Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacology Test 3 > Drug Interactions (Allen-Durrance) > Flashcards

Drug Interactions (Allen-Durrance) Flashcards

(59 cards)

Start Studying
1
Q

Drug list (10)

A
  1. Levetiracetam
  2. Phenobarbital
  3. Cimetidine
  4. Chloramphenicol
  5. Ketoconazole
  6. Omeprazole
  7. Sucralfate
  8. Diazepam
  9. Potassium Bromide
  10. Digoxin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Collard greens have vitamin K

A

Interact with warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Potassium Bromide interaction in FL

A

NaCl

Dogs drinking salt water when on Potassium Bromide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Polypharmacy

A

When you administer multiple drugs for one patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Possible Drug interaction consequences

A

None

Altered therapuetic efficacy

Altered duration of action

Altered intensity of side effects

Novel effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Drug interaction categories

A
  1. Incompatibilites
  2. Pharmacokinetic interactions
    * some drug interactions is altering plasma level of drug
  3. Pharmacodynamic interactions
    * modulating drugs affect at a given plasma concentration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Physical incompatibilities

A

Separation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Chemical Incompatibilies

A
  1. Precipitation
  2. Chelation
  3. Binding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Consequences of Incompatibilites

A

Damage from toxic compounds

Particulate emboli

Tissue irritation (pH changes)

Therapeutic failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Drugs incompatible with EVERYTHING

1.

2.

3.

4.

5.

6.

A
  1. Aminoglycosides
    * Stop fluids even
  2. Diazepam
    * Likes to precipitate
  3. Digitalis glycosides
  4. Pentobarbital
  5. Sodium bicarbonate
  6. Theophylline derivatives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Drugs with limited compatibility

1.

2.

3.

4.

5.

6.

A
  1. Dobutamine
  2. Dopamine
  3. Epinephrine
  4. Norepinephrin
  5. Tetracyclines: Doxy
  6. Parenteral antifungals: amphotericin D
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ketamine and Diazepam

A

Precipitates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Doxycycline and Calcium Gluconate

A

Chelation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Doxy and patient with chronic kidney disease

A

Kidney disease

  • Cant bind phospohrus
  • Give aluminum hydroxide to bind excess phosphorus

Aluminum hydroxide precipitates with the doxy I think

  • Gets pooped out
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Tums

A

Calcium supplements

Hyperparathyroidism post-op can cause hypocalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Drugs that bind to plastic

A

Insulin

Diazepam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Diazepam

A
  1. Bind to plastic
  2. Light sensitive
  3. Now replaced by midazolam (none of these problems)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Sulcralfate

A

Bind irritated areas in the stomach and coats stomach

Drugs it Binds to (which then get pooped out)

  • Tetracyclines
  • Fluoroquinolones
  • Cimetidine
  • Phenobarbital
  • Griseofulvin (antifungal)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pharmacokinetic Interactions

A

Common changes in

  • Absorption
  • Distribution
  • Metabolism
  • Elimination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Drugs that increase pH of stomach

A

Drug examples

  • Omeprazole
  • Famotidine
  • Antacids

Decreases absorption of weak acids

  • Ketoconazole

Increase absorption of weak bases

*This can be a longer term interaction, prolonged increase of stomach pH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Gastric pH changes on Absorption

A

Inc pH

  • antacids increase pH
  • increases absorption of weak bases
  • decreases absorption of weak acids

Dec pH

  • inc absorption of weak acids
  • dec absorptio of weak bases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Metoclopramide

A

Prokinetic: tries to get stuff out of stomachfaster

Causes less absorption of delayed release medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Epinephrine

A

Non selective alpha and beta receptor stimulant

  • vasoconstriction via alpha 1 receptors

Lasts longer when given with lidocaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Licocaine

