Term
| what types of patients (3) are drug interactions most likely to occur? |
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Definition
-pt's on many medications
-pt's not sure of medication names
-pt's who are not honest about there medications |
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|
Term
| what is a way more drug reactions can occur (often found with older people)? |
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Definition
| lots of medications= higher potential for interactions |
|
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Term
| why is it dangerous if a pt is not honest about the medications they are taking? |
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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? |
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Definition
| Drugs, foods and disease states |
|
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Term
| what are drug to drug and drug to food interactions usually due to? |
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Definition
|
|
Term
| what is a Antagonistic Effect? |
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Definition
| when one drug decreases the effect of another drug |
|
|
Term
| what is a Additive effect? |
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Definition
| Is the sum of effects of each drug individually |
|
|
Term
| what is a Synergistic effect? |
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Definition
| when drugs multiply the effects of the drugs together. ( can be good or bad) |
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Term
| How can a synergistic effect be beneficial? |
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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? |
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Definition
|
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Term
| what are some metabolic effects that cause food-drug interactions? |
|
Definition
-grapefruit juice
-caffeine
-alcohol
-dairy products |
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|
Term
| How does grapefruit juice effect a drug-food interaction? |
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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? |
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Definition
| different types of interactions, depends on the other drug. |
|
|
Term
| How does Alcohol effect a drug-food interaction? |
|
Definition
|
|
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
|
|
Term
| How does Dairy Products (calcium containing foods) effect a drug-food interaction? |
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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 |
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Term
| Example: If a patient has an allergy to Penicillin could a Doctor prescribe Amoxicillin? |
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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
|
|
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) |
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|
Term
| A drug is ____ as soon as it enters the body unless bound to a plasma protein? |
|
Definition
|
|
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 |
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|
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 |
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|
Term
| If a drug is excreted to much what happens? (Plasma level) |
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Definition
|
|
Term
| If to little of the drug is excreted what happens? (plasma level) |
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Definition
| pt has a higher drug plasma level |
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|
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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