Drug/nutrient interaction

Question 1

What is alendronate (fosamax) used for?

Answer 1

Bisphosphate used to prevent one resorption

Question 2

What are the interactions that are concerning for alendronate (fosamax)?

Answer 2

Presence of liquids can reduce absorption up to 60% (take two hours prior to a meal)

Question 3

What is ondansetron (zofran) used for?

Answer 3

Antiemetic

Question 4

What are the concerning drug interactions with ondansetron (zofran)?

Answer 4

Increased absorption with increased GI transit time (with food)

Question 5

What is ciprofloxacin used for?

Answer 5

Antibiotic

Question 6

What are the concerning interactions with cipro?

Answer 6

Cipro can bind divalent cations (Ca, Fe, Zn etc) and impairs drug absorption

Question 7

What is omeprazole (prilosec) used for?

Answer 7

PPI

Question 8

What are the concerning interactions of omeprazole (prilosec)?

Answer 8

Impairs B12 absorption d/t higher pH of the stomach

Question 9

What is colestipol (colestid) used for?

Answer 9

Antilipidemic agent to treat hyperlipidemia

Question 10

What are the concerning interactions for colestipol (colestid)?

Answer 10

Loss of ADEK vitamin absorption

Question 11

What is the MOA of colestipol (colestid)?

Answer 11

Sequesters bile salts and causes the liver to pull more cholesterol from the blood to make bile salts

Question 12

What nutrient does cipro impair the absorption of?

Answer 12

Ca

Question 13

What is the use of phenytoin (dilantin)?

Answer 13

Anticonvulsant

Question 14

What is the interaction that is concerning for phenytoin (dilantin)?

Answer 14

Hypoproteinemia will increase the doseage of the drug d/t loss of binding proteins

Question 15

What is ethinyl estradiol used for?

Answer 15

Oral contraception

Question 16

What is the is the concerning interaction of ethinyl estradiol?

Answer 16

St. John’s wort increases p450 enzyme, increasing the metabolism of ethinyl estradiol

Question 17

What is the clinical use of simvastatin (zocor)? MOA?

Answer 17

HMG-coa reductaase inhibitor used to treat hypercholestermia

Question 18

What is the concerning interaction for simvastatin (zocor)?

Answer 18

Grapefruit juice increases bioavailability of drug d/t inhibition of p450 enzyme

Question 19

Grapefruit juice should never be taken with what types of drugs?

Answer 19

Statins

Question 20

What is the therapeutic use of Li (eskaltih)?

Answer 20

Used to treat manic-depressive disorder

Question 21

What is the concerning interaction of Li (eskalith)?

Answer 21

Li and Na can compete for binding sites in the kidney (Na/K ATPase).

Changes in Na intake will change the reabsorption of Li (increased Na, decreased Li effectiveness)

Question 22

What is phenelzine (nardil) used for? MOA?

Answer 22

MAOI used for depression

Inhibits breakdown of catecholamines

Question 23

What is the interaction the is concerning for phenelzine (Nardil)?

Answer 23

Tyramine can increase the release of catecholamine, increasing already high levels

Hypertensive crises

Question 24

What is the MOA of warfarin (coumadin)?

Answer 24

Inhibits vit K epoxidase needed to convert prothrombin, to thrombin

Question 25

What are the concerning interactions of coumadin?

Answer 25

Green leafy vegetables will increase vit K availability

Question 26

What is the MOA of NSAIDs?

Answer 26

Inhibition of prostaglandin (PGE2) synthesis

Question 27

What are the concerns of NSAIDs use?

Answer 27

Mucosal irritation

Decreased stomach pH

Question 28

What is the effect of anticholinergics on the GI tract?

Answer 28

Block smooth muscle contraction

Decrease salivation

Question 29

What are the concerning effets of tricyclic antidepressants?

Answer 29

block H1, stimuating appetite

Question 30

What are the concerning effets of tricyclic SSRIs?

Answer 30

Increased serotonin, decreases appetite

Question 31

Clarithromycin can have what adverse effects?

Answer 31

bitter taste

Question 32

Metronidazole can have what adverse effects?

Answer 32

Metallic taste