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Drug interactions in Dentistry
Pharm. Chapter 4
36
Pharmacology
Undergraduate 3
02/04/2013

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Term
what types of patients (3) are drug interactions most likely to occur?
Definition
-pt's on many medications
-pt's not sure of medication names
-pt's who are not honest about there medications
Term
what is a way more drug reactions can occur (often found with older people)?
Definition
lots of medications= higher potential for interactions
Term
why is it dangerous if a pt is not honest about the medications they are taking?
Definition
because drug reactions are harder to prevent if we don't know all the meds a patient is taking
Term
what 3 things can drugs have a interaction with?
Definition
Drugs, foods and disease states
Term
what are drug to drug and drug to food interactions usually due to?
Definition
Pharmacokinetics
Term
what is a Antagonistic Effect?
Definition
when one drug decreases the effect of another drug
Term
what is a Additive effect?
Definition
Is the sum of effects of each drug individually
Term
what is a Synergistic effect?
Definition
when drugs multiply the effects of the drugs together. ( can be good or bad)
Term
How can a synergistic effect be beneficial?
Definition
a lower dose of each drug indivdually together can equal the same overall effect of drugs together.
Term
what may slow absorption or may prevent it entirely?
Definition
Food
Term
what are some metabolic effects that cause food-drug interactions?
Definition
-grapefruit juice
-caffeine
-alcohol
-dairy products
Term
How does grapefruit juice effect a drug-food interaction?
Definition
it inhibits the enzyme cytochrome p450 (cup) 3A4 and causes a lower metabolism of any drug that uses this enzyme
Term
How does caffeine effect a drug-food interaction?
Definition
different types of interactions, depends on the other drug.
Term
How does Alcohol effect a drug-food interaction?
Definition
depresses nervous system
Term
what type of interaction will occur with Alcohol and a nervous system depressant?
Definition
Additive / Synergistic effect
Term
what type of interaction will occur with Alcohol and a nervous system stimulants?
Definition
Antagonistic effect
Term
How does Dairy Products (calcium containing foods) effect a drug-food interaction?
Definition
calcium can bing to certain medications in digestive tract and prevent drug absorption.
Term
why are certain drugs contraindicated for special disease states?
Definition
because cross reactions could occur
Term
Example: If a patient has an allergy to Penicillin could a Doctor prescribe Amoxicillin?
Definition
No because Amoxicillin is in the same family as Penicillin and the patient would have an allergic reaction.
Term
what are 3 things that may cause a drug interaction through absorption mechanisms?
Definition
Food
low pH
Decrease gastric motility
Term
what can a food-drug interaction do through absorption mechanisms?
Definition
Delay or prevent absorption, often get slower absorption and longer onset when drug is taken with food.
Term
what can a low pH do to the drug interaction through absorption mechanisms?
Definition
Delay or prevent absorption of some drugs.
weak bases are highly ionized at low pH
Term
what can a decreased gastric motility interaction do through absorption mechanisms?
Definition
delay absorption
Term
In distribution, what will drugs do when they are competing for plasma proteins?
Definition
lower their affinity for plasma proteins and bind at a lower percentage than normal
Term
what is the domino effect if a drug binds at a lower percentage than normal?
Definition
higher drug percentage in blood plasma levels -> higher number of side effects
Term
What are 2 possible interactions regarding enzymatic activity?
Definition
1. Inhibitor drug prevents metabolic enzyme activity.
2. Inducers drug enhances metabolic enzyme activity
Term
what happens when a inhibitor drug prevents metabolic enzyme activity?
Definition
Keeps enzyme from metabolizing substrate
higher blood plasma levels
Term
what happens when a inducer drug enhances metabolic enzyme activity?
Definition
-enzyme metabolizes substrate faster than normal (increase)
-lower blood plasma levels (decrease)
Term
A drug is ____ as soon as it enters the body unless bound to a plasma protein?
Definition
Active
Term
What is another possibility that a drug can interact through metabolic pathways?
Definition
Second substrate drug can compete with first for enzyme binding.
Term
when a second substrate drug competes with the first for enzyme binding, what is happening?
Definition
-Decreased metabolism of the drug that does not get to bind
-higher plasma levels of the drug
Term
If the metabolism decreases it causes what in the blood with the drug?
Definition
an increase of the drug in the blood
Term
During excretion drugs can compete for what proteins?
Definition
transport proteins in the kidney
Term
If a drug is excreted to much what happens? (Plasma level)
Definition
lower drug plasma levels
Term
If to little of the drug is excreted what happens? (plasma level)
Definition
pt has a higher drug plasma level
Term
Absorption, distribution, metabolic and excretion all effect what two things?
Definition
the drug level in the blood and the effects of the drug on the body.
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