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29 Cards in this Set
- Front
- Back
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What may one drug do to the action of another?
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Nothing
Additive Effect Synergistic Effect/Potentiating Antagonistic Effect |
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What are the main Mechanisms of Interactions?
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Physicochemical
Pharmacodynamic Pharmacokinetic Physiological |
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What are the subtypes of Physicochemical Drug Interactions?
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Acid/Base
Chelation Binding (Absorption) |
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List some examples of Acid Drugs:
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NSAIDs (Asprin)
B-Lactams Sulfa Drugs Fluoroquinolones (Enrofloxacin) Antifungals (Amphotericin B) Barbituates Warfarin Heparin Site 1 Diuretics Site 2 Diuretics (Furosemide) Site 3 Diuretics (Thiazides) Vitamin C Vitamin K |
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List some examples of Basic Drugs:
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Sympathetic Amines (Epinephrine)
Methylxanthines (Theophylline) Alkaloids (Atropine, Pilocarpine, Neostigmine) Metronidazole Aminoglycosides (Gentamicin) Tranqulizers (Acepromazine, Diazepam) Opiods (Morphine, Butorphanol) Local Anesthetics (Lidocaine) Antihistamines Vitamin B |
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What are Pharmacodynamic Drug Interactions?
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Due to action at receptor of agonist with partial agonist or antagonist.
May result in Additive, >Additive, or Antagonistic Effects. |
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What contributes to Pharmacodynamic Drug Interactions?
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Lack of receptor specificity
Adaptations of the receptor (Down-Regulation or Cross-Resistance) |
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How do Pharmacokinetic Drug Interactions affect Drug Absorption?
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Interacting Drugs may change:
Absorption Rates pH Bioavailability |
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What are 3 ways Pharmacokinetic Drug Interactions change Drug Absorption?
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1) Change pH/pKa Relationship
2) Physiochemical Interactions 3) Changes in Transit Time |
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How do Pharmacokinetic Drug Interactions affect Drug Distribution?
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Disturb Blood Flow
Protein Binding Change Distribution Site |
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List some examples of highly protein bound drugs:
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NSAIDs
Warfarin Amphotericin B Imidazole Antifungals Propranolol Furosemide Thiopental Quinidine Erythromycin |
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How do Phramacokinetic Drug Interactions affect Metabolism?
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Accelerated Metabolism
Inhibited Metabolism |
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List some examples of Microsomal Enzyme Inducers:
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Barbituates
Phenylbutazone Rifampin Chlorinated Compounds of High MW |
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List some examples of indirect Mircosomal Enzyme Inhibitors:
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Tetracycline
Chloramphenicol Macrolides (except Rifampin) Imidazole Antifungals Omeprazole Quinidine |
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List some drugs that are highly metabolized by Microsomal Enzymes:
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Barbiturates
NSAIDs Steroids Antihistamines Opiods Tranquilizers Antifungals Sulfa Drugs Warfarin Quinidine Propranolol Others |
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How do Phramacokinetic Drug Interactions affect Excretion?
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Kidney-Glomerular Filtration
Kidney-Tubular Secretion Kidney-Tubular Reabsorption Gastrointestinal Effects |
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How do Phramacokinetic Drug Interactions affect Kidney Glomerular Filtration?
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Not a site for many drug interactions unless drug causes kidney damage.
GFR increases when Protein Binding Decreases. GFR especially important for drugs with LOW Vd. |
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How do Phramacokinetic Drug Interactions affect Kidney-Tubular Secretion?
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Weak Acids compete for Weak Acid binding sites.
Weak Bases compete for Weak Base binding sites. Competition can be used to keep drugs in circulation longer. |
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How do Phramacokinetic Drug Interactions affect Kidney-Tubular Reabsorption?
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Affect pH/pKa relationship of urine--> Ion Trapping
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How do Phramacokinetic Drug Interactions affect Gastrointestinal Factors?
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One drug can change the transit time of another that uses this route of excretion, increasing or decreasing the time in the body.
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What are Physiological Drug Interactions?
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Those that deal with clinical manifestations rather than mechanisms.
How the whole body or organ is effected. |
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What class of Drug Interaction is the following:
Additive Interaction of Aminoglycoside or Cephalosporins with Loop Diuretics causes renal toxicity if the patient is dehydrated. |
Physiological Drug Interaction
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What class of Drug Interaction is the following:
Additive Arrhythmogenic effects of Epinephrine and Halogenated Inhalant Anesthetics (Halothane). |
Physiological Drug Interaction
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What class of Drug Interaction is the following:
Additive Effects of Sympathomimetics and Methylxanthines |
Physiological Drug Interaction
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What class of Drug Interaction is the following:
Antidotal effects of Epinephrine on Histamine-mediated bronchoconstriction and vasodilation |
Physiological Drug Interaction
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What class of Drug Interaction is the following:
Antidotal effects of barbituates and convulsants. |
Physiological Drug Interaction
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What class of Drug Interaction is the following:
Additive or Synergistic effects of Opiods and Barbituates. |
Physiological Drug Interaction
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Why do the following pairs cause drug interactions??:
Epinephrine & Alpha and Beta Blockers Norepinephrine & Alpha Blockers Prostaglandins & NSAIDs Penicillin & Tetracycline Penicillin & Polymixin B Antacids & Tetracycline Propranolol & Phenylbutazone Lidocaine & Neostigmine |
Epinephrine & Alpha and Beta Blockers: Antagonistic Reaction
Norepinephrine & Alpha Blockers: Antagonistic Reaction Prostaglandins & NSAIDs: Opposite Effects Penicillin & Tetracycline: Bacteriocidal & Bacteriostatic Penicillin & Polymixin B: Weak Acid & Weak Base Antacids & Tetracycline: Antacids contain contain divalent cations that chelate with Tetracycline and decrease its effectiveness. Propranolol & Phenylbutazone: Both highly protein bound Lidocaine & Neostigmine: Lidocaine's metabolism is decreased by ChE Inhibitors like Neostigmine |
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What do all of the following pairs of drugs have in common?
Sympathomimetics & MOA Inhibitor Acepromazine & Opiods Acepromazine & Barbituates Sulfas & Propranolol Site 1, 2, and 3 Diuretics & Digoxin Warfarin & Tetracycline Quinidine & Digoxin Ca & Digoxin Site IV Diuretic & Site 1, 2, or 3 Diuretics NSAIDs & Propranolol |
They all POTENTIATE each other.
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