| Term 
 | Definition 
 
        | phenelzine, tranylcypromine, isocarboxazid and selegiline |  | 
        |  | 
        
        | Term 
 
        | Erythromycin and Seldane (terfenadine) |  | Definition 
 
        | fatal-Torsades de pointes |  | 
        |  | 
        
        | Term 
 
        | pharmacodynamic interactions |  | Definition 
 
        | a drug interaction in which the physiologic effect of one drug is altered by another drug--no change in drug concentrations |  | 
        |  | 
        
        | Term 
 
        | additive drug interactions |  | Definition 
 
        | pharmacodynamic interaction that results in synergistic effect; morphine and benzo's--can be beneficial |  | 
        |  | 
        
        | Term 
 
        | cimetadine and ketoconazole |  | Definition 
 
        | lower pH of stomach, reduced absorption |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | killing of eubacterium lentum results in decreased degradation (metabolic capacity) of drug and increases serum concentration levels |  | 
        |  | 
        
        | Term 
 
        | sulcralfate and ciprofloxacin |  | Definition 
 
        | bind together and reduced absorption of antibiotic |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | bind together and reduced absorption of antibiotic--forms insoluble compound that is not absorbed |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | increased bioavailability |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | increased bioavailability |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | bind together and reduced absorption of antibiotic--forms insoluble compound that is not absorbed |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | increased bioavailability |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | increased bioavailability |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | displaces warfarin from albumin binding site |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | displaces phenytoin from binding site, increasing phenytoin volume of distribution and reduces concentration |  | 
        |  | 
        
        | Term 
 
        | phenytoin and renal failure |  | Definition 
 
        | most likely toxin build up displaces drug from protein binding sites and increases Vd |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | displaces digoxin from tissue binding sites and increases Vd, increases rapidly |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | block tubular secretions of Methotrexate and increases serum concentrations for longer |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | increases lithium levels due to changes in sodium levels |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | blocks tubular secretion and metabolism of procainamide |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | heme containing, location--smooth ER of liver and intestinal tract, defense mechanism |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | CYP1, CYP2, CYP3 mediate most drug metabolisms, account for 70% of the liver content |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | subfamilies name denote by uppercase letters, 20-subfamilies and CYP3A4--individual enzyme designated by second Arabic numeral |  | 
        |  | 
        
        | Term 
 
        | CYP450 enzymes-important in drug interactions and metab (90% of drugs) |  | Definition 
 
        | 1A2, 2C9, 2C19, 2D6, 3A4 and 3A5 |  | 
        |  | 
        
        | Term 
 
        | substrate and inhibitor of CYP3A4 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | substrate and inhibitor of CYP2D6, but metabolized by CYP3A4 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | permanent inhibition of CYP |  | Definition 
 
        | duration depends on t1/2 of isoenzyme; once inhibited a new enzyme must be synthesized |  | 
        |  | 
        
        | Term 
 
        | erythromycin metabolized by CYP3A4 complexes with and permanently inhibits 3A4 |  | Definition 
 
        | metabolism of theophylline may be inhibited days after administration of erythromycin |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | most common type of inhibition, begins with first dose, max SS and reversed after 5 t1/2 after discontinuation |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | causes increase synthesis of that particular isoenzyme, increased metab of any substance through that same pathway |  | 
        |  | 
        
        | Term 
 
        | phenobarbitol and rifampin |  | Definition 
 
        | capable of inducing a host of enzymes |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | most often responsible for life-threatening interactions; some drugs may inhibit many isoenzymes but most are isoenzyme specific |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | autoinducer which induces its own metabolism |  | 
        |  | 
        
        | Term 
 
        | permanent inhibition of CYP |  | Definition 
 
        | duration depends on t1/2 of isoenzyme; once inhibited a new enzyme must be synthesized |  | 
        |  | 
        
        | Term 
 
        | erythromycin metabolized by CYP3A4 complexes with and permanently inhibits 3A4 |  | Definition 
 
        | metabolism of theophylline may be inhibited days after administration of erythromycin |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | most common type of inhibition, begins with first dose, max SS and reversed after 5 t1/2 after discontinuation |  | 
        |  | 
        
        | Term 
 
        | the time of onset and offset of increased activity is related to |  | Definition 
 
        | plasma concentration and duration of its use of inducing drug, t1/2 of drug, t1/2 of turnover of the isoenzyme |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ezyme CYP2B6 and CYP3A4,5,7; t1/2: 50-10 hours; enzyme induction one week; reversal 2-6 weeks |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | t1/2: 2-3 hours, enzyme induction in 2-3 days, reversal 1-3 weeks |  | 
        |  | 
        
        | Term 
 
        | drug features associated with potential interactions |  | Definition 
 
        | steep dose response curve, narrow therapeutic window, dose dependent rate of metabolism (phenytoin) |  | 
        |  | 
        
        | Term 
 
        | the time of onset and offset of increased activity is related to |  | Definition 
 
        | plasma concentration and duration of its use of inducing drug, t1/2 of drug, t1/2 of turnover of the isoenzyme |  | 
        |  | 
        
        | Term 
 
        | birth control and rifampin |  | Definition 
 
        | increased breakthrough bleeding or pregnancy |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | inflammation and infection |  | Definition 
 
        | may increase warfarin alone |  | 
        |  |