Exam 2 thera drug interactions Flashcards

1
Q

Pharmacodynamic:Additive

A

When two drugs have similar pharmacodynamics (same therapeutic effect) and when pt takes them together leads to a exaggerated response but no change in the pharmacokinetics of the drugs
Ex pt take diphenhydramine (causes sedation) + Lorazepam (causes sedation) = greater cause of sedation
-Is pt specific

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Drugs that require acidic pH for absorption

A

Ketoconazole
Dabigatran
Rilpivirine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Grapefruit

A

Inhibit the Pgp (p-glycoproteins in the intestinal)
so increase the absorbtion of Diltiazem and cyclosporine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pharmacokinetic: Absorption
Chelation by Dairy

Decreases the absorption decreases the drug effects

A

Doxycycline
Quinolones- Ciprofloxacin , Levofloxacin
Alendronate
Methotrexate
Levothyroxine

Separate them 2 hrs from consuming dairy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pharmacokinetic: Absorption
Chelation Ca, Mg, Fe

A

Ciprofloxacin- Administer 2 hrs before or 6 hrs after
Levofloxacin- Administer 2 hrs before or 2 hrs after
Moxifloxacin- Administer 4 hrs before or 8 hrs after
Tetracycline- Administer 2hrs before or 4 hrs after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pharmacokinetic interaction: Absorption
Fiber

A

-Digoxin
-Levothyroxine
-Carbamazepine
-TCA
-Metformin
-Lithium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pharmacokinetic: Distribution

A

Compete for the plasma binding protein
Only affect : Phenytoin and Warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Substrate

A

Medication that is metabolize by the enzyme
It can be a substrate to multiple enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Inducer

A

Speed up the enzyme activity
So when another drug pass throw that enzyme is going to be metabolize fast because of the inducer
So the concentration of the other drug is low because of fast metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Inhibitor

A

A drug can inhibit a specific CYP450 enzyme and it blocks the metabolism of the other drugs that need to pass through that enzyme in order to be metabolize so because is inhibited there will be more drug concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

CYP 3A4 Inhibitors

RACEGAVD

A

Ritonavir
-Azole antifungals
Cyclosporine
Erythromycin/Clarithromycin
-Grapefruit
-Amiodarone
-Verapamil
-Diltiazem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CYP 3A4 Inducers

A

Carbamazepine
Phenytoin
Sj’s Wort
Barbiturates (Phenobarbital)
Rafampin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

CYP 3A4 Subtrates

A

Carbamazepine
Simvastatin
Lovastatin
Warfarin
Benzodiazepines (midazolam)
Amlodipine
Nifedepine
Apixaban
Rivaroxaban

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Simvastatin do not exceed more than 20mg when taken with

A

Amiodarone
Amlodipine
Ranozalone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Simvastatin Should not exceed more than 10mg when taken with

A

Dialtiazem
Verapamil
Dronedarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

CYP 2C9 inhibitor

A

-Amiodarone
-Fluconazole
-Metronidazole
-Erythromycin/Clarithromycin
-Sulfamethoxazole/trimethoprim

17
Q

CYP 2C9 inducers

A

-St Johns wort
-Carbamazepine
-Rifampin
-Barbiturates (Phenobarbital)

18
Q

CYP 2C9 Subtrate

19
Q

CYP 2C19 Inhibitor

A

Fluoxetine
Fluvoxamine

20
Q

CYP 2C19 Inducer

A

Rifampin
St Johns worts
Carbamazepine

21
Q

CYP 2C19 Substrate

A

Clopidogrel

22
Q

CYP 2D6 Inhibitor

A

Fluoxetine
Paroxetine
Buproprion
Quinidine
Ritonavir

23
Q

CYP 2D6 Inducer

23
Q

CYP 2D6 Substrate

A

B1 Blocker
Metropolol
Atenolol
Nevibolol
Bisoprolol
Acebutalol
Betaxolol
Esmolol
non selective B blocker
Propranolol(inderal)
Pindolol
Timolol
Levobunalol
Sotalol
Nadolol
-Codeine / tramadol
-Venlafaxine/ duloxetine
-Haloperidol, aripriprazole, risperidone

24
CYP 1A2 Inhibitor
Fluvoxamine Ciprofloxacin
25
CYP 1A2 Inducer
Smoking / tabacco Rifampin
26
CYP 1A2 substratre
Caffeine Acetaminophen Duloxetine Venlafaxine Aripriprazole Risperidone Theophylline
27
P-gp Inhibitors | RACEGAVD
Ritonavir Azole antifungal Cyclosporine Erythromycin clarithromycin Grapefruit Amiodarone Verapamil Diltiazem
28
PGP Inducers
Rifampin Phenytoin Carbamazepine Barbiturates(phenobarbitol) St Johns wort
29
PGP substrate
Sirolimus Cyclosporine Digoxin Dabigatran Colchine Rivoroxaban- apixaban
30
Grapefruit affects what drugs?
Statins-Simvastatin, lovastatin Cyclosporine tacrolimus Warfarin