Drug Interactions

Question 1

What fraction of patients leave the doctor’s office w/ at least 1 prescription?

Answer 1

2/3

Question 2

What percentage of the US pop. has 4 or more prescriptions

Answer 2

40%

Question 3

The rate of ADRs increases after a patient is on how many medications?

Answer 3

4

Question 4

Cordarone should not be take with…?

Answer 4

Zocor - can lead to kidney failure or death

Question 5

Taking Antihistamines should be cautioned when taken with…?

Answer 5

sedatives, tranquilizers, high BP and depression medications

Question 6

Products taken by mouth that contain a “dietary ingredient”

Answer 6

Dietary Supplement

Question 7

What percentage of American adults use dietary supplements on a regular basis?

Answer 7

50%

Question 8

Which dietary supplement, used to treat DEPRESSION, induces the CYP450 system, and negatively reacts with BIRTH CONTROL?

Answer 8

St. John’s Wort

Question 9

This supplement should not be taken with blood-thinners as it can cause an increased risk of bleeding

Answer 9

Vitamin E

Question 10

This supplement counteracts coumadin

Answer 10

Vitamin K

Question 11

This supplement, used for memory, decreases the effectiveness of anticonvulsants

Answer 11

Ginko Biloba (also contains an anti-coagulant property)

Question 12

Food-Drug interactions are caused by which 3 general categories

Answer 12

Food, Caffeine, Alcohol

Question 13

To reduce Food-Drug interactions, take medications ___hrs before or ___hrs after eating

Answer 13

1hr before, 2hrs after

Question 14

Main food interaction recommended to avoid while taking medications

Answer 14

Alcohol

Question 15

Increases the risk for Lanoxin toxicity and may reduce effects of BP medication

Answer 15

Licorice

Question 16

MAOIs should not be consumed with excessive amounts of ___

Answer 16

Chocolate

Question 17

Has more than 40 interactions with drugs including Ca channel blockers, statins, and antihistamines

Answer 17

Grapefruit

Question 18

Should not be consumed while taking Warfarin

Answer 18

Cranberry juice (mainly) - as well as foods high in Vitamin K like dark green leafy vegetables, tomatoes and avocados - no guac for you :(

Question 19

Avoid foods high in ___ while taking MAOIs***

Answer 19

Tyramine (MAOs degrade tyramine)

Question 20

Effects of those taking MAOIs while ingesting foods high in tyramine***

Answer 20

BP spike and possible Stroke

Question 21

Foods high in tyramine***

Answer 21

Cheeses, draft beer, red wine, chocolate (ideal evening)

Question 22

Effect of Tobacco + Coffee

Answer 22

Tobacco speeds up same enzymes needed to clear caffeine - creates a coffee tolerance

Question 23

Foods/Supplements that INDUCE CYP

Answer 23

Caffeine, Licorice, Alcohol, St. John’s Wort, Tobacco - (CLAST)

Question 24

Foods/Supplements that INHIBIT CYP

Answer 24

Black Cohosh, Echinacea, Ginko, Grapefruit - (BEGG)

Question 25

Why should you not give supplements/foods that interfere with CYP enzymes to patients already on other medications

Answer 25

May cause TOXICITY or other life-threatening reactions

Question 26

Side effects of nutrient depletions

Answer 26

GI related - nausea, vomiting, diarrhea, constipation, decreased absorption

Question 27

Antibiotics deplete

Answer 27

Vitamin K

Question 28

SSRIs deplete

Answer 28

Sodium, melatonin