Important Drug Interactions & Mechanisms
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Questions and Answers

What is one of the main factors that can change drug response?

  • Drug storage conditions
  • Concurrent administration of other drugs (correct)
  • Drug manufacturing processes
  • Patient age

    • Which category does NOT describe a mechanism of drug interaction?

  • Pharmacodynamic
  • Pharmacokinetic
  • Physiological (correct)
  • Combined interactions

    • Which of the following is a pharmacokinetic mechanism of drug interaction?

  • Antagonistic effects
  • Gastrointestinal absorption changes (correct)
  • Additive effects
  • Synergistic effects

    • What is a principal challenge in studying interactions of botanical medications?

    <p>Insufficient research on their interactions</p> Signup and view all the answers

    Which factor is least likely to affect the gastrointestinal absorption of drugs?

    <p>Drugs manufactured in liquid form</p> Signup and view all the answers

    Which action is most important to mitigate the risk of patient harm due to drug interactions?

    <p>Prescriber recognition of potential interactions</p> Signup and view all the answers

    What effect can botanical medications have on conventional drugs?

    <p>Both B and C</p> Signup and view all the answers

    Which of the following is NOT a mechanism through which drugs may interact?

    <p>Chemical synthesis modification</p> Signup and view all the answers

    What is clinically important regarding the extent of drug absorption?

    <p>Reductions in the extent of absorption may lead to subtherapeutic serum concentrations.</p> Signup and view all the answers

    Which mechanism does NOT typically alter drug distribution?

    <p>Changes in drug metabolism rate</p> Signup and view all the answers

    What has been shown regarding the clinical importance of protein binding displacement?

    <p>It is unlikely to result in clinical adverse effects.</p> Signup and view all the answers

    What type of interactions are documented on St. John’s wort?

    <p>Pharmacokinetic interactions</p> Signup and view all the answers

    Which of the following does NOT describe a mechanism causing drug interactions?

    <p>Changes in patient diet</p> Signup and view all the answers

    What does the predictability of drug interactions indicate?

    <p>Whether the interaction will occur</p> Signup and view all the answers

    Which mechanism may influence both the time course and methods to circumvent drug interactions?

    <p>Understanding drug interaction mechanisms</p> Signup and view all the answers

    What is often emphasized incorrectly regarding protein binding displacement?

    <p>Its clinical importance is often overemphasized.</p> Signup and view all the answers

    What is the role of CYP2C9 in relation to warfarin?

    <p>It is responsible for warfarin's metabolism.</p> Signup and view all the answers

    Which drug is known to decrease warfarin metabolism?

    <p>Chloramphenicol</p> Signup and view all the answers

    What does a '[P]' designation indicate regarding drug interactions?

    <p>Interactions occur in most patients, but predictability varies.</p> Signup and view all the answers

    Which statement about P-glycoprotein is true?

    <p>It is implicated in the metabolism of multiple anticoagulants.</p> Signup and view all the answers

    Anabolic steroids may alter which aspects of anticoagulant therapy?

    <p>Clotting factor synthesis.</p> Signup and view all the answers

    Which of the following drugs is classified as '[NE]' in drug interactions?

    <p>Alofibrate</p> Signup and view all the answers

    What does '[HP]' indicate in the context of drug interactions?

    <p>Interaction occurs with high predictability in all patients.</p> Signup and view all the answers

    What is the effect of phenytoin on anticoagulant metabolism?

    <p>Increased metabolism of anticoagulants.</p> Signup and view all the answers

    Which of the following statements regarding rivaroxaban is accurate?

    <p>It is affected by P-glycoprotein metabolism.</p> Signup and view all the answers

    Which drug has been noted for increasing the elimination of anticoagulants?

    <p>Ifabutin</p> Signup and view all the answers

    What is the interaction classification of phenytoin's effect on its own metabolism?

    <p>Predictable interaction.</p> Signup and view all the answers

    Which of the following medications does NOT lead to increased anticoagulant elimination?

    <p>Phenobarbital</p> Signup and view all the answers

    What effect does dicumarol have on oral hypoglycemics?

    <p>Inhibits their metabolism.</p> Signup and view all the answers

    What effect does clopidogrel have on warfarin metabolism and platelet function?

