Part 7 clinically important drug interactions

Question 1

3 common groups of drugs to watch what are they

Answer 1

drugs with narrow therapeutic index - increased or decreased levels of these result in toxic effects - warfarin , digoxin and phenytoin, theophylline

drugs that require careful titration of dose according to effect such as antihypetensives and anti-diabetic drugs - where overtreatment lead to significant conswequexes
eg Low GCS question - metformin induced lactic acidosis or ACEi AKI if combined with contrast

drugs that affect cytochorme P450

Question 2

enzyme inducers mean

Answer 2

Enzyme induction usually results in a loss of pharmacologic activity.

Question 3

enzyme inducer exmaples

Answer 3

PC BRAS
Phenytoin
carbamazepine
barbituates
rifampicin
alcohol - chronic use
sulphonyureas

dont do verapamil and BB - low BP

Question 4

enzyme inhibitors

Answer 4

increase pharmocolic activity as levels increased

Question 5

enzyme inhibitors examples

Answer 5

AODEVICES

allopurinol
omeprazoe
disfulfiram
erythromycin
valporate
isoniazid
ciprofloxacin
ethanol - acutely
sulphonamides

Question 6

MOAs can cause - phenelzine, selegiline,

Answer 6

hypertensive crisis

Question 7

enzyme inducer with warfarin does what

Answer 7

reduces anticoagulatn effect of warfarin

Question 8

sweating flushing N adn V caused by what two drugs together

Answer 8

metronidazole and disulfiram

Question 9

sedation caused by what drugs

Answer 9

opiates
benzos
barbituates - phenobarbital