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level: Level 3

Questions and Answers List

level questions: Level 3

Question	Answer
It may be the RESULT OF PRESCRIBING CERTAIN DRUGS to the patient with the INTENTION TO PRODUCE A SPECIFIC DEGREE OF ACTION BUT the nature of the INTENSITY OF THE ACTION PRODUCED IS DIFFERENT FROM that INTENDED by the prescriber. UNDESIRABLE PHARMACOLOGICAL INTERACTION between two or more ingredients that leads to: -POTENTIATION of the therapeutic effects of the ingredients - DESTRUCTION OF THE EFFECTIVENESS of one or more of the ingredients - occurrence of a TOXIC MANIFESTATION within the patient	Therapeutic Incompatibility
Therapeutic Incompatibility Causes:	It may be due to the administration of: 1 Overdose or improper dose of a single drug 2 Improper Dosage form 3 Contraindicated drug 4 Synergistic and Antagonistic drugs
said to OCCUR when the EFFECTS OF ONE DRUG ARE ALTERED by the CO-ADMINISTRATION OF ANOTHER DRUG, HERBAL MEDICINE, FOOD, DRINK or other ENVIRONMENTAL CHEMICAL AGENTS.	Drug Interactions
refer to a COMBINATION OF THERAPEUTIC AGENTS which have DIRECT CONSEQUENCES ON THE PATIENT’S CONDITION.	Clinically significant interaction
Drug interaction includes:	1 Drug- drug = p’ dynamic, p’ kinetic 2 Drug-food 3 Drug-laboratory
1 Drugs increased by Food 2 Drugs Decreased by Food	1) Acarbose Griseofulvin Itraconazole Metoprolol Theophylline 2) Alendronate Captopril Erythromycin Stearate Isoniazid Penicillamine Penicillins Tetracycline Quinolones
1 __ are affected only to a lesser extent 2 absorption are INCREASED by high fat containing foods.	1 > Doxycycline & Minocycline 2 Griseolfulvin & Theophylline
B. Drug- Laboratory Test Interactions	1 Penicillin, Chloramphenicol, Vit. C, INH, Streptomycin - glucose in Urine ( Benedict’s test) - false (+) result 2. Chlordiazepoxide - thyroid function test (I 131) - False (-) result 3. Rifampicin ( red-orange), Vit. B2 ( intense yellow), Chloroquine (Brown) - urinalysis - change in color
C. Drug-Drug Interactions	1 Pharmacokinetic Interactions 2. Pharmacodynamic Interactions
1 + 1 = 2 Response is EQUAL TO THE COMBINED EFFECTS of INDIVIDUAL DRUGS Example: ALCOHOL + Barbiturates, Antihistamines, CNS depressants, Chloral hydrate ( ↑ sedation or CNS depression)	Additive effects
1 + 1 > 2 Response is GREATER THAN THE COMBINED EFFECTS of the individual drugs Ex. Sulfamethoxazole + Trimethoprim ( Bactericidal effect)	Synergism
0 +1 = 2 A drug with NO INTENT ACTIVITY WILL ENHANCE THE EFFECT OF ANOTHER DRUG Amoxicillin + Clavulanic acid ( ↑ Amox effect) Ampicillin + Sulbactam Piperacillin + Tazobactam Levodopan + Carbidopa	Potentiation
1 + 1 = 0 Drug INHIBITS THE EFFECT OF THE OTHER Phenoxybenzamine + Cathecolamines (management of Pheochromocytoma) b. Warfarin + Vit. K c. Heparin + Protamine sulfate d. Opioids + Naloxone e. BZD + Flumazenil	Antagonism
Caused by a CHEMICAL OR PHYSICAL INCOMPATIBILITY when two or more drugs are mixed together Occurs when DRUGS ARE MIXED INAPPROPRIATELY in SYRINGES or INFUSION FLUIDS PRIOR TO ADMINISTRATION. Example: Phenytoin Na ppt in acidic pH Aminophylline (basic pH) should not be mixed with Epinephrine which decomposes at alkaline pH	Pharmaceutic Interactions