Interactions Flashcards
CYP540 inducers
DECREASES THE CONC OF DRUG MET BY CYP450 Carbamazepine Rifampicin Alcohol Phenytoin Griseofulvin Phenobarbitone Sulphonylureas
CYP450 inhibitors
INCREASE THE CONC OF DRUGS MET BY CYP450 Sodium valproate Isoniazid Cimetidine Ketoconazole Fluconazole Alcohol AND Grapefruit Chloramphenicol Erythromycin Sulfonamides . Ciprofloxacin Omeprazole Metronidazole
Dugs metabolised by CYP450
warfarin combined pill theophylline corticosteroids tricyclic antidepressants pethidine statins
Clopidogrel and statins
Clopi and statins are met by CYP450
omeprazole is C/I with clopidogrel
safest is pantoprazole
lansoprazole and rabeprazole are OK
Simvastatin interactions
bezafibrate and ciprofibrate - 10 MG OD
amiodarone/amlodipine/ranolazine - 20 MG OD
verapamil/diltiazem - 20 MG OD
elbasvir with grazoprevir - 20 MG OD
bempedoic acid/bempedoic acid with ezetimibe - MAX 20 MG OD or 40 MG OD if severe hypercholesterolaemia with high risk CVD
Erythromycin/clarithromycin/telithromycin - C/I
Itraconazoles - C/I
Ciclosporins - C/I
antivirals - C/I
Atorvastatin interactions
Ciclosporins (if unavoidable) - 10 MG OD
elbasvir with grazoprevir - 20 MG OD
letermovir WITHOUT ciclosporin - 20 MG OD
sofosbuvir with velpatasvir and voxilaprevir - 20 MG OD
anion exchange resin for heterozygous familial hypercholesterolemia - 40 MG OD
Drug-induced HypERNatraemia
Diuretics sodium bicarbonate sodium chloride corticosteroids anabolic steroids oestrogens
Drug-induced HypONatraemia
ACEI Heparin Diuretics antidepressants (citalopram, etc...) antipsychotics carbamazepine S+S inc: weakness, fatigue or low energy, headache, N+V, muscle spasm, cramps, confusion, irritability.
drug that lower the seizure treshold
tramadol Imipenem 4th gen cephalosporin ciprofloxacin isoniazid penicillin antipsychotics lithium MAOI SSRI SNRI TCA Aminophylline Theophylline pseudoephedine
medication causing QT prolongation
Erythromycin Clritthromycin Fluconazole Ketoconazole Dronedarone Quinidine Amiodarone Flecainide Methadone antipsychotics Citalopram/escitalopram amitriptylline domperidone droperidol ondansetron/Granisetron
Drug induced hyperkalaemia
Potassium-sparing diuretics aldosterone antagonist b-blockers ACEI digoxin trimethoprim and co-trimaxozole NSAID heparin
drug that cause hypokalaemia
Laxatives (excessive use - stool excretion) Diuretics (renal excretion) Beta-blockers (high dose - taken up by cells) Corticosteroids (renal excretion) Insulin (taken up by cells) Theophylline (taken up by cells) Penicillins (high dose - renal excretion) Verapamil (overdose - taken up by cell) Gentamicin Sodium Bicarbonate Amphotericin Echinochandin antifungals Cisplatin Parecoxib
citalopram and NSAID
increased risk of hyponatraemia
increased risk of GI bleeding
drugs that cannot be stopped abruptly
SSRI MAOI LAMOTRIGINE (2 weeks) Corticosteroids Hypnotics and anxiolytics morphine/ALL opioids Buprenorphine antipsychotics antiparkinson drugs mirtazapine lithium venlafaxine (need 4 weeks) Benzodiazepines Pregabalin - over 1 week
Atorvastatin C/I
ciclosporin - VERY BIG MAX 20 MG
Clarithromycin - AVOID
Amlodipine - theoric, pravastatin, rosuvasttain preferred
