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EXAM2:Pharm L23
rational prescribing
13
Medical
Graduate
05/30/2009

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Term
acetaminophen
Definition
adult dose = 325 mg. give less for kids.
Term
codeine
Definition
adult dose = 20 mg. give less for kids. Overdose leads to vometing, decreased respiration, death.
Term
Cholestyramine
Definition
Inhibits lipid uptake in the gut. resin, binds bile salts. Is charged, so binds pretty much every other drug too. If taking other drugs, try to take them at least 4 hrs afterwards or else the drug will be sequestered in stomach and not absorbed. (= pharmacokinetic interaction.)
Term
Pravastatin (Pravachol)
Definition
A statin, stops cholesterol synthesis by inhibiting liver enzymes. Do not take at the same time as cholestyramine. The best time to take it is at night bc you make the most cholesterol during overnight fasting anyway.
Term
Butalbital
Definition
A barbituate, used as part of migrane meds. Induces liver enxymes CYP A4/5, which metabolize Warfarin. Thus, this drug decreases the bioavail of Warfarin. If take patient off bartibuate, INR goes way up, get epitaxis (nose bleeding).
Term
acetaminophen
Definition
part of anti-migrane medications. when combined with Warfarin, increased bleeding.
Term
caffeine
Definition
caffeine should be avoided when taking warfarin because it can increase blood pressure.
Term
ibuprofen
Definition
when taken with warfarin, increases bleeding. also, if taken with asprin, blocks asprins binding to COX1
Term
sumatriptan
Definition
An anti-migrane medication what does not contain a barbituate. This led to an increased bioavail of Warfarin.
Term
Warfarin (coumadin)
Definition
increases bleeding.
Term
aspirin
Definition
pharmacokinetic effect with warfarin: displaces warfarin on plasma proteins, increases warfarin bioavail. pharmacodynamic: both drugs decrease clotting by different mechanisms. pharmacodynamic is more important.
Term
erythromycin
Definition
Digoxin interactions: 1) in 10 percent of ppl kills eubacerium lentum gut flora which normally inactivates dig in gut, leading to dig toxicity. 2) inhibits CYP 3A4 in liber 3) inhibits p-glycoprotein, leading to decreased dig excreation. Interactions with Warfarin: inhibits CYP 2C9, which metabolizes Warfarin -> increased Warfarin levels. 2)Vit K made by gut flora is a competitoor for Warfarin. Kill flora, decrease Vit K, increase Warfarin.
Term
Digoxin
Definition
interacts with erythromycin.
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