Flashcards in Drug Interactions Deck (28):
name two PGP substrates?
name inhibitors of PGP
St John's wort
Pneumonic for BIG CYP450 inducers
St. John's wort
Pneumonic for BIG CYP450 inhibitors
G <3 PACMAN
P rotease inhibotrs
Macrolides except azithromycin
Non-dihydropyridines: verapamil/ diltiazem
Avoid w/ agents that prolong the QT
avoid w/ neg chrnotropes: BB, diltiazem, verap
correct electrolyte abnormailities before starting
decrease the doses of these by 30-50% when using w/ amiodarone: warfarine, digoxin
use lower doses of simva, lova and atorvastatin
all azoles inhibit which enzyme?
which of the azoles requires an acidic environment to be absorbed
name contraindicated voriconazole agents
st johns wort
BB, CCB can dec HR
cyp 3a4 and pgp substate
hypokalemia, hypercalcemia anc dec digxoicn levels
statins : lova, simva, atorva
cyp 3a4 inhibitors and inducer
where is lithium primarily cleared?
renally ! just like sodium
which agents increase lithium levels?
less salt intake, NSAIDS, ACEI, ARBS, dehydration
which agents will decrease lithium levels
salt intake ,
which have additive DDI w/ lithium
RISK OF SEROTONIN SYNDROME
what is the consequence of using non sleective MAOIs that have ddis?
SSRIS, SNRIS, TCAS
tyramine rich foods etc
w/ agents that cuase bleeding
agents that raise blood pressure
agents that causer renal toxiicty
lithium (inc lithium toxicity)
oral contraceptives DDI
antibiotics: amp, smx/ doxy, rif (use backup while on antibiotic for rif for 1.5 months afterwards too.
-st johns wort (do not use concurrentlyO
-ATV, LPV, r, NFV, NVP
-mycophenylate reduces efficacy
Oxycontin and other oxycodone products
increased levels if cyp 3a4 inhibitors
phosphodiesterace inhibitors DDIs
nitrates- severy hypotension
alpha blockers esp non selective agents
which of the FQ is mostly renally cleared
which of the FQ is mostly hepatically cleared?
DDIs of FQ
Polyvalent actions, MVs, bile acids, sucralfate : chelation leading to decreased absorption
They increase Warfarin, SUs and QT prolonging drugs
-NSAIDS and probenacid increase FQ levels
what is Rifampin a strong inducer of?
which of the statins undergo extensive first pass metabolism by cyp 3a4
atorvastatin (but more minimal)
max regimen of rosuvastatin on patients with ritonavir
max rosuvastati w/ cyclosporine?