drug interactions

Question 1

Ranitidine increases the ________ of _______ drugs like ______

Answer 1

Ranitidine increases the absorption of basic drugs like halcion

Question 2

examples of drugs that are highly bound in plasma

Answer 2

ASA

barbituates

phenytoin

sulfonamindes

valproic acid

warfarin

Question 3

free drug or bound to albumin drug has therapeutic effect

Answer 3

free drug

Question 4

when can protein binding be altered

Answer 4

if protein binding sites become saturated

if pt has hypoalbumenia (liver disease)

drug is replaced from protein binding by another drug

can lead to toxic build up of free drug!

Question 5

Warfarin may be displaced from albumin by _______ causing bleeding

Answer 5

valproic acid

Question 6

if drug A inhibits the p450 enzyme that metabolizes drug B, the there is __________

Answer 6

an increased level of drug B (toxic)

Question 7

if drug A induces the p450 enzyme that metabolizes drug B, the there is __________

Answer 7

a decreased level of drug B

Question 8

fluoxetine _______ cyp450 that metabolizes _____ and _____

Answer 8

fluoxetine inhibits cyp450 that metabolizes versed and oxycodone (increased drug levels)

Question 9

omeprazole ______ cyp450 that metabolizes ______ and leads to _____

Answer 9

omeprazole induces cyp450 that metabolizes propranolol and leads to HTN

Question 10

probenecid can ______ the excretion of _____ leading to _____

Answer 10

probenecid can block the excretion of pyranizinamide leading to drug induced hepatitis

Question 11

partial agonists may be good for…

Answer 11

addiction or withdrawal treatment

Question 12

buprenorphine, partial opioid agonist, may displace the following effects compared to opioids:

Answer 12

less euphoria and physical dependence

decreased respiratory depression

less sedation

Question 13

buprenorphine for withdrawal

Answer 13

can help people have less intense withdrawal symptoms, may provide a ceiling on side effects

Question 14

example of non pharmacological interactions

Answer 14

glipizide stimulates endogenous insulin release

metformin causes liver to decrease glucose production

both work together by dif mechanisms to reduce blood sugar

Question 15

additive interactions

Answer 15

when the combined effects of two drugs equal the sum of the effect of each agent given alone

Question 16

additive interactions example

Answer 16

dexamethasone combine with zofran help treat PONV

Question 17

synergistic interactions

Answer 17

when teh combine effects of two drugs are greater than the sum of the effect of each agent given alone

Question 18

synergistic interaction example

Answer 18

versed combine with fentanyl causes much more sedation than either do alone

Question 19

potentiation interactoins

Answer 19

the creation of a toxic effect from one drug (that is not normally toxic) due to the presence of another drug. the second drug is not usually affected

Question 20

potentiation interactions examplee

Answer 20

grapefruit juice + percocet increased teh effects of perc and increases risk of respiratory depression

Question 21

antagonism interactions

Answer 21

combined effect of two drugs is less than the individual agents given alone

Question 22

antagonism interactions example

Answer 22

naloxone and fentanyl

Question 23

statins and ______ interact and cause _____

Answer 23

statins and azoles interact and cause rhabdomyolysis and kidney failure

Question 24

oral anticoagulants and _____ interact and cause____

Answer 24

oral anticoagulants and NSAIDs interact and cause increased INR and severe gastric bleeding

Question 25

alcohol and _____ interact and can cause ____

Answer 25

alcohol and opioids interact and can cause drowsiness and respiratory depression

Question 26

protein pump inhibitors and _____ interact and cause _____

Answer 26

protein pump inhibitors and antibiotics interact and cause long QT syndrome, risk of c diff infection

Question 27

NSAIDs and ____ interact and cause _____

Answer 27

NSAIDs and thiazide diuretics interact and cause renal vascular resistance, sodium retention leading to HTN

Question 28

NSAIDs and SSRIs

Answer 28

can increase bleeding and iron deficiency anemia

Question 29

statins and macrolide abtcs

Answer 29

rhabdymyolyosis and kidney failure

Question 30

what can decrease the effectiveness of BCP

Answer 30

PCN maybe

Question 31

abtcs and immunosuppressive drugs

Answer 31

can cause methotrexate toxicity (mucositis, acute renal failure, hepatotoxicity)

Question 32

anticonvulsants and flagyl

Answer 32

phenytoin toxicity nystagmus, ataxia, coma