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    Drug Interaction

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    Bp ho
    This document discusses drug interactions, which occur when the effects of one drug are changed by another substance like another drug, herbal medicine, food, or chemical. It covers several categories of drug interactions including pharmacokinetic interactions that affect absorption, distribution, metabolism and excretion of drugs, as well as pharmacodynamic interactions that are additive, synergistic, antagonistic or opposing. Specific examples of drug-herb, drug-food and exercise interactions that can impact drug levels are provided.

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    Drug Interaction

    Uploaded by

    Bp ho
    30 views18 pages
    This document discusses drug interactions, which occur when the effects of one drug are changed by another substance like another drug, herbal medicine, food, or chemical. It covers several categories of drug interactions including pharmacokinetic interactions that affect absorption, distribution, metabolism and excretion of drugs, as well as pharmacodynamic interactions that are additive, synergistic, antagonistic or opposing. Specific examples of drug-herb, drug-food and exercise interactions that can impact drug levels are provided.

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    DRUG INTERACTION

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    This document discusses drug interactions, which occur when the effects of one drug are changed by another substance like another drug, herbal medicine, food, or chemical. It covers several categories of drug interactions including pharmacokinetic interactions that affect absorption, distribution, metabolism and excretion of drugs, as well as pharmacodynamic interactions that are additive, synergistic, antagonistic or opposing. Specific examples of drug-herb, drug-food and exercise interactions that can impact drug levels are provided.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    30 views18 pages

    Drug Interaction

    Uploaded by

    Bp ho
    This document discusses drug interactions, which occur when the effects of one drug are changed by another substance like another drug, herbal medicine, food, or chemical. It covers several categories of drug interactions including pharmacokinetic interactions that affect absorption, distribution, metabolism and excretion of drugs, as well as pharmacodynamic interactions that are additive, synergistic, antagonistic or opposing. Specific examples of drug-herb, drug-food and exercise interactions that can impact drug levels are provided.

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    Drug Interactions

    DR dra I A ALIT WIDHIARTINI, Apt., M.Si


    Objective
    • Identifiy the priciples of drug interaction
    • List of several categories of the drug interaction
    Definition
    • An interaction is said to occur when the effects of
    one drug are changed by the presence of another
    drug, herbal medicine, food, drink or by some
    environmental chemical agent.
    DRUG INTERACTION

    Pharmaceutics

    Pharmacokinetics
    •ADME
    •Effects
    •Duration of action
    Pharmacodynamic
    Drug Absorption Ix
    Effects of changes in
    gastrointestinal pH: ionization,
    polarity
    Adsorption, chelation and other
    complexing mechanisms
    Changes in gastrointestinal
    motility

    Induction or inhibition of drug


    transporter proteins

    Malabsorption caused by drugs


    The pathway drug use to enter the circulation
    Drug distribution Ix

    Protein-binding
    interactions

    Induction or inhibition of
    drug transport proteins
    Drug metabolism (biotransformation) Ix
    Changes in first-pass metabolism

    • Changes in blood flow through the liver


    • Inhibition or induction of first-pass metabolism

    Enzyme induction

    Enzyme inhibition

    Genetic factors in drug


    metabolism
    Cytochrome P450 isoenzymes and
    predicting drug
    Drug excretion Ix

    Changes in urinary pH

    Changes in active renal tubular


    excretion
    Changes in renal blood flow
    Biliary excretion and the entero-
    hepatic shunt
    • Enterohepatic recirculation
    • Drug transporters (P –glycoprotein)
    Ix due to changes in renal transport
    Inhibitors and Inducers of P glycoprotein

    • Inhibitors
    – Atorvastatin
    – Clarithromycin, Erythromycin
    – Dypiridamole
    – Itraconazole, Ketoconazole
    – Propafenone
    – Quinidine
    – Valspodar
    – Verapamil
    • Inducers
    – Rifampicn
    – St John wort (Hypericum perforatum) 6
    Pharmacodynamic Ix

    Additive or synergistic
    interactions

    Antagonistic or opposing
    interactions

    Drug or neurotransmitter
    uptake interactions
    Drug-herb interactions

    • St John’s Wort (Hypericum perforatum: serotonergic


    • Induce CYP 450 isoenzyme CYP3A4 and Pglycoprotein
    • <ciclosporin & digoxin
    Drug-food interactions

    • Cruciferous vegetables and charcoal-broiled meats


    • Grapefruit juice processed
    • > level Ca channel blocker: Felodipine
    • Fexofenadine
    Effect Exercise to the PK Drugs

    • Orally given drugs – No substantial effects


    • I.M., S.C, transdermal, and inhalation sites : alters
    physiological parameters : CO, blood flow to active
    skeletal muscle
    Summary
    • If maintainaing the plasma concentration of a
    drug at a certain level is important:
    Consider the alternative drugs and physical activity for
    patients safety

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