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BNF/Pre-Reg 2017-2018 > Pharmacokinetics and Pharmacodynamic Interactions > Flashcards

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
Q

What drugs come with warning cards?

A
  1. Insulin
  2. Lithium
  3. MAOis
  4. Oxygen
  5. Steroids
  6. Warfarin
26
Q

What drugs can cause drug induced photosensitivity? (6)

A 
Amiodarone
Chlopromazine
Doxycyline
Fibrates
Trazam gel
Azapropazone
27
Q

What important interaction does Garlic cause?

A

Increases platelet activity

28
Q

What important interaction does soya have?

A

Enzyme inhibitor

Clozapine, haloperidol, olanzapine, caffeine, phenytoin, zafilukast, warfarin impacted.

29
Q

What is the interaction between Ginger and anticoagulants?

A

Ginger inhibits thromboxane synthesis

30
Q

Grapefruit inhibits which enzyme?

A

CYP3A4

31
Q

What are some of the most commonly impacted drugs by grapefruit juice? (10) [Not an exhaustive list]

A
  1. Amiodarone
  2. Simvastatin
  3. CCB
  4. Sildenafil
  5. Diazepam
  6. Fluvoxamine
  7. Ritonavir
  8. Buspirone
  9. Midazolam
  10. Carbamazepine

BNF/Pre-Reg 2017-2018 (144 decks)

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