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Mechanism and prevention of drug interactions
PharmacoKinetics
34
Pharmacology
Professional
12/05/2013

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Cards

Term
warfarin and NSAID
Definition
avoid concomitant use APAP or COX-II if possible
Term
warfarin and Sulfa
Definition
Avoid concomitant use; decrease warfarin dose by 50% pre and 1 wk post
Term
warfarin and macrolides (especially erythromycin)
Definition
interaction may be delayed; use other category, clarithromycin or azithromycin
Term
warfarin and quinolones
Definition
use other categor; evidence strong for cipro, levo, norflxacin, enoxacin and ofloxacin
Term
ACE and K supplements
Definition
draw potassium levels prior to ACE initiation
Term
GI irritation and erosion, decreased platelet adhesion
Definition
warfarin and NSAID
Term
unknown; infection and inflammation promotes the effect of warf, may be secondatry to decrease warf degradation in the gut
Definition
warfarin and Sulfa
Term
metabolic inhibition; secondary to decreased vit K production by gut flora, may also be inflammation/ infection factor
Definition
warfarin and macrolides (especially erythromycin)
Term
metabolic inhibition; secondary to decreased vit K production by gut flora, may also be inflammation/ infection factor
Definition
warfarin and quinolones
Term
CYP2C9 inhibitor which increases levels of S-warfarin
Definition
Sulfa
Term
unknown; warf metabolism inhibited early effect and late effect (2-3) weeks warf metab might be induced..lack of effect
Definition
warfarin and phenytoin
Term
ACEI → ↓ aldosterone → ↓ K+ excretion
Definition
ACE and K supplements
Term
Additive K+ sparing effects
Definition
ACEIs + Spironolactone
Term
ACEIs + Spironolactone
Definition
Draw K+ level prior to starting spironolactone
Term
warfarin and NSAID
Definition
avoid concomitant use APAP or COX-II if possible
Term
warfarin and Sulfa
Definition
Avoid concomitant use; decrease warfarin dose by 50% pre and 1 wk post
Term
warfarin and macrolides (especially erythromycin)
Definition
interaction may be delayed; use other category, clarithromycin or azithromycin
Term
warfarin and quinolones
Definition
use other categor; evidence strong for cipro, levo, norflxacin, enoxacin and ofloxacin
Term
ACE and K supplements
Definition
draw potassium levels prior to ACE initiation
Term
GI irritation and erosion, decreased platelet adhesion
Definition
warfarin and NSAID
Term
unknown; infection and inflammation promotes the effect of warf, may be secondatry to decrease warf degradation in the gut
Definition
warfarin and Sulfa
Term
metabolic inhibition; secondary to decreased vit K production by gut flora, may also be inflammation/ infection factor
Definition
warfarin and macrolides (especially erythromycin)
Term
metabolic inhibition; secondary to decreased vit K production by gut flora, may also be inflammation/ infection factor
Definition
warfarin and quinolones
Term
CYP2C9 inhibitor which increases levels of S-warfarin
Definition
Sulfa
Term
unknown; warf metabolism inhibited early effect and late effect (2-3) weeks warf metab might be induced..lack of effect
Definition
warfarin and phenytoin
Term
ACEI → ↓ aldosterone → ↓ K+ excretion
Definition
ACE and K supplements
Term
Additive K+ sparing effects
Definition
ACEIs + Spironolactone
Term
ACEIs + Spironolactone
Definition
Draw K+ level prior to starting spironolactone
Term
Digoxin + Amiodarone
Definition
check baseline dig level, decrease dig dose by 50%
Term
↓ digoxin clearance
Possible additive effect on SA node?
Definition
Digoxin + Amiodarone
Term
Digoxin + Verapamil (D)
Definition
check baseline dig level, consider dig dose reduction
Term
Synergistic effect leading to bradycardia and heart block; decreased dig clearance
Definition
Digoxin + Verapamil (D)
Term
Theophylline + Quinolones
Definition
check baseline theophylline levels, avoid enoxacin and cipro (30-40% decrease in clearance)
Term
↓ theophylline Cl- hepatic metabolism inhibited by quinolones
Definition
Theophylline + Quinolones
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