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Pharm 1-3

Drugs easily displaced by albumin characteristics. -Bound to albumin they are sequestered and not able to have a pharm effect. -displaced from albumin pharm active. -easily displaced drugs generally have higher "active" concentrations in body. -Albumin most strongly binds hydrophic drugs.
Drugs that induce P450 characteristics. Lead to increased rate of metabolism of anything metabolized by P450, including other drugs. -If induced than it more quickly metabolizes the drug inducing it as well as any other drugs processed by it --> LESS pharm active drug than expected.
Drugs that inhibit P450 characteristics. Decrease rate of metabolism of itself and other drugs biotransformed by P450 --> greater amount of pharm active drug in the body than expected.
Drugs that compete for renal transporters characteristics. Drugs that are normally excreted out of body via renal transporters on renal tubules (proximal convoluted tubules). Nonspecific & limited # of tranporters so pt taking 2+ drugs that both compete will result in higher levels of pharm active drug in body.
Sulfonamides Sulfa drugs, ABX Easily displaced from Albumin Inhibits P450 Competes at renal transporters
Phenylbutazone Analgesic, anti-inflammatory used for arthritis and gout Easily displaced from albumin Inhibits P450
Tolbutamide hypoglycemic agent, specifically a sulfonylurea used for Type 2 DM. Easily displaced from albumin.
Coumadin anticoagulant. Easily displaced from albumin Inhibits P450
Alcohol Ethanol Inhibits P450
Barbiturates Sedative and anti-spasmodic Induces P450
Phenytoin Antileptic. Induces P450
Rifampin ABX, specifically transcription inhibitor. Induces P450
Chloramphenicol ABX, works as protein synthesis inhibitor Inhibits P450
Uric Acid NATURAL product of human body (not parmaceutical). Competes at renal transporters.
Probenecid Inhibits renal excretion of uric acid and certain drugs, but increases uric acid secretion if administered at high doses b/c of its other effects on kidney that occur only at high doses. Competes at renal transporters.
Penicillins ABX Competes at renal transporters.
Salicylates Analgesic, Antipyretic, antiseptic, disinfectant. Competes at renal transporters.
Thiazides Diuretic. Competes at renal transporters.
Methadone Analgesic and tx for heroin addiction Induces P450.
Levodopa stimulates dopamine production for parkinson's dz. Induces P450.
Oral Contraceptive Pill Induces P450
Isoniazid Antibacterial used for TB. Inhibits P450.
Cimetidine H2 blocker that is used for gastritis and peptic ulcer dz. Inhibits P450.
Dicumarol Anticoagulant Inhibits P450.
Aminoglycosides + Loop diuretics Accentuated nephrotoxicity and ototoxicity.
MAO inhibitors + SSRIs may promote serotonin syndrome.
MAO Inhibitors + TCAs may promote serotonin syndrome or severe sympathetic nervous system activation.
Antiarrhythmics + Fluoroquinolones may cause QT prolongation and resulting torsade de pointe.
Cation-containing drugs/Citric Acid + Fluoroquinolones Severe impairment of fluoroquinolone absorption
Alcohol/Rifampin + Isoniazid Liver damage and possible failure.
Bone marrow toxicity most chemotherapeutic agents chloramphenicol ganciclovir zidovudine interferon flucytosine carbamazepine
Hepatotoxicity all imidazoles interferon nevirapine all HMG CoA inhibitors valproic acid isoniazid
Nephrotoxicity aminoglycosides foscarnet cidofovir NSAIDs cyclosporine amphotericin
Tendon ruptures quinolones
DVTs raloxifene tamoxifen estrogens/progesterones
orthostatic hypotension all alpha blockers most TCAs
hypertensive crisis MAO inhibitors TCAs *most likely to occur when drugs listed herein are mixed w/one another
Serotonin Syndrome MAO inhibitors SSRIs Decongestants w/pseudoephedrine TCAs SNRIs *most likely to occur when drugs listed herein are mixed w/one another.
Cutaneous flushing Niacin
Seizure Meperidine
G6PD Eacerbation any drug has the ability, but especially: Sulfa Drugs Primaquine
Drug-induced lupus hydralazine procainamide
Malignant hyperthermia halothane
Non-arteritic anterior ischemic optic neuropathy (NAION) PDE-5 Inhibitors
Ototoxicity Aminoglycosides PDE-5 Inhibitors
Neural Tube Defects Carbamazepine (when used by mother during pregnancy). Valproic Acid (when used by mom during pregnancy).
Ebstein's Anomaly Lithium (when used by mother during pregnancy).
Teratogenic NSAIDs
Decreased libido and erectile dysfunction 5-Alpha Reductase Inhibitors
Created by: celaschiac