or ____ is needed

Answer 3

therapeutic activity , toxicity , dose adjustment, medical intervention

Question 4

What’s an object drug?
Precipitant drug?

Answer 4

Object : Drug affected by interaction

Precipitant : Drug causes the interaction

Question 5

Chelation
1. Affects ___
2. Whats an example?

Answer 5

1. absorption
2. cipro and orange juice

Question 6

What are some strong or common CYP Inhibitors? (6)

What are some strong or common inducers?

Answer 6

Ketoconazole, itraconazole, cimetidine, Grapefruit juice, erythromycin, clarithromycin

Rifampin, carbamazepine, St johns wort

Question 7

Determine if there’s a SIGNIF risk of an adverse outcome

1. Identify ___ and ___ factors
2. Level of _____ in ___
3. Determine ___ of interaction. Can you anticipate the DI will result in a loss of ___ incr ___ or an ___ of the dose of the object drug?

Answer 7

1. Patient, drug related
   (Low F, route of admin, diet)
2. Documentation , literature
3. significance
   -efficacy, toxicity, adjustment

Question 8

Providing a recommendation
-recommend an alternative ____ drug
-Recc a ___ for object drug
-Recc ____ in dosing times
-Recc ___ for altered response

Answer 8

non interacting

dose adjustment

adjustment

monitoring

Question 9

What happens with Ketoconazole and Saxagliptin?

Answer 9

Keto inhibits CYP3A4, incr saxagliptin (cyp 3A substrate) –> drug induced hypoglycemia