Drug Interactions

vitohuxo's version from 2016-02-19 00:15


Question Answer
oxidation, reduction, and hydrolysisphase 1 reactions (puts functional group on so can be attacked by phase 2)
phase 2 reactionnormally terminates activity of the drug
more than 80% of drugs are metabolized by CYP3A4
one of the strongest meds as being an inducerrifampin. basically induces all CYP enzyme and p glycoprotein.
codeine is metabolized to___ which is much of its effectmorphine by 2D6. between people wide variability of metabolizers (gene expression of 2D6) for converting so why drug unsafe!
pain and psych drugs through this CYP2D6
things like paroxetine can block codeine to morphine so less analgesia
when having induction it can take awihle to make enzymes so can take up to ___ to see effecttwo weeks. same goes for when stopped can take 2-4 weeks effect go away
medications that must have dose decreased by about 50% when starting amiodarone=digoxin, warfarin
digoxin drug level increases mostly due todecline in renal function or hyokalemia
digoxin watch with other drugs decrease heart rate==beta blockers and non-dihydro calcium blockers diltiazem and verapamil. also amiodarone, precedex, clonidine, and opiods
grapefruit juice could causeincreased bleeding risk or QT
BIG inducers PS PORCS= phenytoin, smoking, phenobarb, oxcarbazepine, rifampin, carbamazepine, st johns wort
big inhibitorsG PACMAN= grapefruit, protease inhbitors (ritonavir), azole antifungals, cyclosporine and cimetidine, macrolides, amiodarone, non DHP calcium blockers
high risk for severe rashlamotrigine and valproate
do not use monamine oxidase inhbiitros withSSRI SNRI or TCA
5 G's that can increase bleeding risk=ginkgo, garlic, ginger, glucosamine, ginseng
fish oils can cause what at higher doses?bleeding risk. also vitamin E and willow bark
chelation risk inhibit absorption=quinolones and tetracyclines. antacids, sucralfate, bile acid resins, magnesium, aluminum, calcium, iron, zinc, multivitamins, and any product containing these seperate