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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
this drug is an inhibitor of 2C9, 2D6, 34A and P-glycoprotein
amiodarone
26
what drug should avoid the consumption of grapefruit juice
amiodarone
27
amiodarone decreases the dose of these medications by 30-50%
digoxin warfarin
28
what type of drug are these ketoconazole itraconazole voriconazole poasconazole
azole antifungals
29
what 2 antifungals require low pH for effective absorption and must be avoided with drugs that increase pH (antacids, H2 blockers, proton pump inhibitors)
itraconazole ketoconazole
30
this azole antifungal is an inhibitor of 2C9, 2C19, and 3A4 and many drugs are contradicted
voriconazole
31
this drug has a very narrow TI and is a substrate of p-glycoprotein
digoxin
32
this drug has an inverse relationship with serum potassium levels
digoxin
33
how is most of digoxin cleared?
renal excretion
34
true or false- there is more risk of digoxin toxicity with hypokalemia
true
35
this type of drug is a substrate of 3A4
statins
36
what are the 3 most prevalent DI statin?
lovastatin simvastatin atorvastatin
37
this drug is 100% renally cleared
lithium
38
these conditions lead to increased lithium levels
NSAIDs ACEI ARBs dehydration diuretics
39
what type of drugs are these isocarboxazid phenelzine selegiliine tranylcypromine
MAOIs
40
these decrease MAOI metabolism
tyramine (aged, fermented, pickled, or smoked foods) serotonin NE and epi
41
these drugs raise levels of monoamines
antidepressants triptans dextromethorphan
42
this type of drug inhibits COX1 and COX2 enzymes and decrease the synthesis of PGs
NSAIDs
43
NSAIDs carry risks of...
GI bleeding kidney injury cardiovascular toxicity
44
CYP450 enzyme _____ decreases effectiveness of BC
inducers
45
what 5 factors contradict BC
anticoagulants St. Johns Wort Abx anti-retrovirals smoking
46
this drug is the gold standard inducer and is used to treat TB and leprosy
rifampin
47
this drug is a strong inducer of CYP 2C9 2C19, and 3A4 and will decrease the concentration of any drug that is a substrate
rifampin
48
this drug induces CYP 2C8, 9 and 19, 3A4, and p-glycoprotein
phenytoin
49
this drug is highly protein bound and must have caution if pt on other CNS depressants (addictive effects)
phenytoin
50
this drug is a strong 3A4 inducer and induces its own metabolism which decreases the level of 3A4 substrate drugs
carbamazepine
51
3A4 inhibitors will ______ carbamazepine levels
increase
52
3A4 inducers will _______ carbamazepine levels
decrease
53
these must not be consumed within 2 hours of tetracycline and quinolone abx
vitamins iron supplements antacids dairy sucralfate coated aspirin
54
these types of drugs leads to decreased absorption of abx and chelates with aluminum, magnesium, calcium, iron, and zinc
tetracycline and quinolone abx
55
what class of medication are these ciprofloxacin levofloxacin moxifloxacin
tetracycline and quinolone abx
56
this drug is a substrate of 2C9 (major) and 1A2 and 3A4 (minor)
warfarin
57
induction of 2C9, 1A2, or 3A4 will _______ effectiveness of warfarin
decrease
58
inhibition of 2C9, 1A2, or 3A4 will ______ effectiveness of warfarin
increase
59
what drugs/ supplements lead to increased bleeding risk on warfarin?
NSAIDs and antiplatelets garlic, ginseng, and gingko foods/ supplements high in vitamin K
60
this health condition may lead to cardiac arrhythmias and sudden cardiac death
hyperkalemia
61
these medication classes may lead to hyperkalemia
ACEIs ARBs K+- sparing diuretics trimethoprim aldosterone antagonists NSAIDs digoxin cyclosporine or tacrolimus
62
these are drug classes that are red flags for QTc
warfarin HAART meds amiodarone some antidepressants quiolones antipsychotics w/ abx antiarrhythmics w/ abx anti-epileptic meds statins

Pharmacology (13 decks)

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