Interactions Part 2 Flashcards
What is the interaction between methotrexate and fluconazole?
Increases risk of liver toxicity
What is the interaction between methotrexate and isotretinoin?
Increased risk of liver toxicity
What is the interaction between methotrexate and penicillins?
Reduced clearance of methotrexate (if short course up to 10 days - consider using and monitor for signs of methotrexate toxicity)
What is the interaction between methotrexate and PPIs?
Reduced methotrexate clearance - consider H2-receptor antagonists as alternative
What is the interaction between methotrexate and statins?
Increased risk of liver toxicity
What is the interaction between methotrexate and tamoxifen?
Increased risk of liver toxicity
What is the interaction between methotrexate and terbinafine?
Increased risk of liver toxicity
What juice decreases ciclosporin concentration?
Purple grape juice
What is the interaction between an SSRI and NSAIDs
GI bleed
What is the interaction between Ibuprofen and ramipril
Nephrotoxicity
What is the interaction between simvastatin and amlodipine
myopathy
What is the interaction between ramipril and spironolactone
Hyperkalaemia
What is the interaction between bisoprolol and donepezil?
Bradycardia
What would cause a pharmacodyamic interaction with donepezil?
Oxybutynin - anticholinergic drugs counteract what this does because donepezil prevents the breakdown of acetylcholinterase in the brain whereas anticholingeric drugs does the opposite
What is the interaction between sodium valproate and doxycycline?
Risk of hepatotoxicity
Do SSRIs impact epilepsy?
SSRIs lower seizure threshold
What is the interaction between sildenafil and nitrates?
CONTRAINDICATED - risk of hypotension
What is the interaction between alpha blockers and sildenafil?
Risk of hypotension
What is the interaction between ACEi and insulin or other oral antidiabetics?
Hypoglycaemia
What is the interaction between lithium and candesartan?
Candesartan increases concentration of lithium
What do MAOIs interact with?
Tyramine: the cheese effect - hypertensive crisis
Sympathomimetics: pseudoephedrine, epherdrine - hypertensive crisis
Sumatriptan: increases exposure to sumatriptan - avoid for 14 days after stopping MAOI
Other antidepressants: washout period
Lithium: increased risk of serotonin syndrome