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85 Cards in this Set
- Front
- Back
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ph of weak acid
where do weak acids get absorbed |
-ph 1-3
-stomach |
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ph of weak base
where do weak bases get absorbed |
- ph 6-8
- small intestine |
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how do antacids alter the gastric and intestinal ph
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- inc the ph of the gi tract
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antacids have what effect on acidic drugs
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- bc they inc the ph of the gi tract, dec absorption of acidic drugs
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antacids have what effect on basic drugs
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- bc they inc the solubility of basic drugs, they inc absorption of basic drugs
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antacids may chelate drug molecules to form soluble or insoluble complex, how does this affect F
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inc or dec F
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name some drugs with drug interaction with antacid
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-chlorpromazine
-isoniazid -quinine - tetracycline - indomethacin - chlorpromazine - digoxin |
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patient counseling/education for antacids
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- stagger doses of antacids and drugs by 2 hrs
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drug interactions with resins
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- resins bind to drugs in the gi tract
-cholestryaine reduced the absorption |
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cholestryamine is what kind of drug
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-resin
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eg of resins
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- chephalexin
- sulphamethoxazole -thyroxine - warfarin |
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factors that effect on distribution on absorption
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-lipid solubility
-binding to plasma protein and tissues |
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in order for drug to effect distribution, does the drug need to have low or high protein binding
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- high protein binding will affect vd
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t/f drugs with high cl , will get cl faster
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drugs with high cl, means they have a high extraction ration, cl is not dependent on protein binding, cl is unaltered
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warfarin more potent isomer is
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s isomer
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inducer or inhib
- rifampin |
inducer
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ind or inhib
-barbiturates |
- nonselective inducer
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ind or ihbit
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phenytoin
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ind or inhib
carbamazepine |
inducer
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ind or inhib
st. johns wort |
inducer
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name of all of the factors that cause enzyme induction
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-rifampin
-barbiturates - phenytoin -carbamazepine - st. johns wort |
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cyp 1a2 is induced by
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- smoking, omeprazole
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cyp 2 c9 is induced by
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- phenytoin
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cyp 2c19 is induced by
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rifampin
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cyp 2d 6 is induced by
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nothing
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cyp 3a4 is induced by
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rifampin
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what cyps are induced during a enzyme induction
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- cyp 1a2
- cyp 2c19 -cyp 2c9 -cyp 2d6 - cyp 3a4 |
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what is the interaction b/t phenobarbital and warfarin
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- phenobarb potent inducer
- inc cl - dec css - dec plasma conc - dec effect |
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phenobarb effect on contraceptives
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- dec effect of contraceptives
- need back up method of contraception |
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rafampin ind or inhibt
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potent inducer of cyp 3a4
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name the drugs that have a interaction with rafampin- 2
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oral contraceptives
warfarin |
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warfarin and rifampin effect
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- dec auc
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warfarin and contraceptives
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- dec t1/2
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inhibt or inducer
carbamezapine |
autoinducer
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wht is the effect of taking carbamezpine and clonazepm
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- since carb is a potent inducer, it causes the inc in enzymes
- inc enzymes , inc cl of clonazepam -dec cp of clonazepam |
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st johns wort induced what cyps
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cyp 3a4
cyp 2 c9 cyp 1a2 - pgp |
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what are the active components of st johns wort
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-hypericin
- hyperforin |
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main st john interactions
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- cyclosporin
- warfarin - digoxin |
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induc or inhbit
cipro |
- inhibits cyp 1a2
- inhibitor |
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induc or inhib
sulfaphenzole, sulfinpyrazone |
- inhibit 2c19
-inhib |
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induc or inhib
- ketoconzaole, itraconazole |
-inhib
- inhib cyp 3a4 |
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inhib or induc
cimetedine |
- inhib
-cyp 1a2, 2c9, 2c19, 3a4 |
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chloramphenicol inducer or inhib
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inhibitor
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what happens when you take chloramphenicol with phenytoin
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t1/2 inc longer half life
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alcohol and disulfiram rxn
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- inhibits acetaldehyde dehydrogenase
- severe nausea - treatment for chronic alcoholism |
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disulfiram and warfarin
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- inhibit the metabolism of warfarin
- inc anticoag effect of warfarin |
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name two main benzodiazepines that disfulfiram reactions with
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- chlordiazepoxide
- diazepam |
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drug interactions with sulfinyrazone
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- inhibits
- displaces from plasma protein binding - inhibits hepatic metab - inc plasma concen |
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metonidazole and warfarin
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- t1/2 inc of warfarin
- inc in anticoag effect - inc in s warfarin, inc more potent effect - no effect on r warfarin |
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what is cimetidine
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- h2 antagonist
- non selective inhibitor |
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other h2 antagonists that do not inhibit drug metabolism
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- ranitidine
- famotidine |
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cimetidine and warfarin
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- cim is a ihibit
- inc in in cp of warfarin - |
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cimetidiene affects the metabolism of 3 main drugs
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- warfarin
- theophylline - phenytoin |
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cimetidine affects benzodiapepines
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- inc t1/2
- dec cl - inc in plasma con exception (LOT)- lorazepam, oxazepam, temazepam okay to give bc no drug interactions |
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drug interactions with cipro-2
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- inhibit 1a2
- responsible for the metabolism of theophylline - inc t 1/2 of theophy - inc se of theophylline |
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cipro inhib or induc
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- inhibitor of cyp 1a2
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se of theophylline
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- nausea
- vommiting - dizzines - tachy - seizure |
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if you cant have cipro and theophylinne together , what is in alternative
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- give other quinone antibiotics
- levofloxacin - gatifoxacin - moxifloxacin - sparfloxacin |
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amiodarone inhibts or induces what cyps
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- inhibits cyp 2c9
- inhibits cyp 2d6 |
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what is the drug interaction with grapefruit
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- grapefruit juice has been shown to inc F and cp of many drug with low oral F
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grapefruit is metabolized by what cyp
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- cyp 3a4
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grapefruit has the most potent interactions with what 2 drugs
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- cyclosporine, inc and cp
- amiodarone |
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active ingredient in grapefruit juice
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- naringin
- inhibits cyp 3a4 |
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what is a cheaper and more expensive way or reducing cyclorporine con
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- cheap, take grapefruit juice
- expensive: ketoconazole and diltiazem |
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what drug reduc hepatic blood flow
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- phenobarb
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what drugs inc hepatic blood flow
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- propranolol
- cimetidine - indomethacin |
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phenob barb and blood flow
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-inc blood flow
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propranolol and blood flow
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dec in Qh
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phenobarb and blood flow
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inc in Qh
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cimetididine and qh
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- dec in qh
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indometh and qh
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- dec in qh
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what happens when you take lidocaine and propanolol together
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- prop dec in qh
- dec cl of lidocaine - inc in CP of lidocaine |
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explain the lithium and indomethacin rxn
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- indometh has been shown to dec cl of li by dec gfr
- inc con of li - have to monitor lithium dosages |
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why is it imp to monitor the li and indomethacin
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- b/c li is only excreted renally and when you take indometh, it dec cl
- can cause tox |
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probenicid inhib or inducer
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inhibitor
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probenicid inhibts what drugs -4
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ms. i
m methotrexate s sulfinpyraone i indomethacin |
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clinically effect of probenicid
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to inc concentration of ms. i
m methotrexate s sulfinpyraone i indomethacin |
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mw of biliary excretion
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- mw > 300-500
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enterohepatic circulation plays an important role in inc or dec excretion of ddrugs
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delays excretion of drug, dec cl
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drugs that undego enterhepatic circulation
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- phenobarbital
- carbamazepine - pbz - dapsone - rifampin - digitoxin - indomethacin |
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probenicid has what effect on renal and bile
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- inhibits renal tubular secretion
- dec biliary excretion |
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probenicid has what effect of rifampin and indomethain cl
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-dec both biliary excretion of rifam and indometh
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does activated charcoal inc or dec enterohepatic circ
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dec enterohepatic circulation
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based on pgp
digoxin induces |
-rifampin
- st johns wort |
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based on pgp
dixogin inhibts |
- quinidine
- verapamil - eryhromycin - itraconazole - ritonavir - clarithromycin |
