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Definition
| Can cause GI bleeding if taken with Warfarin. If taken with alcohol, increased hepatotoxicity. |
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| Induces CYP 2E1, increasing acetominophen toxicity. |
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Definition
| Used in gout, xanthine-oxidase inhibitor. Xanthane-oxidase creates uric acid, but also metabolizes methotrexane. So, dont give this with methotrexane, even though it might be tempting to decrease gout symptoms in chemo. Also: Increased absorption if taken with iron. |
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Definition
| A tricyclic antidepressant. If taken with Ditropan (an anticholinergic), causes abdominal distension and constipation. Because of a pharmacodynamic interaction: tricyclics inhibit the cholinergic system also via diff mech. Also: tricyclics affect membrane pump that moves nts and antihypertensive drugs into intracellular storage sites. So may alter anti-HTN treatments. Also: metabolized via CYP 2D6, inhibited by Prozac. |
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Definition
| Pharmacodynamic: Inhibits platlet function/ anti-thrombosis/ decreases vasoconstriction. Pharmacokinetic: Also, is highly bound to plasma (99%), so displaces Warfarin, leading to increased levels of Warfarin that is active. Therefore increases bleeding if taken with Warfarin. Also: decreases renal excretion of Penicillin and Methotrexate by competing for the transport mechanism. |
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Definition
| In milk etc. Ion, so can cause chelation. Ion binds to drug, gets trapped inside drug in a wierd shape. Changes absorption of the drug (eg, Tetracycline). |
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Definition
| An ion exchange binding resin. Used to lower cholesterol by disrupting enterohepatic circulation. It is a charged molecule, so it just sticks to the wall and blocks cholesterol absorption. Will also block the absorption of other drugs (decreased bioavail): such as digitalis, Warfarin, phenobarbitol, tetracycline, penicillin. |
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Definition
| a "leafy green," contains VitK. If you eat a lot of it, it may decrease the activity of Warfarin. Eating less increases the liklihood of bleeding if taking Warfarin. |
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Definition
| Anti-coagulant, b/c reduces VitK dependent clotting factor production in the plasma. Has a narrow TI: with a little Warfarin, the INR = 2, but with a little more, INR = 6+. Highly bound to plasma (95%). Too much Warfarin leads to bleeding. Interactions: Increased bleeding (asprin), GI bleeding (NSAIDS), Impairment of Warfarin metabolism and increased bleeding (Quinolone or phenytoin), increased bleeding, maybe bc less VitK (sulfa drugs). Bartituates like phenobarbital increase metabolism, so need more Warfarin. Also: cholesteramine causes decreased abosorption. |
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Definition
| Binds to muscle tissue, Vd=400. If something else binds to muscle tissue, digoxin is displaced, leading to higher blood levels and lower Vd. = Digoxin toxicity. (eg, quinidine) Also: Can cause increased bleeding if taken with Warfarin. Also: Cholestyramine causes decreased absorption. Also: Erthromycin increases bioavail by 3 mechanisms. |
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Definition
| An anticholinergic. When taken with Amitriptyline, causes abdominal distension and constipation. Because of a pharmacodynamic interaction : tricyclics inhibit the cholinergic system via a different mechanism. |
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Definition
| Give with lidocaine to vasoconstrict and keep the drug local. |
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| Erythromycin (+ macrolides in general) |
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Definition
| Antibiotics. Increase risk of bleeding when taking Warfarin. 2 possibilities 1) change gut flora, so decrease amt of VitK, so increase action of Warfarin. 2) inhibit liver enzyme responsible for Warfarin metabolism. Also: increases Digoxin bioavailability by the above 2 mechanisms and also maybe inhibitin p-glycopritein transport system in kidney for Dig. |
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Definition
| Inhibits CYP 3A4 in gut wall, so increases drug absorption and bioavail. |
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Definition
| Give with epinepherine to vasoconstrict and keept drug local. Also: in CHF, increased action of the drug because decreased blood flow. |
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Definition
| An antacid, used to treat ulcers. Charged molecule, sticks to gut wall. Decreases abosorption of other drugs. |
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Definition
| Used as chemo, which can cause gout like symptoms from cell breakdown. However, the drug is metabolized by xantine oxidase, so dont give with Allopruinol, as that would increase the effects of chemo. Also: renal excretion decreased by Probenecid and Salicylate. |
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Term
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Definition
| Increase risk of bleeding when taking Warfarin. 2 possibilities 1) change gut flora, so decrease amt of VitK, so increase action of Warfarin. 2) inhibit liver enzyme responsible for Warfarin metabolism. Also: cholesteramine causes decreased abosorption. Also: excretion decreased by Probenecid and salicylate. |
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Term
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Definition
| Barbituate. Induces liver P450 enzymes that metabolize Warfarin. Thus, need to take more Warfarin when on this drug. However, if taken patient off Penobarbital, INR rises, too much Warfarin effect. Also: cholesteramine causes decreased abosorption. Also: renal clearance is increased by alkalinization. |
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Term
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Definition
| Inhibits uptake of uric acid in renal tubules. Used in treatment of gout and to increase the action of penicillin and methotrexane (decrease excretion). |
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Term
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Definition
| Anti-arrythmic drug. Impairs Warfarin liver metabolism, so increases the amount of active Warfain, thus increasing INR and bleeding risk. Also may be caused by decreased production of VitK in the gut. Also: if taken with digoxin, binds to muscle tightly, so causes Dig Tox. |
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Term
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Definition
| Antibiotic. Don't take with milk or other things containing calcium, bc will cause chelation and change absorption. Also: Cholesteramine causes decreased absorption. |
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