    <p>Decreases warfarin metabolism and inhibits platelet function</p> Signup and view all the answers

    Which of the following substances is known to decrease warfarin metabolism?

    <p>Fluconazole</p> Signup and view all the answers

    Which medication is associated with impaired synthesis of clotting factors?

    <p>Danazol</p> Signup and view all the answers

    What mechanism is proposed for the effect of fluoxetine on warfarin?

    <p>Inhibition of anticoagulant metabolism</p> Signup and view all the answers

    Which drug is classified as decreasing apixaban, dabigatran, and rivaroxaban elimination?

    <p>Itraconazole</p> Signup and view all the answers

    How do nonsteroidal anti-inflammatory drugs (NSAIDs) typically affect platelet function?

    <p>Inhibit platelet function</p> Signup and view all the answers

    What is a common effect of quinidine on anticoagulants?

    <p>Creates additive hypoprothrombinemia</p> Signup and view all the answers

    Which of the following drugs is least likely to affect warfarin metabolism?

    <p>Diclofenac</p> Signup and view all the answers

    Which drug is known to lead to enhanced metabolism of antidepressants?

    <p>Barbiturates</p> Signup and view all the answers

    What effect does carbamazepine have on antidepressants?

    <p>Increased antidepressant metabolism</p> Signup and view all the answers

    Which of the following antidepressants can lead to excitation and hyperpyrexia when combined with MAOIs?

    <p>Clomipramine</p> Signup and view all the answers

    Which drug was noted to have a decreased antidepressant metabolism effect?

    <p>Quinidine</p> Signup and view all the answers

    Which drug is likely to amplify the antimuscarinic effects when combined with tricyclic antidepressants?

    <p>Other antimuscarinic drugs</p> Signup and view all the answers

    What is a common interaction between antidepressants and haloperidol?

    <p>Decreased antidepressant metabolism</p> Signup and view all the answers

    Which has been documented to decrease the antihypertensive effect of clonidine?

    <p>Guanadrel</p> Signup and view all the answers

    Which of the following drugs is not known to interact negatively with antidepressants?

    <p>Aspirin</p> Signup and view all the answers

    Study Notes

    Important Drug Interactions & Their Mechanisms

    • Drug interactions can alter drug responses.
    • Mechanisms are categorized as pharmacokinetic (absorption, distribution, metabolism, excretion), pharmacodynamic (additive, synergistic, or antagonistic effects), or combined.
    • Botanical medications ("herbals") may interact with each other or conventional drugs.
    • Fewer interactions with botanicals are well-studied.
    • Time course and method of circumventing an interaction are influenced by the mechanism.
    • Various mechanisms can result in drug interactions.

    Pharmacokinetic Mechanisms

    • Gastrointestinal absorption can be affected by concurrent agents.
    • Factors can include large surface area for drug adsorption, binding/chelating, altering gastric pH, changing motility, and affecting transport proteins (e.g., P-glycoprotein).
    • Changes in absorption rate (vs extent) affect clinical significance.
    • Distribution interactions involve competition for plasma protein binding, displacement from tissue binding, and changes in local tissue barriers.
    • Protein binding displacement is less clinically significant than previously thought.
    • Metabolism can be stimulated or inhibited by concurrent therapies, impacts varying from negligible to dramatic.
    • Primarily occurs in the liver and small intestine, but also in plasma, lungs, and kidneys.

    Predictability of Drug Interactions

    • Estimates are used to assess drug interaction predictability.
    • Estimates indicate if an interaction is likely to occur, not necessarily that it will produce adverse effects.
    • Patient-specific factors are key, including drug clearance, genetics, gender, concurrent diseases, and diet.
    • Drug properties like dose, administration route, and formulation also influence predictability.
    • Important for prescribers to recognize potential interactions and take appropriate action.

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    Related Documents

    Drug Interactions PDF

    Description

    Explore the critical drug interactions and their underlying mechanisms. This quiz covers pharmacokinetic and pharmacodynamic mechanisms, along with the effects of botanical medications. Understand how various factors influence clinical significance and the ways to circumvent potential interactions.

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