Interactions / P450 Flashcards

(51 cards)

1
Q

What classes of medications interact with Triptans?

A
Other Triptans
Ergotamine
SSRIs
MAOIs
QT Prolonging Medications
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2
Q

Ergotamines are associated with life threatening ischemia when administered with what?

A

CYP3A4 Inhibitors (ie: Macrolides)

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3
Q

Other than 3A4 inhibitors what drugs interact with Ergotamines?

A

Other Ergotamines
Vasoconstrictors
Serotonin Drugs

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4
Q

Should Levodopa be used with MAOIs?

A

No

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5
Q

Would Rasagiline and Selegiline interact with each other?

A

Yes

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6
Q

What Opioids do MAOIs interact with?

A
Dextromethorphan
Meperidine
Tramadol
Methadone
Propoxyphene
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7
Q

What Abx with interact with MAOIs?

A

Ciprofloxacin

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8
Q

T/F: St. John’s Wart interactions with MAOIs

A

True

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9
Q

What P450 enzyme metabolizes Rasagiline?

A

CYP1A2

Extensively metabolized in the liver

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10
Q

When would Entacapone be considered a P450 inhibitor?

A

At higher doses than recommended for treatment

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11
Q

What medications interact with Safinamide?

A
Dextromethorhan
MAOIs
SNRIs
St. John's Wart
SSRis
TCAs
Cyclobenzaprine
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12
Q

T/F: Donepezil is metabolized by CYP 3A4 and 2D6

A

True

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13
Q

Is Rivastigmine metabolized by P450?

A

No

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14
Q

Are drug interactions commonly seen with Galantamine?

A

No

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15
Q

In what cardiac conditions should Galantamine be avoided?

A

Heart Block

Sick Sinus Syndrome

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16
Q

Tetrabenazine should be avoided with what class of medications?

A

MAOIs

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17
Q

Does acetaminophen interact with P450 2E1 inhibitors or inducers?

A

Inducers

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18
Q

Should NSAIDs be given to patients taking blood thinners?

A

No

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19
Q

Should patients with G6PD Deficiency take ASA?

A

No, this can trigger hemolysis

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20
Q

What may happen if NSAIDs (Particularly Ibuprofen) is given with ASA?

A

It may block the antiplatalet effects of ASA.

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21
Q

Other than ASA, what medication classes may interact with NSAIDs?

A

Anti-coagulants
Anti-hypertensives
Diuretics
Hypoglycemics

22
Q

Codeine is a CYP 2D6 ________ (Inducer/Inhibitor/Substrate)

What medications would inhibit this?

A

Substrate

Inhibited by…..

Bupropion, Cimetidine, Celecoxib, Cocaine

23
Q

Oxycodone is metabolized by CYP 2D6 to __________.

24
Q

Hydrocodone is metabolized by CYP 2D6 to __________.

A

Hydromorphone

25
Does Oxymorphone have P450 interactions?
No
26
What P450 isoenzyme is fentanyl metabolized by?
CYP 3A4
27
What class of medications will Meperidine interact with?
MAOIs (Respiratory Depression)
28
Propoxyphene is a CYP 3A4 _________ (substrate/inhibitor/inducer).
Inhibitor
29
What P450 isoenzymes is methadone metabolized by?
CYP 3A4 and 2D6
30
What P450 isoenzymes is Bupenorphine metabolized by?
3A4
31
Tramadol used in combination with a MAOI or SSRI may result in an increased risk of what?
Seizures
32
Should Tramadol be given with CYP 2D6 and 3A4 inhibitors?
No
33
Can tramadol be used in combination with carbamazepine?
No
34
Does Tapentadol have P450 Interactions?
No
35
What may happen if Tapentadol is taken with EtOH?
Death
36
What would happened to the levels of TCAs if given with morphine or methadone?
Decrease the metabolism of TCAs leading to toxicity
37
How would quinidine effect codeine levels?
It would slow the conversion of codeine to morphine leading to decreased efficacy
38
If metoclopramide was given in combination with an opioid, what would you expect to see in the plasma levels of the opioid?
Earlier peak plasma levels
39
Would propoxyphene ___________ (increase/decrease) levels of carbamazepine, Metoprolol, and propanolol
Increase
40
Why should propoxyphene be avoided in benzodiazepines?
It decreases the excretion of benzodiazepines leading to increased accumulation
41
Does erythromycin increase or decrease the effect of opioids?
Increase
42
Rifampin, Phenytoin, and Carbamazepine all __________ (increase/decrease) levels of methadone
Decrease
43
CYP2D6 Inhibitors __________ (increase/decrease) tramadol levels
Increase
44
CYP2D6 Inhibitors __________ (increase/decrease) efficacy of hydrocodone and codeine
Decrease
45
CYP2D6 Substrates __________ (increase/decrease) tramadol levels
Increase
46
CY3A4 inhibitors __________ (increase/decrease) methadone levels
Increase
47
CY3A4 inducers __________ (increase/decrease) methadone levels
Decrease
48
What P450 isoenzymes is cyclobenzaprine metabolize by?
CYP 3A4, 1A2, 2D6
49
What are patients taking tramadol and cyclobenzaprine more at risk for?
Seizures
50
What should MAOIs be avoided with cyclobenzaprine?
It can be a potentially fatal interaction
51
When should you avoid using BenGay (Methyl Salicylate)?
Sulfa Allergies | ASA Allergies