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84 Cards in this Set
- Front
- Back
carbamazepine
|
strong CYP inducer
|
|
adriamycin
|
P-glycoprotein – substrate
|
|
amiodarone
|
2D6 – moderate inhibitor
use sotalol 2C9 – moderate inhibitor use sotalol P-glycoprotein – inhibitor |
|
amphetamines
|
2D6 – major substrate
|
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atypical antipsychotics
|
2D6 – major substrate
|
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benzodiazepines (alprazolam, triazolam, diazepam, midazolam)
|
3A4 – major substrate
use lorazepam or oxazepam for triazolam esp. |
|
caffeine
|
1A2 – major substrate
|
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carvedilol
|
2C9 – major substrate
|
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CCB (amlodipine, felodipine, diltiazem, verapamil)
|
3A4 – major substrate
|
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celecoxib
|
2C9 – major substrate
|
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charcoal-broiled foods
|
1A2 – moderate inhibitor
|
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cigarette smoke
|
1A2 – moderate inhibitor
|
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cimetidine
|
1A2 – moderate inhibitor
use famotidine 2C19 – moderate inhibitor use famotidine 2D6 – moderate inhibitor use famotidine 3A4 – moderate inhibitor |
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ciprofloxacin
|
1A2 – strong inhibitor
use another FQ |
|
citalopram
|
2C19 – major substrate
|
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clarithromycin
|
1A2 – moderate inhibitor
use azithromycin 3A4 – strong inhibitor P-glycoprotein – substrate P-glycoprotein – inhibitor |
|
clozapine
|
1A2 – major substrate
|
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codeine --> morphine
|
2D6 – major substrate
|
|
daunorubicin
|
P-glycoprotein – substrate
|
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diazepam
|
2C19 – major substrate
use lora-/oxa-/tema-zepam |
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digoxin
|
P-glycoprotein – substrate
|
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erythromycin
|
1A2 – moderate inhibitor
use azithromycin 3A4 – moderate inhibitor P-glycoprotein – substrate P-glycoprotein – inhibitor |
|
fluconazole
|
2C19 – strong inhibitor
use voriconazole 3A4 – moderate inhibitor 2C9 – strong inhibitor use voriconazole |
|
fluoxetine
|
2C19 – moderate inhibitor
2C9 – major substrate 2D6 – strong inhibitor use escitalopram |
|
fluvastatin
|
2C9 – major substrate
2C9 – moderate inhibitor |
|
fluvoxamine
|
1A2 – major substrate
1A2 – strong inhibitor use escitalopram 2C19 – strong inhibitor |
|
garlic (allicin)
|
strong CYP inducer
|
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gemfibrozil
|
2C19 – strong inhibitor
use fenofibrate 2C9 – strong inhibitor |
|
glimepiride
|
2C9 – major substrate
|
|
glipizide
|
2C9 – major substrate
|
|
grapefruit juice
|
3A4 – strong inhibitor
|
|
haloperidol
|
2D6 – major substrate
|
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hydro-/oxy-codone
|
2D6 – major substrate
|
|
hypericum (St. John’s Wort)
|
strong CYP inducer
|
|
ibuprofen
|
2C9 – strong inhibitor
use APAP |
|
isoniazid
|
2C19 – strong inhibitor
3A4 – strong inhibitor |
|
itraconazole
|
3A4 – strong inhibitor
|
|
ketoconazole
|
1A2 – strong inhibitor
use fluconazole 2D6 – moderate inhibitor use fluconazole 3A4 – strong inhibitor 2C9 – strong inhibitor P-glycoprotein – inhibitor |
|
losartan
|
2C9 – major substrate
|
|
methadone
|
2D6 – major substrate
|
|
metoprolol
|
