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Pharmacology II - EXAM 2 > Interactions / P450 > Flashcards

Interactions / P450 Flashcards

1
Q

What classes of medications interact with Triptans?

A 
Other Triptans
Ergotamine
SSRIs
MAOIs
QT Prolonging Medications
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2
Q

Ergotamines are associated with life threatening ischemia when administered with what?

A

CYP3A4 Inhibitors (ie: Macrolides)

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3
Q

Other than 3A4 inhibitors what drugs interact with Ergotamines?

A

Other Ergotamines
Vasoconstrictors
Serotonin Drugs

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4
Q

Should Levodopa be used with MAOIs?

A

No

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5
Q

Would Rasagiline and Selegiline interact with each other?

A

Yes

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6
Q

What Opioids do MAOIs interact with?

A 
Dextromethorphan
Meperidine
Tramadol
Methadone
Propoxyphene
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7
Q

What Abx with interact with MAOIs?

A

Ciprofloxacin

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8
Q

T/F: St. John’s Wart interactions with MAOIs

A

True

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9
Q

What P450 enzyme metabolizes Rasagiline?

A

CYP1A2

Extensively metabolized in the liver

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10
Q

When would Entacapone be considered a P450 inhibitor?

A

At higher doses than recommended for treatment

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11
Q

What medications interact with Safinamide?

A 
Dextromethorhan
MAOIs
SNRIs
St. John's Wart
SSRis
TCAs
Cyclobenzaprine
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12
Q

T/F: Donepezil is metabolized by CYP 3A4 and 2D6

A

True

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13
Q

Is Rivastigmine metabolized by P450?

A

No

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14
Q

Are drug interactions commonly seen with Galantamine?

A

No

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15
Q

In what cardiac conditions should Galantamine be avoided?

A

Heart Block

Sick Sinus Syndrome

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16
Q

Tetrabenazine should be avoided with what class of medications?

A

MAOIs

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17
Q

Does acetaminophen interact with P450 2E1 inhibitors or inducers?

A

Inducers

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18
Q

Should NSAIDs be given to patients taking blood thinners?

A

No

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19
Q

Should patients with G6PD Deficiency take ASA?

A

No, this can trigger hemolysis

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20
Q

What may happen if NSAIDs (Particularly Ibuprofen) is given with ASA?

A

It may block the antiplatalet effects of ASA.

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21
Q

Other than ASA, what medication classes may interact with NSAIDs?

A

Anti-coagulants
Anti-hypertensives
Diuretics
Hypoglycemics

22
Q

Codeine is a CYP 2D6 ________ (Inducer/Inhibitor/Substrate)

What medications would inhibit this?

A

Substrate

Inhibited by…..

Bupropion, Cimetidine, Celecoxib, Cocaine

23
Q

Oxycodone is metabolized by CYP 2D6 to __________.

A

Oxymorphine

24
Q

Hydrocodone is metabolized by CYP 2D6 to __________.

A

Hydromorphone

25
Q

Does Oxymorphone have P450 interactions?

A

No

26
Q

What P450 isoenzyme is fentanyl metabolized by?

A

CYP 3A4

27
Q

What class of medications will Meperidine interact with?

A

MAOIs (Respiratory Depression)

28
Q

Propoxyphene is a CYP 3A4 _________ (substrate/inhibitor/inducer).

A

Inhibitor

29
Q

What P450 isoenzymes is methadone metabolized by?

A

CYP 3A4 and 2D6

30
Q

What P450 isoenzymes is Bupenorphine metabolized by?

A

3A4

31
Q

Tramadol used in combination with a MAOI or SSRI may result in an increased risk of what?

A

Seizures

32
Q

Should Tramadol be given with CYP 2D6 and 3A4 inhibitors?

A

No

33
Q

Can tramadol be used in combination with carbamazepine?

A

No

34
Q

Does Tapentadol have P450 Interactions?

A

No

35
Q

What may happen if Tapentadol is taken with EtOH?

A

Death

36
Q

What would happened to the levels of TCAs if given with morphine or methadone?

A

Decrease the metabolism of TCAs leading to toxicity

37
Q

How would quinidine effect codeine levels?

A

It would slow the conversion of codeine to morphine leading to decreased efficacy

38
Q

If metoclopramide was given in combination with an opioid, what would you expect to see in the plasma levels of the opioid?

A

Earlier peak plasma levels

39
Q

Would propoxyphene ___________ (increase/decrease) levels of carbamazepine, Metoprolol, and propanolol

A

Increase

40
Q

Why should propoxyphene be avoided in benzodiazepines?

A

It decreases the excretion of benzodiazepines leading to increased accumulation

41
Q

Does erythromycin increase or decrease the effect of opioids?

A

Increase

42
Q

Rifampin, Phenytoin, and Carbamazepine all __________ (increase/decrease) levels of methadone

A

Decrease

43
Q

CYP2D6 Inhibitors __________ (increase/decrease) tramadol levels

A

Increase

44
Q

CYP2D6 Inhibitors __________ (increase/decrease) efficacy of hydrocodone and codeine

A

Decrease

45
Q

CYP2D6 Substrates __________ (increase/decrease) tramadol levels

A

Increase

46
Q

CY3A4 inhibitors __________ (increase/decrease) methadone levels

A

Increase

47
Q

CY3A4 inducers __________ (increase/decrease) methadone levels

A

Decrease

48
Q

What P450 isoenzymes is cyclobenzaprine metabolize by?

A

CYP 3A4, 1A2, 2D6

49
Q

What are patients taking tramadol and cyclobenzaprine more at risk for?

A

Seizures

50
Q

What should MAOIs be avoided with cyclobenzaprine?

A

It can be a potentially fatal interaction

51
Q

When should you avoid using BenGay (Methyl Salicylate)?

A

Sulfa Allergies

ASA Allergies

Pharmacology II - EXAM 2 (5 decks)

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