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Pharmacology > drug interactions > Flashcards

drug interactions Flashcards

1
Q

CVS meds (ACE inhibitors, diuretics, beta blockers, digoxin) rely on the function of what

A

kidney

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2
Q

what do NSAIDs do that prevent ACE inhibitors from working? What is the resulting effect?

A
  • NSAIDs block prostaglandins so they block kidney function
  • ACE inhibitors rely on kidney function
  • BP increases
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3
Q

how long does it take for an interaction to occur between NSAIDs and other drugs

A

7-10 days

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4
Q

does high or low dose of methotrexate interact with NSAIDS

A

high dose interacts; low does not

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5
Q

interaction between acetominophen and NSAIDs is good or bad?

A

good

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6
Q

interaction between misoprostol and NSAIDs is good or bad?

A

good

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7
Q

what is misoprostol used to treat

A

ulcers and gastric bleeding

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8
Q

can you take misoprostol if you want to get pregnant

A

no. it causes abortion

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9
Q

name 5 drugs with a low therapeutic index

A
  • lithium
  • digoxin
  • carbamazepine
  • warfarin
  • cyclosporine
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10
Q

what are the 4 pharmacodynamic effects that can occur with drug interactions

A
  • antagonism
  • unexpected drug effect
  • summation
  • synergism/potentiation
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11
Q

antagonism

A

reduction of drug response by one or both drugs

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12
Q

unexpected drug effect

A

combination of drugs gives response not observed when given individual drug

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13
Q

summation

A

both drugs show their effects

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14
Q

synergism/potentiation

A

drugs show GREATER effect than each individually

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15
Q

why is epi given with LA

A

constrict blood bc LA causes dilation

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16
Q

name 5 things than interact with epi

A
  • beta blockers
  • tricycle antidepressants (TCA)
  • GA
  • cocaine
  • amphetamines
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17
Q

what happens if you are taking beta blockers and you get epi

A
  • beta blockers prevent vasodilation of b.v. of skeletal m (beta 2)
  • vasoconstriction still happens with alpha 1
  • vasoconstriction with no vasodilation => increase BP
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18
Q

what happens if you are taking TCA and you get epi

A
  • increase HR and BP

- abnormal heart rhythm

19
Q

what happens if you are taking cocaine and amphetamines and you get epi

A
  • increase BP
  • may lead to cardiac arrhythmia
  • toxicity
20
Q

what happens if you are taking GA and you get epi

A

-cardiac arrythmia

21
Q

how does omeprazole affect absorption

A
  • its a proton pump inhibitor and changes GI pH

- affects ionization of another drug in stomach => ionized is harder to absorb

22
Q

how can tetracycline absorption get affected

A

chelation of tetracycline with calcium or iron ions slow absorption

23
Q

metoclopramide increases gastric motility. how does this affect absorption?

A

earlier and higher peak concentrations

24
Q

opioids decrease gastric motility. how does this affect absorption?

A

slower, later, and lower peak concentrations

25
Q

how does taking Abx chronically affect absorption

A

changes bowel bacteria which help with absorption

26
Q

if Abx wipe out bowel bacteria, which drug would have an issue getting absorbed

A

digoxin

27
Q

displacement phenomenon

A

if 2 drugs have the affinity for the binding site, the one with greater affinity will displace the other

28
Q

main enzymes for metabolism in the liver

A

CYP P450

29
Q

what happens if drug A induces CYP for drug B

A

B gets metabolised => less effectiveness

30
Q

what happens if drug A inhibits CYP for drug B

A

B increases in body => OD or toxic effects

31
Q

what does rifampin do to warfarin

A

rifampin is an inducer => more enzymes => more warfarin gets metabolised => low INR decreases

32
Q

what does ketoconazole do to warfarin

A

ketoconazole is an inhibitor => less enzymes => more warfarin available => high INR

33
Q

low INR means

A

coagulation, clots, stroke

34
Q

high INR means

A

high bleeding

35
Q

what does st johns wort do to cyclosporine A

A

it induces 34A and 1A2 => cyclosporine is metabolised

36
Q

what does st johns wort do to crixivan

A

lowers its levels to ineffective levels

37
Q

what does grapefruit do to CYP3A4

A

inhibits CYP 34A

38
Q

is enzyme inhibition fast or slow? why

A

fast; may be binding competitively

39
Q

is enzyme induction fast or slow? why

A

slow; involves protein synthesis

40
Q

pt is on a prodrug. what happens if they take an inducer

A

INCREASE of the drug

41
Q

pt is on a prodrug. what happens if they take an inhibitor

A

DECREASE of the drug

42
Q

codeine is considered a “prodrug” because it gets metabolized by 2D6 to morphine. why do some people not feel like “codeine is working”?

A

genetic variability of amount of 2D6. so if little, codeine doesnt go to morphine (so no affect)

43
Q

in tubular secretion, drugs compete for transport to secretion. how might this be useful?

A

drug A prevents drug B from secretion to maintain conc of B in the body

44
Q

name 2 deliberate drug interactions that are beneficial

A
  • misoprolol and NSAID

- probenacid and penicillin

Pharmacology (17 decks)

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