2D6 – major substrate
|
|
metronidazole
|
3A4 – moderate inhibitor
|
|
mirtazapine
|
1A2 – major substrate
|
|
omeprazole
|
2C9 – moderate inhibitor
use lansoprazole or famotidine |
|
oral contraceptive
|
1A2 – major substrate
3A4 – major substrate |
|
paclitaxel
|
P-glycoprotein – substrate
|
|
paroxetine
|
2D6 – strong inhibitor
use escitalopram |
|
PDE5-I (sildenafil, tadalafil, & vardenafil)
|
3A4 – major substrate
|
|
phenobarbital
|
strong CYP inducer
2C19 – major substrate |
|
phenytoin
|
strong CYP inducer
2C19 – major substrate 2C9 – major substrate P-glycoprotein – substrate P-glycoprotein – inducer |
|
primidone
|
strong CYP inducer
|
|
propranolol
|
1A2 – major substrate
2D6 – major substrate |
|
protease inhibitors
|
3A4 – major substrate
P-glycoprotein – substrate |
|
quinidine
|
2D6 – strong inhibitor
3A4 – strong inhibitor P-glycoprotein – inhibitor |
|
rifampin
|
strong CYP inducer
P-glycoprotein – inducer |
|
ritonavir
|
2D6 – strong inhibitor
3A4 – strong inhibitor |
|
sertraline
|
2C19 – major substrate
2D6 – moderate inhibitor |
|
SSRIs
|
2D6 – major substrate
|
|
St. John’s Wort
|
P-glycoprotein – inducer
|
|
statins (atorvastatin, lovastatin, simvastatin)
|
3A4 – major substrate
use pravastatin or rosuvastatin |
|
TCA
|
2D6 – major substrate
|
|
telithromycin
|
3A4 – strong inhibitor
|
|
theophylline
|
1A2 – major substrate
|
|
TMP/SMX
|
2C9 – major substrate
2C9 – strong inhibitor |
|
tramadol
|
2D6 – major substrate
|
|
verapamil
|
P-glycoprotein – inhibitor
|
|
vinca alkaloids
|
P-glycoprotein – substrate
|
|
voriconazole
|
3A4 – moderate inhibitor
2C9 – major substrate |
|
warfarin
|
2C9 – major substrate
|
|
zileuton
|
1A2 – moderate inhibitor
use montelukast |
|
cyclosporine and tacrolimus are substrates of |
3A4 and P-gp |
|
mycophenolate |
decrease levels of hormonal contraception decreased by antacids, multivit, cyclosporine, metronidazole, PPIs, fluoroquinolones, sevelamer, bile acid resins, rifampin. increased by acyclovir, valganciclovir, ganciclovir. avoid grapefruit |
|
triptan product comparisons |
sumatriptan (Imitrex): PO, nasal, SQ, transdermal patch rizatriptan (Maxalt): PO, ODT zolmitriptan (Zomig): PO nasal, ODT frovatriptan (Frova): long t1/2 eletriptan (Relpax): more effective than sumatriptan |
|
Fiorinal vs Fioricet |
Fiorinal: ASA, butalbital, caffeine Fioricet: APAP, butalbital, caffeine +/- codeine |
|
migraine prophylaxis |
acute medication use more than 2 times per week
propranolol, timolol, metoprolol, valproate, topiramate |
|
gout prophylaxis |
more than 2 acute attacks per year, goal uric acid: 5-6 mg/dL |
|
Loop dose equivalency |
furosemide 40 mg bumetanide 1 mg torsemide 20 mg ethacrynic acid 50 mg |
|
beta blocker use in HF |
recommend: carvedilol, metoprolol succinate, bisoprolol start: class II-IV improves ventricular systolic function, decrease morbidity/mortality |
|
aldosterone antagonist in HF |
reduce morbidity and mortality start: class III-IV |
|
hydralazine+nitrate in HF |
black patients start: class III-IV with symptoms despite therapy no effect on outcomes alone. |
|
digoxin in HF |
Positive ionotropic effect (increase CO), negative chronotropic effect (decrease HR) no change in survival but reduced hospitalizations and improved symptoms |
|
ADHF |
congestion: jugular vein distension, edema, rales, ascites hypoperfusion: cool extremities, hypotension, decreased renal function, impaired mental function -- DC beta blocker |
|
factor Xa inhibitor |
SQ: fondaparinux PO: rivaroxaban, apixaban |
|
direct thrombin inhibitors |
SQ/IV: argatroban, bivalirudin, desirudin PO: dabigatran |