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48 Cards in this Set

  • Front
  • Back
all drug-drug interactions are undesirable
false
all drug-drug interactions are unintended
false
all drug-drug interactions are predictable and therefore avoidable
false
3 possible outcomes when 2 drugs interact
-intensify effect (potentative)
-reduce the effect
-create a unique response
additive effect of drug interaction
2 drugs w/similar actions working together
2 drugs work together but the combine effect is higher than if both given were given alone
synergistic effect
taking two meds, one may intensify effect of other
potentiative
benefits of potentiative interactions
enhance therapeutic effect
detriments of potentiative interactions
intensify adverse effects
benefits of sulbactum and ampicillin interaction
when two interact, sulbactum inhibits enzymes to rapidly inactivate ampicillin, prolonging amps therapeutic effects
interaction of aspirin & warfarin
warfarin & aspirin both suppress formation of clots, if given @ same time pt @ risk for spontaneou bleeding
interactions that result in reduced drug effects
inhibitory
inhibitory interaction that reduce toxicity
beneficial interaction
inhibitory interactions that reduce therapeutic effects
detrimental interactions
interaction of albuterol & propranolol
propanolol can act in lung to block affect albuterol, reducing its therapeutic effect
morphine & naloxone interaction
naloxone is used to treat morphine overdose, naloxone blocks morphine reversing symptoms of toxicity
2 undesirable effects of drugs w/incompatible physical/chemical properties mixed in IV bottle/tubing
altered absorption & altered distribution
antacids decreasing ionization of basic drugs and elevate gastric pH (incr. ability to cross mbrn & be absorbed)
ways drug-drug interactions may alter absorption
laxatives can accelerate drug passage thru intestines (lax. reduce absorb.)
ways drug-drug interactions may alter absorption
drugs can depress peristalsis prolonging transit time in intestines (incr. time for absorb.)
ways drug-drug interactions may alter absorption
drug that induce vomit decrease absorption of oral drugs
ways drug-drug interactions may alter absorption
oral adsorbent drugs that dont undergo absorption- adsorb other drubs onto themeselves (preventing absorption of other drugs into blood)
ways drug-drug interactions may alter absorption
drug that reduce regional blood flow - reduce absorption of other drugs in that region
ways drug-drug interactions may alter absorption
2 mechanisms by which one drug alters distribution of another
-competition for protein binding
-alteration of extracellular pH
how drugs increase metabolism of other drugs
inducing synthesis of hepatic drug-metabolizing enzymes
an eg. of how 1 drug may alter renal excretion of another drug thru decreased glomeration filtration
drugs that reduce cardiac output decr. renal blood flow which decr. drug filtration @ glomerulus & then decr. rate of drug excretion
two basic types of pharmacodynamic drug interactions
-interactions @ same receptors
-interactions resulting fr: actions @ separate site
term used almost always to describe drug-drug interactions that occur @ same receptor site
inhibitory
describe interaction that occurs at same receptor site
inhibition occurs when antagonist block access of agonist to its receptor
drug-drug interactions from actions @ separate sites termed potentative
interactions resulting fr: concurrent use of drugs @ seperate sites --drugs dont share same mechanism of action
drug-drug interations from actions @ separate sites termed inhibitory
drug acting @ one site counteracts effects of 2nd drug @ another site
result if 2 drugs that are both toxic to same organ are given together
would cause more injury to organ than if given separate
(rule-drugs w/overlapping toxicity aren't used together if possible)
2 factors that increase risk of drug-drug interactions
-number of drugs people take (multiple)
-overlapping toxicity
Q/A #20, p61
adjust timing of administration
ways drug-drug interactions may be minimized
adjust dosage
ways drug-drug interactions may be minimized
avoid detrimental interaction
ways drug-drug interactions may be minimized
minimize number of drugs pt receives
ways drug-drug interactions may be minimized
monitor for early signs of toxicity when combinations of toxic agents cannot be avoided
ways drug-drug interactions may be minimized
be vigilant when pt is taking drug w/low therapeutic index
ways drug-drug interactions may be minimized
effect calcium containing foods have on the absorption of tetracycline
tetracycline binds w/Ca to form insolube nonabsorbance complex, absorp. decreases, antibacterial effect is lost
effect of high fiber foods on absorption of digoxin
dig. has low therapeutic level, hi-fiber foods decr. it more--reducing absorption =therapeutic failure
citrus fruit that can inhibit metabolism of certain drugs
grapefruit
food product that can interact
w/theophylline & result in excessive CNS excitation
caffeine
electrolyte present in salt substitutes that may interact w/some diuretics
potassium
vitamin involved in clotting process, fd in common foods & may interact w/certain anticoagulant
Vitamin K
recommended time frame to use when scheduling drug to be admin. "on empty stomach"
administer: 1 hour before meal or 2 hrs after meal
recommended time frame to use when scheduling drug to be admin. "with meals"
administer: with or shortly after meal
2 drugs w/similar actions working together
additive effect