Study These Flashcards
A

Makes epinephrine last longer

25
Prozinc
Insulin (protamine zinc) * harvest it from salmon * neutral pH Saline pH: 4.2 \*Insulin plus saline lowers pH of insulin and slows absorption * can cause hyperglycemia
26
Saline
pH of 4.2 lowers pH of neutral drugs can slow absorption of insulin (neutral pH)
27
Protein Binding
Distribution Drugs that bind to albumin * Bound drugs are inactive * Unbound drugs are active component Competition when two highly protein bound drugs administered simultaneously * Erythromycin * Doxycycline * NSAIDs * **Amphoteracin B: toxic to kidneys** * Furosemides
28
Altered drug-albumin binding Decreased production albumin
Low albumin * Decreased production * Acute phase (stress, injury, SIRS) * Hepatic disease * Malnutrition * Aging * Malignancies
29
Altered drug-albumin binding Capillary leakage from serum to tissues
Low albumin * Capillary leakage from serum to tissues * Burns * SIRS * Pregnancy * Diabetes mellitus * Pulmonary edema
30
Altered drug-albumin binding Increased elimination of albumin
Low albumin * Increased elimination * Nephrotic syndrome * Burns (wound loss) * Iatrogenic binding to starch
31
Altered drug-albumin binding Displacement by endogenous molecules
Normal albumin * Displacement by endogenous molecules * **Bilirubin** (hyperbilirubinemia) * Urea * Other waste products (hippuric acid, p-cresol) * Free fatty acids * Hormones
32
Altered drug-albumin binding Displacement/modification by exogenous molecules
Normal albumin * Displacement/modification by exogenous molecules * Highly albumin-bound antibacterials * Other drugs * aspirin * furosemide
33
Pharmacokinetic Interaction Metabolism
Common metabolic path: Intestines =\> portal circulation =\> liver =\> modified * Oxidation * Reduction * Hydrolysis * Inactivated Most become water soluble and exreted renally Tolerance * Inc activity of microsomal enzymes to speed metabolism of drug
34
Hallmark drug that increases metabolism
Phenobarbital Pull blood and do therapeutic drug monitoring
35
Keppra
Leviteracetum When you add on Keppra to long-term phenobarb user need to give 30 % higher dose of Keppra
36
Metabolism Inducers Inhibitors Metabolites
Inducers: decrease duration/potency of other drugs * Phenobarbital * Rifampin Inhibitors: Increase duration/ potency of other drugs * Cimetidine * Chloramphenicol * Ketoconazole Metabolites * Diazepam * Ketamine * Morphine
37
Pharmacokinetic Interaction Elimination
Renal * Competition for same renal tubular transport system * Alter urinary pH (ion trapping) * Alter renal blood flow Biliary * Enterohepatic recirculation * Antibiotics alter (clindamycin) Respiratory
38
Post op drug that changes blood flow to kidneys via prostaglandins
NSAIDs
39
Considerations for treating Endocrinopathies
Treatments usually require enterohepatic recirculation Antibiotics can alter gut flora and affect the enterohepatic recirculation
40
Decrease in respiratory drive
All Opioids Slows respiratory elimination
41
Aspirin and phenobarb
Increase elimination if given with Ammonium-chloride Decrease elimination if given with Sodium bicarb
42
Drugs that compete for renal excretion Acidic Drugs
Acidic Drugs * Penicillins * Cephalosporins * Sulfonamids (TMS) * Furosemide * NSAIDS
43
Drugs that compete for renal excretion Basic Drugs
Basic Drugs * Procainamide * Dopamine * Trimethoprim * Opioids
44
Pharmacodynamic Interaction ## Footnote 1. 2. 3.
1. Pharmacological * Act on same receptor 2. Physiological * Act on different recptors that regulate a common process 3. Elicit effects that aren't receptor mediated but have final comon pathway
45
Pharmacodynamic Drug Interactions Synergistic
Synergistic * CNS depressants * phenobarb + diazepam * Autonomic drugs * ..... * Beta blockers + Ca2+ blockers * bradycardia * NSAIDS + steroids * ulcers * Aminoglycosides + amphotericin B * kidneys
46
Pharmacodynamic Drug Interactions Antagonistic
Antagonistic * Alcohol + caffeine * Anticoagulants + phytonadione (vitamin K) * Furosemide + digoxin
47
Warfarin
Anticoagulant Negated by vitamin K Dogs that eat......put on Vitamin K for for weeks
48
Drug Interaction and electrolyte changes Hypokalemia Hyperkalemia
Decreased K when diuretics (furosemide) given w/ * digitalis * antiarrhythmias * muscle relaxants Hypokalemia: increased digitalis binding to Na/K ATPase * Toxicity Hyperkalemia: decreased digitalis binding to Na/K ATPase * Decreased efficacy
49
Digoxin other drug interactions
1. Quinidine (Class 1A) * competes for same receptor * Dec renal clearance of digoxin (higher therapeutic drug conc) 2. Diuretics * worry about hypokalemia * can use potassium sparing diuretic 3. Hypercalcemia * induces inc in Intracellular calcium * enhances digitalis 4. Hypomagnesemic patient * more likely to cause an arrhythmia on digoxin
50
Preventing Drug interactions
1. Avoid polypharmacy 2. Assess and plan treatment regimen 3. Compatibility assessment * **especially with metal ions** 4. Color code IV lines 5. Multilumen catheters 6. In-line filters
51
Drug effects on lab tests
1. Steroids * inc ALP (dogs) 2. Potassium bromide * Pseudohyperchloridemia * Machine reads bromides as chlorides 3. Phenobarbital * Inc liver enzymes * neutropenia (can cause bone marrow necrosis) 4. Acetominophen, methimazole, methylene blue * methemoglobinemia (esp cats) 5. Chemotherapy, estrogens, griseofulvin, phenylbutazone * bone marrow supression 6. NSAIDS * platelet dysfunction
52
Drug interactions can start
Prior to administration
53
In vivo drug interactions are...
Hard to predict or diagnose
54
three types of drug interactions
1. Incompatibilities 2. PK 3. PD
55
PK interactions Absorption Phenobarb and Griseofulvin
Diminished absorption of griseofulvin in animals treated with phenobarb
56
Altered drug absorption in presence of food Inc Dec
Inc: * Chlorothiazide * Diazepam * Phenytoin Dec: * Amoxicillin * Tetracyclin * Aspirin
57
Drugs that are highly protein bound
Erythromycin Phenylbutazone Thiopental
58
Excretion and alteration of urinary pH
Drugs that alter urinary pH * may alter urinary excretion of ionizable drugs by **ion trapping**
59
Lidocaine for
ventricular arrhythmias

Pharmacology Test 3 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions