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20 Cards in this Set
- Front
- Back
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DRUGS AFFECTED
antacids, sucralfate, iron, ca, mg ↓ absorption |
quinolones, tetracyclines, methyldopa, levodopa
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MOA
antacids, sucralfate, iron, ca, mg ↓ absorption |
Chelation: forms insoluble complexes, ↓ & inhibiting absorption of affected drug
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RECOMMENDATION
antacids, sucralfate, iron, ca, mg ↓ absorption |
Administer affected drug 2 hrs before or 6 hours after precipitant
Administer affected drug via another route |
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DRUGS AFFECTED
cholestyramine, colestipol ↓ absorption |
warfarin & thiazides
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MOA
cholestyramine, colestipol ↓ absorption |
Binding resins bind affected drugs
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RECOMMENDATION
cholestyramine, colestipol ↓ absorption |
Use colesevelam
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DRUGS AFFECTED
activated charcoal, kaolin-pectin, & antacids ↓ absorption |
clindamycin, metronidazole, & digoxin
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MOA
activated charcoal, kaolin-pectin, & antacids ↓ absorption |
Large surface area absorb affected drugs onto their surfaces
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RECOMMENDATION
activated charcoal, kaolin-pectin, & antacids ↓ absorption |
Monitor effect
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DRUGS AFFECTED
antacids, H2-blockers, PPI, didanosine ↓ absorption |
atazanavir
ketoconazole & itraconazole dapsone |
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MOA
antacids, H2-blockers, PPI, didanosine ↓ absorption |
↓ BA of affected drug due to ↓ GI acidity (↑ pH)
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RECOMMENDATION
antacids, H2-blockers, PPI, didanosine ↓ absorption |
atazanavir: PPI contraindicated, Administer affected drug 2 hrs before or 6 hrs after antacid
ketoconazole & itraconazole: Use fluconazole dapsone: Monitor effect |
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DRUGS AFFECTED
warfarin, tolbutamide, methotrexate, phenytoin distribution |
aspirin, sulfonamides, chloral hydrate
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MOA
warfarin, tolbutamide, methotrexate, phenytoin distribution |
Displaces affected drugs from PB sites, ↑ unbound concentrations & ↑ incidence of AE
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RECOMMENDATION
warfarin, tolbutamide, methotrexate, phenytoin distribution |
Monitor effects
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strong CYP450 inducers (7)
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(1) carbamazepine
(2) phenytoin (3) phenobarbital (4) rifampin (5) primidone (6) hypericum (St. John’s Wort) (7) garlic (allicin) |
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1A2 – Major Substrates
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(1) theophylline
(2) caffeine (3) clozapine (4) fluvoxamine (5) mirtazapine (6) oral contraceptives (7) propranolol |
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1A2 – Strong Inhibitors
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(1) fluvoxamine: use escitalopram
(2) ciprofloxacin: use another FQ (3) ketoconazole: fluconazole |
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1A2 – Moderate Inhibitors
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(1) zileuton: use montelukast, (2) clarithromycin/erythromycin: use azithromycin, (3) cimetidine: use famotidine
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1A2 – Additional Inducers
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(1) cigarette smoke: nicotine patch will not affect
(2) charcoal-broiled foods |
