2.2 - Incompatibilities

b. Acidic environment

[Alteration of Gastric pH]

A weak acid shows increased absorption in which type of environment?
a. Basic environment
b. Acidic environment
c. Neutral environment
d. Alkaline environment

d. Basic environment

[Alteration of Gastric pH]

A weak base shows increased absorption in which type of environment?
a. Neutral environment
b. Alkaline environment
c. Acidic environment
d. Basic environment

b. Decrease absorption

[Alteration of Gastric pH]

Aspirin (weak acid) + Omeprazole (↑ pH) → _______

a. Increase absorption

b. Decrease absorption

b. Decrease absorption

[Alteration of Gastric pH]

Diphenhydramine (weak base) + Antacid (↑ pH) → _______

a. Increase absorption

b. Decrease absorption

b. Absorption

[Alteration of Gastric pH]

When a weak acid drug is combined with another weak acid drug, what is the resulting pharmacokinetic effect?
a. Excretion
b. Absorption
c. Toxicity
d. Precipitation

c. Absorption

[Alteration of Gastric pH]

When a weak base drug is combined with another weak base drug, what is the resulting pharmacokinetic effect?
a. Precipitation
b. Excretion
c. Absorption
d. Toxicity

d. Excretion

[Alteration of Gastric pH]

When a weak acid drug is combined with a weak base drug, what is the resulting pharmacokinetic effect?
a. Absorption
b. Toxicity
c. Precipitation
d. Excretion

c. Decreased gut flora

[Alteration of Gastric pH]

Broad-spectrum antibiotics (precipitant drug) cause what effect on gut flora?
a. Increased gut flora
b. No change in gut flora
c. Decreased gut flora
d. Altered gut flora pH

b. Vitamin K

[Alteration of Gastric pH]

Combining Warfarin with an antibiotic causes a marked decrease in this vitamin, leading to bleeding
a. Vitamin A
b. Vitamin K
c. Vitamin D
d. Vitamin B12

a. Bleeding

[Alteration of Gastric pH]

Warfarin + Antibiotic = decrease Vitamin K → ______

a. Bleeding
b. Precipitation
c. Pregnancy
d. Toxicity

b. Vitamin K

[Alteration of Gastric pH]

Gut flora are responsible for producing vitamin ______
a. Vitamin D
b. Vitamin K
c. Vitamin B12
d. Vitamin A

c. Pregnancy

[Alteration of Gastric pH]

Oral contraceptives + Antibiotic → ______

a. Bleeding
b. Precipitation
c. Pregnancy
d. Toxicity

c. Enhances absorption of oral contraceptives

[Alteration of Gastric pH]

Oral contraceptives combined with an antibiotic can result in pregnancy because gut flora normally does what to the absorption of oral contraceptives?
a. Decreases absorption of oral contraceptives
b. Has no effect on absorption of oral contraceptives
c. Enhances absorption of oral contraceptives
d. Directly excretes oral contraceptives

b. Decreased absorption and increased failure of contraception

[Alteration of Gastric pH]

When an antibiotic decreases gut flora, what is the resulting effect on oral contraceptive absorption and contraceptive failure?
a. Increased absorption and decreased failure of contraception
b. Decreased absorption and increased failure of contraception
c. Increased absorption and increased failure of contraception
d. Decreased absorption and decreased failure of contraception

b. Increased absorption

[Alteration of GI Motility]

Increased GI motility results in what effect on drug absorption?
a. Decreased absorption
b. Increased absorption
c. No change in absorption
d. Delayed absorption

c. Decreased absorption

[Alteration of GI Motility]

Decreased GI motility results in what effect on drug absorption?
a. Increased absorption
b. No change in absorption
c. Decreased absorption
d. Immediate absorption

b. Slower absorption

[Alteration of GI Motility]

Lithium + Loperamide (decreases GI motility) → _______

a. Faster absorption
b. Slower absorption
c. No change in absorption
d. Complete absorption

a. Faster absorption

[Alteration of GI Motility]

Levodopa + Metoclopramide (increases GI motility) → _______

a. Faster absorption
b. Slower absorption
c. No change in absorption
d. Complete absorption

b. Anti-emetic

[Alteration of GI Motility]

Metoclopramide is classified under this drug category based on its use for vomiting

a. Antihistamine

b. Anti-emetic

c. Antacid

d. Antidiarrheal

b. Prokinetic agent

[Alteration of GI Motility]

Metoclopramide acts as this type of agent that increases GI motility
a. Antikinetic agent
b. Prokinetic agent
c. Antiemetic agent only
d. Antimotility agent

b. Slower absorption

[Alteration of GI Motility]

Tirzepatide (↓ GI motility) + Any oral drug → ______

a. Faster absorption

b. Slower absorption

c. No change in absorption

d. Complete absorption

a. Weight loss

[Alteration of GI Motility]

Tirzepatide causes _______ primarily through decreased gastric emptying.

a. Weight loss
b. Hypertension
c. Hyperglycemia
d. Tachycardia

b. Decreased gastric emptying

[Alteration of GI Motility]

Tirzepatide causes weight loss primarily through this mechanism
a. Increased gastric emptying
b. Decreased gastric emptying
c. Increased GI motility
d. Increased appetite stimulation

c. Inactive

[Distribution]

