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

What effect can botanical medications have on conventional drugs?

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

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

<p>Chemical synthesis modification (A)</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. (B)</p> Signup and view all the answers

Which mechanism does NOT typically alter drug distribution?

<p>Changes in drug metabolism rate (D)</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. (B)</p> Signup and view all the answers

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

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

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

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

What does the predictability of drug interactions indicate?

<p>Whether the interaction will occur (B)</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 (A)</p> Signup and view all the answers

What is often emphasized incorrectly regarding protein binding displacement?

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

Which drug is known to decrease warfarin metabolism?

<p>Chloramphenicol (B)</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. (D)</p> Signup and view all the answers

Which statement about P-glycoprotein is true?

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

Anabolic steroids may alter which aspects of anticoagulant therapy?

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

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

<p>Alofibrate (B)</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. (C)</p> Signup and view all the answers

What is the effect of phenytoin on anticoagulant metabolism?

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

Which of the following statements regarding rivaroxaban is accurate?

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

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

<p>Ifabutin (C)</p> Signup and view all the answers

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

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

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

<p>Phenobarbital (C)</p> Signup and view all the answers

What effect does dicumarol have on oral hypoglycemics?

<p>Inhibits their metabolism. (C)</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 (D)</p> Signup and view all the answers

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

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

Which medication is associated with impaired synthesis of clotting factors?

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

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

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

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

<p>Itraconazole (D)</p> Signup and view all the answers

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

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

What is a common effect of quinidine on anticoagulants?

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

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

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

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

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

What effect does carbamazepine have on antidepressants?

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

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

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

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

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

What is a common interaction between antidepressants and haloperidol?

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

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

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

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

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

Flashcards

Pharmacodynamic Interactions

Interactions between herbs that affect how the body reacts to a drug.

Pharmacokinetic Interactions

Interactions that arise from how the body processes drugs, such as absorption and metabolism.

Absorption Rate Reduction

A decrease in how quickly a drug enters the bloodstream.

Absorption Extent Reduction

A decrease in the total amount of drug absorbed.

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Drug Interaction Mechanism

The way two or more drugs affect each other, influencing the drug's action and time course.

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Plasma Protein Binding Competition

Two drugs competing for binding sites on proteins in the blood.

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Predictability of Drug Interactions

The likelihood that a drug interaction will occur and lead to an adverse effect.

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Clinical Importance of Protein Displacement

The significance of a drug displacing another drug from plasma proteins, which may be less than expected.

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Drug Interactions

Drug interactions occur when a patient takes multiple medications, resulting in alterations in the body's response to the drugs.

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Gastrointestinal Absorption

The process of a drug entering the bloodstream after being consumed.

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Botanical Medications

Herbal remedies (botanicals) that may interact with other medications.

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Surface Area

The extent of the area available for absorption of a drug in the gastrointestinal tract.

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Binding/Chelation

Process through which molecules bond together, potentially impacting drug absorption.

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Gastric pH

The acidity of the stomach, which influences drug absorption.

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Warfarin metabolism

Warfarin's breakdown in the body is influenced by other drugs.

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CYP2C9 interaction

Some drugs can impact Warfarin's metabolism through CYP2C9, a crucial enzyme.

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CYP3A4 interaction

Drugs interacting with CYP3A4 can alter how Apixaban and Rivaroxaban are processed.

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P-glycoprotein interaction

P-glycoprotein impacts the metabolism of Apixaban, Dabigatran, and Rivaroxaban.

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Drug Interactions and Anticoagulants

Certain drugs influence anticoagulant response, affecting clotting factors.

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Timedime effect on warfarin

Timedime decreases warfarin's breakdown, impacting its effectiveness.

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Clofibrate's effect on anticoagulants

Mechanism of interaction of Clofibrate is unclear regarding anticoagulants.

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Warfarin Plasma Protein Binding

Warfarin strongly binds to plasma proteins, influencing its action.

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Phenytoin and Anticoagulants

Phenytoin increases the metabolism of anticoagulants. This can lead to a temporary increase in anticoagulant effect when starting phenytoin therapy, due to protein displacement of warfarin.

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Primidone and Anticoagulants

Primidone increases the metabolism of anticoagulants.

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Rifabutin and Anticoagulants

Rifabutin increases the elimination of anticoagulants.

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Rifampin and Anticoagulants

Rifampin increases the elimination of anticoagulants.

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St. John's Wort and Anticoagulants

St. John's Wort increases the elimination of anticoagulants.

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Clopidogrel Effect on Warfarin

Clopidogrel reduces warfarin metabolism and inhibits platelet function.

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Disulfiram's Impact on Warfarin

Disulfiram decreases warfarin metabolism.

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Erythromycin's Potential Effect on Anticoagulants

Erythromycin may inhibit anticoagulant metabolism.

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Fluconazole and Warfarin Metabolism

Fluconazole reduces warfarin metabolism.

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NSAID Effect on Platelets and Clotting

NSAIDs can inhibit platelet function and potentially increase the effect of blood thinners.

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Lovastatin and Warfarin Metabolism

Lovastatin reduces warfarin metabolism.

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Irinotecan and Warfarin

Irinotecan effects are unknown but generally not understood from the provided info.

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Quinidine and Hypoprothrombinemia

Quinidine can cause a more substantial hypoprothrombinemia effect.

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Antidepressant Interactions

Antidepressants can interact with other medications, potentially altering their effectiveness or causing adverse effects.

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Amiodarone & Antidepressants

Amiodarone can decrease the metabolism of antidepressants, potentially increasing their levels in the blood.

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Barbiturates & Antidepressants

Barbiturates can increase the metabolism of antidepressants, potentially decreasing their levels in the blood.

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Antidepressants & Bupropion

Bupropion can decrease the metabolism of antidepressants, potentially increasing their levels in the blood.

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Antidepressants & Carbamazepine

Carbamazepine can enhance the body's breakdown of antidepressants, potentially decreasing their levels.

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Antidepressants & Cimetidine

Cimetidine can decrease the metabolism of antidepressants, potentially increasing their blood levels.

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MAOIs & Other Antidepressants

Combining MAOIs with some other antidepressants can cause potentially harmful side effects like agitation or seizures.

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Rifampin & Antidepressants

Rifampin can increase the metabolism of antidepressants, potentially decreasing their blood levels.

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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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