Metabolism
Drug Interaction
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Drug Interaction
, Food Interaction, Food-Drug Interactions
See Also
Drug-Drug Interactions in the Elderly
Polypharmacy
Types
Pharmacokinetic (most common)
Two drugs compete for the same mechanism of absorption, distribution, metabolism or excretion (
ADME
)
Results in a change in one or both drugs concentration at the site of their action when both agents are taken
Typically involves
Cytochrome P450
, UGT,
P-Glycoprotein
or OATP
Often drug dosage changes and monitoring are sufficient for low to moderate risk interactions
Pharmacodynamic
One drug directly blocks or exacerbates another drugs activity without modifying drug concentrations
Offending drug, typically must be stopped (drug dosage modifications typically do not resolve interaction)
Causes
Food Interactions
See
Antibiotic Food Interactions
See
Grapefruit
Interactions
Causes
Common Serious Drug-Drug Interactions
Drugs with numerous interactions
Warfarin Drug Interactions
Direct Oral Anticoagulant
s
HMG-CoA Reductase Inhibitor
(
Statin
s)
Drug Interactions due to Chelating Cations
Specific important drug-Drug Interactions
Phosphodiesterase Inhibitor
(e.g.
Viagra
) and
Nitroglycerin
(
Hypotension
)
Beta Blocker
s and
Clonidine
(
Hypertensive Crisis
)
ACE Inhibitor
s and
Potassium
supplements,
Potassium-Sparing Diuretic
s or
Septra
(
Hyperkalemia
)
Drug-Induced Syndromes (exacerbated by combinations of agents)
Prolonged QT Interval due to Medication
Serotonin Syndrome
CNS Depressant
s
References
Asher (2017) Am Fam Physician 96(2): 101-7 [PubMed]
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