Question

16-19 help

16. List an anti-platelet drug that has a DDI with methotrexate (DMARD medication) and explain? 17. Which anti-platelet drug should be used with caution in patient with gout, and why? 18. In considering DDIs, be able to explain the DDI that can occur in each of the following pairs involving anti-platelet medications: a. clopidogrel and duloxetine: b. aspirin and warfarin: c. prasugrel and naproxen: d. tirofiban and rivaroxaban: e. clopidogrel and pantoprazole: 19. Which of the drugs in the previous question are used to treat clotting disorders but are not anti-platelet drugs?

Answer 1

16. Aspirin is an anti platelet drug that interacts with methotrexate. Aspirin alters methotrexate disposition and increases methotrexate blood level.

17. Aspirin since low dose of aspirin increases serum uric acid level.

18 a. Duloxetine is a serotonin reuptake inhibitor and cause bleeding and addition of clopidogrel leads to thrompocytopenia.

18 b. Aspirin is an anti platelet drug and warfarin is an anticoagulant. Hence, both cause hemorrhage.

18 c. Prasugrel and Naproxen interaction increases bleeding risk.

18 d. Tirofiban is an anti platelet drug and Rivaroxaban is an anticoagulant. Hence, both cause hemorrhage.

18 e. Pantoprazole reduces clopidogrel effect due to CYP450 dependency.

19. Warfarin and Rivaroxaban