drug interactions Flashcards
acetaminophen
● Increased effect with caffeine.
● Decreased effect with antacids, anticholinergics, carbamazepine, and phenytoin.
● Alcohol may increase hepatotoxicity risk
activated charcoal
● Moderate interactions with acetylcysteine, citalopram, digoxin, dyphylline, methotrexate, and theophylline
adenosine
● Methylxanthines (stimulants) block actions of adenosine.
● Actions are potentiated with dipyridamole, carbamazepine, and nicotine
albuterol
● May potentiate hypokalemia caused by diuretics
amiodorone
● May increase the effects of digoxin, disopyramide, fentanyl, lidocaine,
procainamide, quinide, or warfarin.
● Cimetidine may increase amiodarone levels.
● Beta blockers or calcium channel blockers may potentiate bradycardia, sinus
arrest and AV blocks.
● Amiodarone will precipitate with sodium bicarbonate and heparin. Use a
different IV if coadministering.
● Do not combine with other drugs that prolong the QT interval (ondansetron,
procainamide)
aspirin
● Increased risk of bleeding with concurrent anticoagulant/NSAID use.
● Diminishes effects of ACE inhibitors and loop diuretics.
● Decreased effectiveness and absorption with antacids and corticosteroids.
● Increased risk of hypoglycemia when administered with oral hypoglycemic
drugs.
atropine
● Potential adverse effects with administered with digitalis, cholinergics, and
physostigmine.
● Effects enhanced by antihistamines, procainamide, quinidine, antipsychotics,
benzodiazepines and antidepressants.
calcium chloride
● May increase ventricular irritability and precipitate digitalis toxicity when taken
with digoxin.
● Potentiated by thiazide diuretics
● Incompatible with most medications
calcium gluconate
● Severe bradycardia with concurrent digitalis use.
● Incompatible with most medications
dexamethasone
● Simultaneous use with ASA/NSAIDs may increase risk of GI bleed and ulcers.
● Concurrent use with diuretics can result in hypokalemia
dextrose
Sodium Bicarbonate, Warfarin
diazepam
● Incompatible with most drugs and fluids
diltiazem
● Use with caution in patients taking medications that affect cardiac contractility
diphenhydramine hydrochloride
● Potentiates effects of CNS depressants.
● MAOIs prolong and intensify anticholinergic effects.
dopamine hydrochloride
● Deactivated by alkaline solutions.
● MAOIs and TCAs prolong and potentiate effects.
● Beta blockers antagonize cardiac effects.
● Simultaneous use of vasopressors may result in severe hypertension.
● Simultaneous administration of phenytoin may cause hypotension, bradycardia
and seizures
epinephrine
none
etomidate
● Potentiated by other CNS depressants
fentanyl citrate
none
flumazenil
● Toxic effects when combined with TCAs
furosemide
● May potentiate lithium toxicity and digitalis toxicity because of sodium depletion and potassium depletion, respectively
glucagon
● Incompatible in solution with most substances
glucose, oral
none