Question

Big Picture_DIs (in addition to the patient case study guide/tables/and DI_PK_PD_PGx_Abdalla_Schematics_Animations_iMCPI_2019.pptx) Drug 1 Drug 2 Type of Interaction Effect and Outcome *Mechanism (Mum) of Interaction Fluoxetine metabolized via CYP2D6 and CYP3A4 Cimetidine Fluoxetine PK (metabolism) Effect: Increased fluoxetine plasma concentration Cimetidine strongly inhibits CYP3A4 and moderately inhibits CYP2D6 Outcome: leads to increased risk for QT prolongation Nitroglycerin Pharmaceutical Interactions (Physiochemical Photodegradation - exposed to light HORAS, PPIs. Antacids Metallons (such ase Antifungals (Such as Tetracyclines (such as and Fluoroquinolones (such as Oral contraceptive CYP inducers (such as Warfarin CYP inhibitors (Such as Clopidogrel Opioids Naloxone Type of interaction indicate whether it's physiochemical, PK (A.D.M. and/or E) or PD (Additive/synergestic vs antagonistie), "Mxm of Interaction describe how and why these drugs affect cach other

Answer 1

drug 1	drug2	types of interaction	mechanism of interaction	effect and outcome
nitriglycerin			photodegradation exposed to light.	nitroglycerin may form unstable compounds on time and exposure to light.so it is highly dangerous, it should be stored very carefully.
H2A,PPI'S ,ANTACIDS	ANTIFUNGALS (ketoconazole)	Pharmacodynamic	PPI'S can modify intragastric release of antifungals by elevating PH.	reduce the antifungal activity.
metal ions	tetracyclins( flouroquinolones.	complex formation	decrease in absorption and bioavailability.	ca and tetracycline complex is formed which remain unabsorbed. decrease in solubility.
CYP INDUCERS (topiramate,rifampicin)	oral contraceptives	cyp induction	increase oral contraceptive metabolism	decrease effectiveness
CYP INHIBITOR	Warfarin	drugs like amiodarone inhibit cyp450	potentiate the effect of warfarin	so dose adjustment is necessary.
CYP INHIBITOR	CLOPIDOGREL	Coadministration with cyp inhibitors like erythromycin and ketoconazole reduce clopidogrel antiplatelet activity.	effect of clopidogrel attenuated.	coadministaration of clopidogrel with these drugs should be monitored
opioids	naloxone	naloxone is opioid antagonist	used in opioid overdose	counteract ipiod overdose