Drug Interactions for PTCB Exam

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Questions and Answers

Grapefruit juice can heighten the likelihood of experiencing side effects from statins like atorvastatin.

True (A)

The combination of antiplatelet drugs and NSAIDs decreases the risk of bleeding.

False (B)

Multivalent ions such as calcium and magnesium can diminish the efficacy of drugs like levothyroxine.

True (A)

Combining nitrates with PDE5 inhibitors can cause severe hypotension.

<p>True (A)</p> Signup and view all the answers

ACE inhibitors such as ramipril are safe to use with potassium-elevating drugs.

<p>False (B)</p> Signup and view all the answers

Ritonavir does not affect the metabolism of protease inhibitors.

<p>False (B)</p> Signup and view all the answers

Combining beta-blockers with calcium channel blockers can increase the risk of heart failure.

<p>True (A)</p> Signup and view all the answers

Broad-spectrum antibiotics can lead to increased levels of vitamin K in the body.

<p>False (B)</p> Signup and view all the answers

Flashcards

Statins and Grapefruit Juice

Grapefruit juice interferes with statin metabolism, increasing side effects like muscle pain.

Antiplatelet/NSAID/Anticoagulant Combo

Combining these drugs significantly increases the risk of bleeding.

Multivalent Ions and Medications

Substances like milk and antacids can reduce the effectiveness of certain drugs like levothyroxine.

Nitrates and PDE5 Inhibitors

Combining nitrates and PDE5 inhibitors can cause dangerous drops in blood pressure.

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ACE Inhibitors and Potassium

ACE inhibitors can raise potassium levels, potentially causing hyperkalemia.

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Ritonavir and Protease Inhibitors

Ritonavir can change how protease inhibitors are processed, allowing for lower doses.

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Beta-Blockers and Calcium Channel Blockers

Combining these two types of blood pressure medications can worsen heart conditions.

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Broad-Spectrum Antibiotics and Warfarin

Broad-spectrum antibiotics can affect vitamin K levels, thus influencing the effectiveness of warfarin.

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Study Notes

Drug Interactions for PTCB Exam

  • Statins and Grapefruit Juice: Grapefruit juice contains furanocoumarins that interact with enzymes metabolizing statins (atorvastatin, simvastatin, lovastatin). This increases the risk of muscle pain/aches.

  • Antiplatelet, NSAIDs, and Anticoagulants: Combined use of antiplatelet drugs (clopidogrel), NSAIDs (aspirin, ibuprofen), and anticoagulants (warfarin, heparin) significantly increases bleeding risk. Also, SSRIs further amplify this risk.

  • Multivalent Ions and Various Drugs: Milk, antacids, calcium, magnesium, and iron can interact with medications like levothyroxine, tetracyclines, fluoroquinolones, and bisphosphonates, reducing their effectiveness.

  • Nitrates and PDE5 Inhibitors: Combining nitrates (e.g. nitroglycerin) and PDE5 inhibitors (sildenafil, tadalafil) can cause severe hypotension.

  • ACE Inhibitors and Potassium-Elevating Drugs: ACE inhibitors (ramipril, lisinopril) can elevate potassium levels. Avoid combining with potassium-elevating drugs (trimethoprim, potassium supplements) to prevent hyperkalemia.

  • Ritonavir and Protease Inhibitors: Ritonavir inhibits CYP enzymes, thus allowing lower doses of protease inhibitors (lopinavir) to achieve similar effects with fewer side effects.

  • Beta-Blockers and Calcium Channel Blockers: Combining beta-blockers (metoprolol) and calcium channel blockers (verapamil, diltiazem) increases the risk of heart failure and bradycardia.

  • Broad-Spectrum Antibiotics and Warfarin: Broad-spectrum antibiotics (penicillin, cephalosporins) deplete gut flora, reducing vitamin K production, increasing bleeding risk when taken with warfarin.

  • Digoxin and Loop/Thiazide Diuretics: Loop diuretics (furosemide) and thiazide diuretics (hydrochlorothiazide) can induce low potassium levels, increasing the risk of digoxin toxicity.

  • Aminoglycosides and Loop Diuretics: Combining aminoglycosides (gentamicin, amikacin) and loop diuretics (furosemide) increases the risk of ototoxicity and kidney damage.

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