Drug Interactions Flashcards
1
Q
CYP INDUCERS (PS PORCS)
A
Phenytoin Smoking Phenobarbital Oxcarbazepine Rifampin Carbamazepine St. John's wort
2
Q
CYP INHIBITORS (G PACMAN)
A
Grapefruit juice Protease inhibitors Azoles Cyclosporine, cimetidine, cobicistat Macrolides (but NOT azithromycin) Amiodarone Non-DHP CCBs (diltiazem, verapamil)
3
Q
Effects of CYP inducers
A
- increased metabolism of substrates
- decreased serum concentrations and decreased clinical effect of substrates
- inDucers = Decreased levels/effects of substrates
- Prodrugs–inducers increase levels of active drug form
4
Q
Effects of CYP inhibitors
A
- decreased metabolism of substrates
- increased serum concentrations and increased clinical effects of substrates
- INhibitors = INcreased effects/levels/ADR/toxicities of substrates
- Prodrugs–inhibitors decrease levels of active drug form
5
Q
P-GP substrates
(PGP transports drugs and their metabolites out of the body by pumping them into the gut where they can be excreted in the stool)
A
- Anticoagulants- apixaban, rivaroxaban, edoxaban
- Cardiovascular drugs- carvediol, digoxin, ranolazine
- Immunosuppressants- cyclosporine, sirolimus, tacrolimus
- HCV drugs- dasabuvir, paritaprevir, simeprevir, sofosbuvir
- Others- colchicine, dolutegravir, raltegravir, saxagliptin
6
Q
P-GP inducers
A
carbamazepine dexamethasone phenobarbital phenytoin rifampin St. John's wort tipranavir
7
Q
P-GP inhibitors
A
- Anti-infectives- clarithromycin, itraconazole, posaconazole
- Cardiovascular drugs- amiodarone, carvedilol, dronedarone, conivaptan, diltiazem, verapamil
- HIV drugs- cobicistat, ritonavir
- HCV drugs- daclatasvir, ledipasvir, simeprevir
- Others- cyclosporine, flibanserin, ticagrelor
8
Q
CYP3A4 substrates
A
- Analgesics- buprenorphine, diclofenac, fentanyl, hydrocodone, meloxicam, tramadol
- Anticoagulants
- Antidiabetic drugs- pioglitazone, repaglinide, saxagliptin, sitagliptin
- Antiplatelet drugs- cilostazol, prasugrel, ticagrelor
- Cardiovascular drugs- aminodarone, diltiazem, eplerenone, ivabradine, nifedipine, quinidine, tolvaptan, verapamil
- Immunosuppressants- cyclosporine, tacrolimus, sirolimus
- Statins- atorvastatin, lovastatin, simvastatin
- HIV drugs- atazanavir, efavirenz, ritonavir, tipramavir
- PDE-5 inhibitors- sildenafil, tadalafil, vardenafil
9
Q
CYP3A4 inducers
A
carbamazepine oxcarbazepine phenytoin phenobarbital primidone rifabutin rifampin rifapentine smoking St. John's wort
10
Q
CYP3A4 inhibitors
A
- Anti-infectives- clarithromycin, erythromycin, azoles, isoniazid
- Cardiovascular drugs- amiodarone, diltiazem, dronedarone, quinidine, ranolazine, verapamil
- HIV drugs- atazanavir, cobicistat, efavirenz, darunavir, ritonavir
- Others- aprepitant, cimetidine, cyclosporine, grapefruit juice, haloperidol, sertraline
11
Q
CYP1A2 substrates
A
alosetron, aprepitant, clozapine, cyclobenzaprine, duloxetine, ethinyl estradiol, fluvoxamine, methadone, mirtazapine, olanzapine, ondansetron, pimozide, propranolol, rasagiline, ropinirole, theophylline, warfarin
12
Q
CYP1A2 inducers
A
carbamazepine phenobarbital phenytoin primidone rifampin ritonavir smoking** St. John's wort
13
Q
CYP1A2 inhibitors
A
atazanavir cimetidine ciprofloxacin fluvoxamine zileuton
14
Q
CYP2C8 substrates
A
amiodarone dasabuvir pioglitazone repaglinide rosiglitazone
15
Q
CYP2C8 inducers
A
phenytoin
rifampin
