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Pharmacology > Drug Interactions > Flashcards

Drug Interactions Flashcards

1
Q

what are three types of drugs that are most commonly involved in DDIs?

A

NSAIDs
anticoagulants
cardiovascular drugs

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2
Q

in this type of DI, one drug has a pharmacologic action that increases, decreases, or somehow alters the pharmacologic action of another drug

A

pharmacodynamic

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3
Q

this type of DI is related to the drug’s effect in the body
one drug modulates the pharmacologic effect of another (addictive, synergistic, or antagonist)
CANNOT be remedied by adjusting the dose of the interacting drugs

A

pharmacodynamic

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4
Q

in this type of DI, one drug alters the concentration of another drug in the body and usually can be remedied by adjusting the dose of the altered drug

A

pharmacokinetic

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5
Q

this is a group of enzymes in the liver that are highly involved in drug metabolism

A

CYP450 enzymes

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6
Q

this type of medication increases the rate of metabolic activity of a specific CYP450 enzyme

A

inducer

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7
Q

this type of medication decreases the rate of metabolic activity of a specific CYP450 enzyme

A

inhibitor

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8
Q

this type of medication uses CYP450 enzymes to be metabolized in the liver

A

substrate

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9
Q

these protein are transporters found in the gut and pump drugs out of the blood stream and into the gut

A

p-glycoproteins

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10
Q

are these p-glycoprotein inhibitors or substrates?
azole antifungals
ritonavir
verapamil
St. John’s Wort

A

inhibitor

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11
Q

are these p-glycoprotein inhibitors or substrates?
rivaroxaban
dabigatran- novel oral anticoagulants

A

substrates

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12
Q

2C9 inhibitors

A

bactrim
metronidazole

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13
Q

2D6 inhibitors

A

TCAs
fluoxetine
paroxetine

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14
Q

34A inhibitors

A

haloperidol
azoles
protease inhibitors
NNRTIs
diltiazem
verapamil
erythromycin

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15
Q

are these inducers or inhibitors?
rifampin
carbamazepine
phenobarbital
phenytoin
ritonavir
efavirenz
St. John’s Wort
Nafcillin

A

inducers

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16
Q

inducer timeline

A

2-3 weeks

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17
Q

inhibitor timeline

A

2-3 days

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18
Q

in what diseases should chronic NSAID use be avoided?

A

chronic renal insufficiency
heart failure
previous peptic ulcer

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19
Q

what drug should those with heart failure avoid?

A

diltiazem/ verapamil

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20
Q

what diseases should avoid metformin?

A

chronic renal insufficiency
heart failure

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21
Q

what diseases should avoid thiazide diuretics?

A

gout
renal insufficiency (GFR less than 30)

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22
Q

clinical presentations of DI

A

serious ADR
poor tolerability
decreased efficacy
worsening of disease state
withdrawal symptoms

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23
Q

with prodrugs, will inhibiting CYP450 enzymes increase or decrease active level of drug in the body?

A

decrease

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24
Q

with prodrugs, will inducing CYP450 enzymes increase or decrease active level of drug in the body?

A

increase

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25
Q

this drug is an inhibitor of 2C9, 2D6, 34A and P-glycoprotein

A

amiodarone

26
Q

what drug should avoid the consumption of grapefruit juice

A

amiodarone

27
Q

amiodarone decreases the dose of these medications by 30-50%

A

digoxin
warfarin

28
Q

what type of drug are these
ketoconazole
itraconazole
voriconazole
poasconazole

A

azole antifungals

29
Q

what 2 antifungals require low pH for effective absorption and must be avoided with drugs that increase pH (antacids, H2 blockers, proton pump inhibitors)

A

itraconazole
ketoconazole

30
Q

this azole antifungal is an inhibitor of 2C9, 2C19, and 3A4 and many drugs are contradicted

A

voriconazole

31
Q

this drug has a very narrow TI and is a substrate of p-glycoprotein

A

digoxin

32
Q

this drug has an inverse relationship with serum potassium levels

A

digoxin

33
Q

how is most of digoxin cleared?

A

renal excretion

34
Q

true or false- there is more risk of digoxin toxicity with hypokalemia

A

true

35
Q

this type of drug is a substrate of 3A4

A

statins

36
Q

what are the 3 most prevalent DI statin?

A

lovastatin
simvastatin
atorvastatin

37
Q

this drug is 100% renally cleared

A

lithium

38
Q

these conditions lead to increased lithium levels

A

NSAIDs
ACEI
ARBs
dehydration
diuretics

39
Q

what type of drugs are these
isocarboxazid
phenelzine
selegiliine
tranylcypromine

A

MAOIs

40
Q

these decrease MAOI metabolism

A

tyramine (aged, fermented, pickled, or smoked foods)
serotonin
NE and epi

41
Q

these drugs raise levels of monoamines

A

antidepressants
triptans
dextromethorphan

42
Q

this type of drug inhibits COX1 and COX2 enzymes and decrease the synthesis of PGs

A

NSAIDs

43
Q

NSAIDs carry risks of…

A

GI bleeding
kidney injury
cardiovascular toxicity

44
Q

CYP450 enzyme _____ decreases effectiveness of BC

A

inducers

45
Q

what 5 factors contradict BC

A

anticoagulants
St. Johns Wort
Abx
anti-retrovirals
smoking

46
Q

this drug is the gold standard inducer and is used to treat TB and leprosy

A

rifampin

47
Q

this drug is a strong inducer of CYP 2C9 2C19, and 3A4 and will decrease the concentration of any drug that is a substrate

A

rifampin

48
Q

this drug induces CYP 2C8, 9 and 19, 3A4, and p-glycoprotein

A

phenytoin

49
Q

this drug is highly protein bound and must have caution if pt on other CNS depressants (addictive effects)

A

phenytoin

50
Q

this drug is a strong 3A4 inducer and induces its own metabolism which decreases the level of 3A4 substrate drugs

A

carbamazepine

51
Q

3A4 inhibitors will ______ carbamazepine levels

A

increase

52
Q

3A4 inducers will _______ carbamazepine levels

A

decrease

53
Q

these must not be consumed within 2 hours of tetracycline and quinolone abx

A

vitamins
iron supplements
antacids
dairy
sucralfate
coated aspirin

54
Q

these types of drugs leads to decreased absorption of abx and chelates with aluminum, magnesium, calcium, iron, and zinc

A

tetracycline and quinolone abx

55
Q

what class of medication are these
ciprofloxacin
levofloxacin
moxifloxacin

A

tetracycline and quinolone abx

56
Q

this drug is a substrate of 2C9 (major) and 1A2 and 3A4 (minor)

A

warfarin

57
Q

induction of 2C9, 1A2, or 3A4 will _______ effectiveness of warfarin

A

decrease

58
Q

inhibition of 2C9, 1A2, or 3A4 will ______ effectiveness of warfarin

A

increase

59
Q

what drugs/ supplements lead to increased bleeding risk on warfarin?

A

NSAIDs and antiplatelets
garlic, ginseng, and gingko
foods/ supplements high in vitamin K

60
Q

this health condition may lead to cardiac arrhythmias and sudden cardiac death

A

hyperkalemia

61
Q

these medication classes may lead to hyperkalemia

A

ACEIs
ARBs
K+- sparing diuretics
trimethoprim
aldosterone antagonists
NSAIDs
digoxin
cyclosporine or tacrolimus

62
Q

these are drug classes that are red flags for QTc

A

warfarin
HAART meds
amiodarone
some antidepressants
quiolones
antipsychotics w/ abx
antiarrhythmics w/ abx
anti-epileptic meds
statins

Pharmacology (9 decks)

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