Podcast
Questions and Answers
What is an example of a drug-food interaction that decreases drug absorption?
What is an example of a drug-food interaction that decreases drug absorption?
- Tetracycline with calcium-containing foods (correct)
- Ibuprofen with vitamin C
- Aspirin with green tea
- Grapefruit juice with statins
Which scenario best describes a drug-drug interaction?
Which scenario best describes a drug-drug interaction?
- A patient has dinner before taking their medication.
- A patient taking a painkiller and an antihistamine together experiences increased drowsiness. (correct)
- A patient takes a medication with a glass of water.
- A patient is prescribed antibiotics for a bacterial infection.
Which of the following is NOT a type of drug interaction?
Which of the following is NOT a type of drug interaction?
- Drug-food interactions
- Drug-exercise interactions (correct)
- Drug-disease interactions
- Drug-drug interactions
What factor can contribute to the occurrence of drug interactions?
What factor can contribute to the occurrence of drug interactions?
Which of the following substances is known to inhibit CYP3A4 and thus can interact with certain medications?
Which of the following substances is known to inhibit CYP3A4 and thus can interact with certain medications?
What is a common reason for patients taking multiple medications that can lead to drug interactions?
What is a common reason for patients taking multiple medications that can lead to drug interactions?
How do drug-disease interactions mainly occur?
How do drug-disease interactions mainly occur?
Which medication should avoid being taken with dairy products due to a drug-food interaction?
Which medication should avoid being taken with dairy products due to a drug-food interaction?
What effect does grapefruit juice have on atorvastatin levels?
What effect does grapefruit juice have on atorvastatin levels?
Which food is known to reduce the effectiveness of warfarin?
Which food is known to reduce the effectiveness of warfarin?
Which type of drug interaction is characterized by changes in the absorption, distribution, metabolism, or excretion of a drug?
Which type of drug interaction is characterized by changes in the absorption, distribution, metabolism, or excretion of a drug?
What condition might lead to increased blood pressure when taking pseudoephedrine?
What condition might lead to increased blood pressure when taking pseudoephedrine?
Which of the following interactions can occur prior to systemic administration?
Which of the following interactions can occur prior to systemic administration?
Which of the following can decrease the absorption and effectiveness of ketoconazole?
Which of the following can decrease the absorption and effectiveness of ketoconazole?
What is one potential consequence of serious drug interactions?
What is one potential consequence of serious drug interactions?
Which mechanism of drug interaction typically involves changes in drug effect due to interactions at the site of action?
Which mechanism of drug interaction typically involves changes in drug effect due to interactions at the site of action?
What effect do antibiotics have on the concentration of digoxin when taken together?
What effect do antibiotics have on the concentration of digoxin when taken together?
Which rating indicates that there is a significant interaction that requires monitoring of therapy?
Which rating indicates that there is a significant interaction that requires monitoring of therapy?
In terms of drug-drug interactions, which scenario exemplifies a pharmacodynamic interaction?
In terms of drug-drug interactions, which scenario exemplifies a pharmacodynamic interaction?
What does a rating of 'X' signify regarding drug interactions?
What does a rating of 'X' signify regarding drug interactions?
Which option describes the action needed when a 'D' drug interaction rating is assigned?
Which option describes the action needed when a 'D' drug interaction rating is assigned?
Which of the following is NOT a mechanism through which drug interactions can occur?
Which of the following is NOT a mechanism through which drug interactions can occur?
When may dosage adjustments be required due to drug interactions?
When may dosage adjustments be required due to drug interactions?
An example of a drug interaction that requires avoiding the combination would be indicated by which rating?
An example of a drug interaction that requires avoiding the combination would be indicated by which rating?
Flashcards
Drug Interactions
Drug Interactions
When one drug's effects are changed by another drug, herb, food, or drink.
Drug-Drug Interaction
Drug-Drug Interaction
When two or more drugs react with each other, potentially causing unexpected (and sometimes dangerous) side effects.
Drug-Food Interaction
Drug-Food Interaction
When food alters how a drug is absorbed by the body, potentially reducing its effectiveness or causing problems.
