What classes of medications interact with Triptans?
Other Triptans Ergotamine SSRIs MAOIs QT Prolonging Medications
Ergotamines are associated with life threatening ischemia when administered with what?
CYP3A4 Inhibitors (ie: Macrolides)
Other than 3A4 inhibitors what drugs interact with Ergotamines?
Should Levodopa be used with MAOIs?
Would Rasagiline and Selegiline interact with each other?
What Opioids do MAOIs interact with?
Dextromethorphan Meperidine Tramadol Methadone Propoxyphene
What Abx with interact with MAOIs?
T/F: St. John’s Wart interactions with MAOIs
What P450 enzyme metabolizes Rasagiline?
Extensively metabolized in the liver
When would Entacapone be considered a P450 inhibitor?
At higher doses than recommended for treatment
What medications interact with Safinamide?
Dextromethorhan MAOIs SNRIs St. John's Wart SSRis TCAs Cyclobenzaprine
T/F: Donepezil is metabolized by CYP 3A4 and 2D6
Is Rivastigmine metabolized by P450?
Are drug interactions commonly seen with Galantamine?
In what cardiac conditions should Galantamine be avoided?
Sick Sinus Syndrome
Tetrabenazine should be avoided with what class of medications?
Does acetaminophen interact with P450 2E1 inhibitors or inducers?
Should NSAIDs be given to patients taking blood thinners?
Should patients with G6PD Deficiency take ASA?
No, this can trigger hemolysis
What may happen if NSAIDs (Particularly Ibuprofen) is given with ASA?
It may block the antiplatalet effects of ASA.
Other than ASA, what medication classes may interact with NSAIDs?
Codeine is a CYP 2D6 ________ (Inducer/Inhibitor/Substrate)
What medications would inhibit this?
Bupropion, Cimetidine, Celecoxib, Cocaine
Oxycodone is metabolized by CYP 2D6 to __________.
Hydrocodone is metabolized by CYP 2D6 to __________.
Does Oxymorphone have P450 interactions?
What P450 isoenzyme is fentanyl metabolized by?
What class of medications will Meperidine interact with?
MAOIs (Respiratory Depression)
Propoxyphene is a CYP 3A4 _________ (substrate/inhibitor/inducer).
What P450 isoenzymes is methadone metabolized by?
CYP 3A4 and 2D6
What P450 isoenzymes is Bupenorphine metabolized by?
Tramadol used in combination with a MAOI or SSRI may result in an increased risk of what?
Should Tramadol be given with CYP 2D6 and 3A4 inhibitors?
Can tramadol be used in combination with carbamazepine?
Does Tapentadol have P450 Interactions?
What may happen if Tapentadol is taken with EtOH?
What would happened to the levels of TCAs if given with morphine or methadone?
Decrease the metabolism of TCAs leading to toxicity
How would quinidine effect codeine levels?
It would slow the conversion of codeine to morphine leading to decreased efficacy
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
Would propoxyphene ___________ (increase/decrease) levels of carbamazepine, Metoprolol, and propanolol
Why should propoxyphene be avoided in benzodiazepines?
It decreases the excretion of benzodiazepines leading to increased accumulation
Does erythromycin increase or decrease the effect of opioids?
Rifampin, Phenytoin, and Carbamazepine all __________ (increase/decrease) levels of methadone
CYP2D6 Inhibitors __________ (increase/decrease) tramadol levels
CYP2D6 Inhibitors __________ (increase/decrease) efficacy of hydrocodone and codeine
CYP2D6 Substrates __________ (increase/decrease) tramadol levels
CY3A4 inhibitors __________ (increase/decrease) methadone levels
CY3A4 inducers __________ (increase/decrease) methadone levels
What P450 isoenzymes is cyclobenzaprine metabolize by?
CYP 3A4, 1A2, 2D6
What are patients taking tramadol and cyclobenzaprine more at risk for?
What should MAOIs be avoided with cyclobenzaprine?
It can be a potentially fatal interaction
When should you avoid using BenGay (Methyl Salicylate)?