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Pharmacology > Drug reactions > Flashcards

Drug reactions Flashcards

1
Q

what happens when patients are taking multiple medications

A
  • the potential for adverse drug events (ADEs) with medications and food in an increased concern
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2
Q

what is the drug-drug interaction

A
  • the pharmacological or clinical response to the administration of a drug combination
  • different from that anticipated from the known effects of the two drugs when given alone
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3
Q

what are the two possible results from a drug-drug interaction

A
  • additive (synergistic)

- antagonistic, where two drugs have opposing activities

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4
Q

what is recommended for dental clinicians to have available regarding prescribing medications and drug interactions

A
  • a drug handbook and/or

- a computerized version of drug interactions (LexiComp)

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5
Q

what are risk factors that increase the incidence of a drug interaction

A
  • medication factors (protein binding, small therapeutic window, effects on enzymes)
  • patient factors (age, sex and medical conditions)
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6
Q

how are drug interactions rated

A
  • according to the severity of the interaction ie life threatening or mild
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7
Q

what are the two main types of drug interactions (regarding the body not the drugs)

A
  1. pharmacokinetic: a change in the pharmacokinetics of one drug caused by the interacting drug or food. ex: tetracycline + dairy products/antacids
  2. pharmacodynamic: a change in the pharmacodynamics of one drug by the interacting drug. ex: Advil + lasik -> fluid retention -> worsening of CHF
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8
Q

what are 3 other types of drug interactions

A
  1. addition: the effect of two or more drugs when administered together is the same as if the drugs were given separately. 1 + 1 = 2
  2. synergism: the effect of two or more drugs when administered together is greater than if the drugs were given separately; may produce responses equivalent to overdosage. 1 + 1 = 3
  3. antagonism: the effect of two or more drugs when administered together is less than when the drugs are given separately. 1 + 1 = 1, ex Advil + lasik
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9
Q

how can absorption be affected in drugs

A
  • presence of food or supplement can = decreased absorption into the blood
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10
Q

what are other factors that can affect absorption

A
  • gastric (stomach) pH (delay)

- changes in gastrointestinal motility that alter transit time within the intestines (delay)

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11
Q

how can the absorption of antibiotics be altered

A
  • many antibiotics should be taken on an empty stomach due to food interactions
  • 1 hour before or 2 hours after meals
  • exception: penicillin V, amoxicillin, doxycycline, minocycline
  • while other antibiotics should be given with food to minimize gastric upset (ie clavulin)
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12
Q

what are free drugs

A
  • drugs that aren’t bound to plasma proteins in the blood

- drugs that are bound to plasma proteins are too big to diffuse through membranes

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13
Q

what will happen if two drugs have affinity for the same bidding site on a protein molecule in the blood

A
  • may compete for the binding site

- one molecule will displace the other drug from the protein molecule

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14
Q

what do the cytochrome P450 enzymes do

A
  • metabolize drugs involving the alteration of groups on the drug molecule
  • mostly found in the liver
  • also found in the intestines, lungs and other organs
  • key pathway for drug metabolism
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15
Q

what is a substrate

A
  • a drug that is metabolized by a specific CYP450 isoenzyme
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16
Q

what is an inhibitor

A
  • a drug that inhibits or reduces the activity of a specific CYP450 isoenzyme
17
Q

what is an inducer

A
  • a drug that increases the amount and activity of that specific CYP450 isoenzyme
18
Q

what are the major isoenzymes that are responsible for most drug metabolism

A
  • CYP1A2, CYP2C9, CYP2C19, CYP2D6, CYP2E1 AND CYP3A4
19
Q

why should we avoid grapefruits when using medications

A
  • grapefruit juice inhibits CYP3A4 in the small intestine
20
Q

how do oral contraceptives work

A
  • become activated in the intestines by the gastrointestinal flora
21
Q

see lists of clinically significant drug-drug interactions in dentistry from slides 34-39

A

see lists of clinically significant drug-drug interactions in dentistry from slides 34-39

22
Q

what are drug-disease interactions

A
  • refers to a patient who has an allergy to a certain drug or a systemic disease that would contraindicate the use of a drug
  • ex. patient with ulcerative colitis should not be prescribed clindamycin
23
Q

see lists of clinically significant drug-disease interactions in dentistry slide 41

A

see lists of clinically significant drug-disease interactions in dentistry slide 41

24
Q

what are some examples of drug-food interactions

A
  • grapefruit juice
  • caffeine
  • alcohol
25
Q

see lists of clinically significant drug-food interactions in dentistry slide 43

A

see lists of clinically significant drug-food interactions in dentistry slide 43

Pharmacology (21 decks)

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