Polypharmacy
Polypharmacy
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Grapefruit Juice & Drug Interaction
Grapefruit Juice & Drug Interaction
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Calcium & Tetracycline
Calcium & Tetracycline
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Multiple Prescribers
Multiple Prescribers
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Grapefruit Juice and Drug Metabolism
Grapefruit Juice and Drug Metabolism
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Atorvastatin and Grapefruit Juice
Atorvastatin and Grapefruit Juice
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Vitamin K and Warfarin
Vitamin K and Warfarin
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Drug-Disease Interactions
Drug-Disease Interactions
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Drug Interaction Costs
Drug Interaction Costs
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Pharmaceutical Interactions
Pharmaceutical Interactions
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Pharmacokinetic Interactions
Pharmacokinetic Interactions
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Pharmacodynamic Interactions
Pharmacodynamic Interactions
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Ketoconazole and Antacids
Ketoconazole and Antacids
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Pharmacodynamic Interactions
Pharmacodynamic Interactions
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Drug Interaction Risk Rating
Drug Interaction Risk Rating
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No Interaction (A)
No Interaction (A)
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No Action Needed (B)
No Action Needed (B)
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Monitor Therapy (C)
Monitor Therapy (C)
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Modify Regimen (D)
Modify Regimen (D)
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Avoid Combination (X)
Avoid Combination (X)
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Digoxin + Antibiotics
Digoxin + Antibiotics
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Study Notes
Drug Interactions
- Medicines improve health and well-being, but drug interactions can cause problems.
- Drug interactions occur when one drug's effects change due to other drugs, herbs, food, or drink.
- A drug interaction is defined as a change in the pharmacological activity of a drug due to use with another drug or substance.
- Multiple drug use is common due to single or multiple disorders, or OTC medications.
- Patients may take caffeine, nicotine, alcohol, herbal remedies, and other drugs concurrently.
Possible Effects of Drug Interactions
- Drugs may decrease in effectiveness.
- Drugs may increase in effectiveness.
- Drugs may cause more adverse effects.
Factors Contributing to Drug Interactions
- Multiple drug use (polypharmacy)
- Multiple prescribers
- Multiple pharmacological effects of a drug
- Multiple diseases (e.g., hepatic, renal)
- Poor patient compliance
- Older age
- Drug-related factors
Types of Drug Interactions
- Drug-drug interactions: When two or more drugs interact.
- Drug-food interactions: When food affects how drugs are absorbed.
- Drug-disease interactions: When pre-existing conditions affect how drugs work.
Drug-Food Interactions
- Food commonly decreases drug absorption rate.
- Grapefruit juice can increase blood levels of certain drugs by inhibiting their metabolism.
- Foods rich in Vitamin K may reduce the effectiveness of warfarin.
Examples
- Tetracycline (antibiotic) and calcium-containing foods: Reduces absorption and antibacterial effectiveness.
- Ketoconazole (antifungal) and antacids, proton pump inhibitors, H2-receptor blockers: Reduces absorption and effectiveness against fungal infections.
- Digoxin (heart medication) and antibiotics: Increases digoxin concentration and toxicity, as antibiotics reduce the intestinal flora.
Mechanisms of Drug Interactions
- Pharmaceutical interactions: Occur prior to systemic administration (e.g., incompatibility of drugs mixed in IV fluids).
- Pharmacokinetic interactions: One drug alters rate or extent of absorption, distribution, metabolism or excretion of another drug; blood concentration changes impact the drug's effect (ADME interactions).
- Pharmacodynamic interactions: One drug's effect is changed by another drug in a combination regimen. If two drugs are toxic to the same organ, taking them together can intensify negative effects.
Drug Interaction Categorization
- Each drug interaction monograph is assigned a rating of A, B, C, D, or X.
- A: No interaction.
- B: No action needed.
- C: Monitor therapy (often, the benefits outweigh the risks).
- D: Modify regimen.
- X: Avoid combination (risks outweigh the benefits).
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