Pharmacokinetics and Pharmacodynamic Interactions Flashcards

1
Q

What is a pharmacokinetic interaction?

A

A drugs affects the ADME of another drug.

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2
Q

What is a pharmacodynamic interaction?

A

The effects of one drug are changed by the presence of another drug at its pharmacological site of action.

Interactions between drugs with similar or antagonistic pharmacological effects or S/Es

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3
Q

Enzyme inductions takes how long to wear off?

A

2-3 weeks

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4
Q

What does CRAP GPs SBS stand for?

A

Inducers.

Carbamazepine.
Rifampicin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulphonylureas

St Johns Wort
Barbituates
Smoking

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5
Q

Enzyme inhibition typically takes how long to wear off?

A

A few days

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6
Q

What does SICKFACES.COM.GF stand for?

A
Inhibitors
Sodium Valproate
Isoniazid 
Cimetidine
Ketoconazole
Fluconazole
Alcohol
Chloramphenicol
Erythro/Clarithro
Sulphonamides
Ciprofloxacin
Omeprazole
Metronidazole

Grapefruit
Fluoxetine

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7
Q

What does the C stand for in CRAP GPs SBS? (inducers)

A

Inducers.

>>Carbamazepine<<
Rifampicin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulphonylureas

St Johns Wort
Barbituates
Smoking

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8
Q

What does the R stand for in CRAP GPs SBS? (inducers)

A

Inducers.

Carbamazepine.
>>Rifampicin<<
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulphonylureas

St Johns Wort
Barbituates
Smoking

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9
Q

What does the A stand for in CRAP GPs SBS?

A

Alcohol:

Inducers.

Carbamazepine.
Rifampicin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulphonylureas

St Johns Wort
Barbituates
Smoking

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10
Q

What do the P’s stand for in CRAP GPs SBS (inducers)?

A

Phenytoin and phenobarbital

Inducers.

Carbamazepine.
Rifampicin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulphonylureas

St Johns Wort
Barbituates
Smoking

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11
Q

What do the S’s stand for in CRAP GPs SBS (inducers)?

A

Sulphonylureas
St Johns Wort
Smoking

Inducers.

Carbamazepine.
Rifampicin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulphonylureas

St Johns Wort
Barbituates
Smoking

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12
Q

What do the S’s stand for in SICKFACES.COM.GF?

A

Inhibitors:
Sodium valproate
Sulphonamides

Sodium Valproate
Isoniazid 
Cimetidine
Ketoconazole
Fluconazole
Alcohol
Chloramphenicol
Erythro/Clarithro
Sulphonamides
Ciprofloxacin
Omeprazole
Metronidazole

Grapefruit
Fluoxetine

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13
Q

What do the C’s stand for in SICKFACES.COM.GF?

A

Cimetidine
Chloramphenicol
Ciprofloxacin

Sodium Valproate
Isoniazid 
Cimetidine
Ketoconazole
Fluconazole
Alcohol
Chloramphenicol
Erythro/Clarithro
Sulphonamides
Ciprofloxacin
Omeprazole
Metronidazole

Grapefruit
Fluoxetine

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14
Q

What does the COM stand for in SICKFACES.COM,GF?

A
Sodium Valproate
Isoniazid 
Cimetidine
Ketoconazole
Fluconazole
Alcohol
Chloramphenicol
Erythro/Clarithro
Sulphonamides
Ciprofloxacin
Omeprazole
Metronidazole

Grapefruit
Fluoxetine

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15
Q

What does the GF stand for in SICKFACES.COM.GF?

A
Sodium Valproate
Isoniazid 
Cimetidine
Ketoconazole
Fluconazole
Alcohol
Chloramphenicol
Erythro/Clarithro
Sulphonamides
Ciprofloxacin
Omeprazole
Metronidazole

Grapefruit
Fluoxetine

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16
Q

What is the interaction between alcohol and MAOI?

A

Tyramine = hypertensive crisis when taken with MAOI

17
Q

What drugs are so enzyme inducing that an IUD is recommended for effective contraception in women using them?

A

Rifampicin and Rifabutin are such potent enzyme inducers that IUD is
always recommended.

18
Q

he effectiveness of combined oral contraceptives is considerably reduced by
interaction with enzyme inducing drugs because they increase metabolism of the
contraceptives. Such as what?

A

Enzyme inducers: Carbamazepine, Phenobarbital, Primidone,

Phenytoin, Topiramate, Ritonavir, Griseofulvin, Rifampicin, Rifabutin, St John’s Wor

19
Q

For Women taking enzyme inducers, additional precautions should be used for how long after stopping the inducers?

A

Additional contraceptive precautions should be taken for at least 4 to 8 weeks after
stopping treatment. A ‘tricycling’ method whereby daily intake of 50mcg
ethinylestradiol (unlicensed) 3 or 4 packs in a row without a break and then having a 4
day pill free interval can be used by women treated with these drugs but effectiveness
is uncertain.

20
Q

Pseudoephedrine + MAOI results in what?

A

Hypertensive crisis

21
Q

Pseudoephedrine + BBs results in?

A

Increased risk of hypertension

22
Q

Orlistat + amiodarone results in?

A

May reduce amiodarone serum level.

23
Q

Orlistat + anticoagulants may result in?

A

Variable anticoagulant effect of coumarins.

24
Q

Orlistat + ciclosporin interaction

A

Reduced absorption of ciclosporin, black dot interaction.

25
What drugs come with warning cards?
1. Insulin 2. Lithium 3. MAOis 4. Oxygen 5. Steroids 6. Warfarin
26
What drugs can cause drug induced photosensitivity? (6)
``` Amiodarone Chlopromazine Doxycyline Fibrates Trazam gel Azapropazone ```
27
What important interaction does Garlic cause?
Increases platelet activity
28
What important interaction does soya have?
Enzyme inhibitor | Clozapine, haloperidol, olanzapine, caffeine, phenytoin, zafilukast, warfarin impacted.
29
What is the interaction between Ginger and anticoagulants?
Ginger inhibits thromboxane synthesis
30
Grapefruit inhibits which enzyme?
CYP3A4
31
What are some of the most commonly impacted drugs by grapefruit juice? (10) [Not an exhaustive list]
1. Amiodarone 2. Simvastatin 3. CCB 4. Sildenafil 5. Diazepam 6. Fluvoxamine 7. Ritonavir 8. Buspirone 9. Midazolam 10. Carbamazepine