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Principles of Disease > Drug Interactions > Flashcards

Drug Interactions Flashcards

1
Q

What is a drug interaction?

A

Modification of drugs effect by prior or concomitant administration of another drug herb foodstuff drink.

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2
Q

What are the 5 types of drug interactions?

A 
Drug
Herbal
Food
Drink
Pharmacogenetic
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3
Q

What is the object drug?

A

The drug whose activity is affected by the interaction.

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4
Q

What is the precipitant drug?

A

Agent which precipitates such an interaction.

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5
Q

What factors modify drug action?

A

Food
Smoking
Alcohol
Herbs

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6
Q

What drug interactions are not detrimental?

A

Treatment of hypertension

Treatment of Parkinsonism

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7
Q

What are the patient specific risk factors?

A

Advanced age
Genetic polymorphisms
Concomitant diseases

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8
Q

What are the drug specific risk factors?

A

Polypharmacy
Narrow therapeutic range
Dose

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9
Q

What are the other risk factors?

A

Multiple prescribing physicians
Self prescription
Prolonged length of stay

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10
Q

Drugs involved with serious interactions have narrow/broad therapeutic index.

A

Narrow

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11
Q

What are the drugs involved with serious interactions that are in the antimicrobial booklet?

A 
Cyclosporin
Gentamicin
Fluconazole
Clarithromycin
Erythromycin
Linezolid
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12
Q

What foods interact with warfarin?

A 
Asparagus
Broccoli
Lettuce
Onions
Avocado
Fish oils
Liver
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13
Q

What herbals interact with warfarin?

A

Ginseng

Green tea

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14
Q

Who are susceptible patients?

A

Elderly
Young
Critically Ill
Patients undergoing complicated surgical procedures.

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15
Q

What chronic conditions make patients susceptible?

A 
Liver disease
Renal impairment
Diabetes mellitus
Epilepsy
Asthma
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16
Q

What are the 2 mechanisms of drug interaction?

A

Pharmaceutical

Pharmacokinetic

17
Q

What are the 4 stages of pharmacokinetic?

A

Absorption
Distribution
Metabolism
Elimination

18
Q

What are the 4 types of pharmacodynamic reactions?

A

Antagonistic
Additive/Synergistic
Interactions due to drug transport
Interactions due to fluid/electrolyte distribution

19
Q

What can you predict?

A

If there is a potential drug interaction, but not the clinical severity

20
Q

What are the 4 mechanisms of absorption interactions?

A

Insoluble complexes
Altered pH
Altered bacterial flora
Altered GI motility

21
Q

How are drug interactions stopped in absorption?

A

Time before and after taking pill before eating for example.

22
Q

What does tetracycline/erythromycin bind to in the GI tract?

A

Iron
Calcium
Magnesium

23
Q

Where are GI bacterial flora found?

A

Large bowel

24
Q

What can GI bacterial flora lead to failure of?

A

Oral contraceptive

Digoxin toxicity

25
Q

When does protein binding displacement occur?

A

When there is a reduction in the extent of plasma protein binding

26
Q

What are the 2 most important proteins?

A

Albumin

Alpha 1-glycoprotein

27
Q

Are drugs with protein binding greater than 95% common?

A

Yes

28
Q

What does erythromycin/clarithromycin inhibit?

A

Cytochrome system

29
Q

What does an inhibited cytochrome system cause?

A

Metabolism in liver failure.

30
Q

What does tobacco induce?

A

Cytochrome P450 system

31
Q

Where are most drugs excreted?

A

Urine

Bile

32
Q

What occurs in elimination?

A

Changes in GFR or tubular secretion

33
Q

What are the 4 ways pharmacodynamic interactions can occur?

A

Direct
Indirect
Antagonistic
Synergistic

34
Q

What is an example of direct antagonism?

A

Beta-blockers

35
Q

What happens in synergistic interactions?

A

When two drugs with the same pharmacological effect act on the same receptor at the same time.

36
Q

What is CNS depression interactions?

A

Indirect agonism

Principles of Disease (42 decks)

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