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18 Cards in this Set
- Front
- Back
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Drug Interactions
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result from drug-drug or drug-food
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Drug-Drug
Pharmacokinetic |
Direct: alter physiological process involved in absorbtion, distribution, biotransformation, elimination
Indirect: Changes intensity of drug |
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Drug-Drug
Pharmacodynamic |
Direct: alteration of pharmacological effects at receptor sites
Indirect: Acting on systems different from those of primary drug |
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What are treatments commonly employed in Multiple drug therapy and what are the goals?
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Hypertension
Heart Failure Cancer Pain Goals: enhance desired therapeutic result, and decrease drug induced toxicity |
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Drug-Drug
Pharmacokinetic PO Administration |
Fomration of unabsorable comple with metal ions and with other drugs
Alteration of gastro flora Reduced GI Motility: Anticholinergic Increased GI Motility: Cathardics effect sustained release |
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Drug-Drug
Pharmacokinetic IV Administration |
IV of one drug can form precipitate with another IV drug
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Drug-Drug
Pharmacokineitc Displacement |
Plasma binding protein: competition between drugs for smae binding sites
Acidic Drug: Albumin Basic Drug: alpha-1-acid glycoprotein Produce toxix effects whenever protein bound fraction >80% |
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Drug-Drug
Pharmacokinetic Biotransformational |
Changes in rate of biotransformation more impact on P.O. than other routes
Major organ is Liver, but also kidney, lungs, GI |
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How are microsomes formed?
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Vesicles formed by fractionation and ultracentrifugation of cells
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Two important Microsomal Enzymes and what are they important in?
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NADPH - Cytochrome c reductase
Cytochrome P-450 Very important in ox.-reduction rxn in reagard to hepatocytes contain alot of SER |
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Drug-Drug
Pharmacokinetic Enzyme Induction |
Increase in CYP from chronic therapy
Results: shorter T 1/2 and reduced pharmacological activity Drugs: Barbittates, Anticonvulsants, Rifampin |
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Drug-Drug
Pharmacokinetic Enzyme Inhibition |
Reduced biotransformational activity Reduced enzyme
Results: Longer T 1/2 and Increase pharmacological activity Drugs: Cimetidine (Tagamet), Cipro, Contraceptives, Fluoxetine |
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Drug-Drug
Pharmacokinetic Elimination |
Highly polar are redily excretable, not reabsorbed unless carrie transport
Nonionized high L/W are reabsorbed Competitive inhibition |
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Drug-Drug
Pharmacokinetic Elimination: Tubular Secretion |
Proximal tubules site of active secretion
Energy dependent Can be blocked by metabolic inhibitors Exists for anions and cations Can be saturated |
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Drug-Drug
Pharmacodynamic Enhancement |
Additive: total effect simple combination of actions of drugs; giving multiple opioids similar mechanisms
Potentiating: Total effect larger that simple combination of each drug, often different mechanisms of action |
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Drug-Food
Pharmacokinetic PO Administration |
Formation of unabsorbable complex with Ca2+ or food in gi may reduce OR increase absorbtion
Can have both situations with same class of drug |
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Drug-Food
Pharmacokinetic Biotransformational |
Enzyme inhibition
Reduced biotransformational capacity Grapefruit juice: increase pharmacological effects |
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Drug-Food
Pharmacodynamic MAO Inhibitors |
Diet restriction: Substances containing TYRAMINE are likely to cause potentialy lethal increase in BP
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