In displacement interactions, a drug that is bound to plasma protein is considered
a. Active
b. Free
c. Inactive
d. Unbound

d. Active

[Distribution]

In displacement interactions, a drug that is free or unbound from plasma protein is considered
a. Inactive
b. Bound
c. Sequestered
d. Active

b. Free warfarin, active, bleeding

[Distribution]

Warfarin + Phenylbutazone (NSAID that is more protein bound) → ______

a. Bound warfarin, inactive, no effect
b. Free warfarin, active, bleeding
c. Free warfarin, inactive, no effect
d. Bound warfarin, active, bleeding

c. CYP450

[Metabolism]

This enzyme system is responsible for the metabolism of most drugs in the liver
a. P-glycoprotein
b. UGT enzymes
c. CYP450
d. Monoamine oxidase

c. Increased metabolism

[Metabolism]

An enzyme inducer causes what effect on metabolism?
a. Decreased metabolism
b. No change in metabolism
c. Increased metabolism
d. Blocked metabolism

b. Decreased drug concentration

[Metabolism]

An enzyme inducer causes what effect on drug concentration?
a. Increased drug concentration
b. Decreased drug concentration
c. No change in drug concentration
d. Stable drug concentration

c. Decreased metabolism

[Metabolism]

An enzyme inhibitor causes what effect on metabolism?
a. Increased metabolism
b. No change in metabolism
c. Decreased metabolism
d. Complete metabolism

d. Increased drug concentration

[Metabolism]

An enzyme inhibitor causes what effect on drug concentration?
a. Decreased drug concentration
b. No change in drug concentration
c. Unstable drug concentration
d. Increased drug concentration

c. 2E1

[Metabolism]

BEQ: The cytochrome enzyme that degrades (inhibits) paracetamol is
a. 3A4
b. 2D6
c. 2E1
d. 1A2

• Carbamazepine

• Rifampicin

• Alcohol (Chronic)

• Phenytoin

• Griseofulvin

• Phenobarbital

• Sulphonylureas

📌Mnemonic: “CRAP” “GPS”

[Metabolism]

Enzyme Inducers include _____ [7]

• Sodium Valproate

• Isoniazid

• Cimetidine

• Ketoconazole

• Fluconazole

• Alcohol (Acute)

• Ciprofloxacin

• Erythromycin (All Macrolides)

• Streptomycin

• Chloramphenicol

• Omeprazole

• Metronidazole

📌Mnemonic: “SICKFACES.COM

[Metabolism]

Enzyme inhibitors include _____ [12]

c. Alkalinized

[Excretion]

To enhance excretion of a weak acid drug, the urine should be ______
a. Acidified
b. Neutralized
c. Alkalinized
d. Buffered

b. Acidified

[Excretion]

To enhance excretion of a weak base drug, the urine should be ______
a. Alkalinized
b. Acidified
c. Neutralized
d. Buffered

c. Sodium bicarbonate (NaHCO₃)

[Excretion]

This agent is used to alkalinize urine in order to enhance excretion of weak acid drugs
a. Ammonium chloride (NH₄Cl)
b. Potassium citrate
c. Sodium bicarbonate (NaHCO₃)
d. Acetazolamide

c. Sodium bicarbonate (NaHCO₃)

[Excretion]

To enhance excretion of a weak acid drug, urine is alkalinized using this agent
a. Ammonium chloride (NH₄Cl)
b. Potassium citrate
c. Sodium bicarbonate (NaHCO₃)
d. Acetazolamide

a. Ammonium chloride (NH₄Cl)

[Excretion]

To enhance excretion of a weak base drug, urine is acidified using this agent
a. Ammonium chloride (NH₄Cl)
b. Potassium citrate
c. Sodium bicarbonate (NaHCO₃)
d. Acetazolamide

c. Excretion

[Excretion]

Aspirin + Bicarbonate → ______

a. No excretion
b. Precipitation
c. Excretion
d. Reabsorption

d. Excretion

[Excretion]

Methamphetamine + Ammonium chloride → ______
a. No excretion
b. Reabsorption
c. Precipitation
d. Excretion

b. No excretion, no trace in urine

[Excretion]

Methamphetamine + Base → ________

a. Excretion
b. No excretion, no trace in urine
c. Increased excretion
d. Precipitation

a. Alteration of gastric pH

[Classify]

Aspirin + Omeprazole

a. Alteration of gastric pH

b. Alteration of Gut flora

c. Alteration of GI Motility

d. Distribution

e. Metabolism

f. Excretion

a. Alteration of gastric pH

[Classify]

Diphenhydramine + Antacid

a. Alteration of gastric pH

b. Alteration of Gut flora

c. Alteration of GI Motility

d. Distribution

e. Metabolism

f. Excretion

a. Alteration of gastric pH

[Classify]

Broad-spectrum antibiotics

a. Alteration of gastric pH

b. Alteration of Gut flora

c. Alteration of GI Motility

d. Distribution

e. Metabolism

f. Excretion

b. Alteration of Gut flora

[Classify]

Warfarin + antibiotic

a. Alteration of gastric pH

b. Alteration of Gut flora

c. Alteration of GI Motility

d. Distribution

e. Metabolism

f. Excretion

b. Alteration of Gut flora

[Classify]

Oral contraceptives + antibiotic

a. Alteration of gastric pH

b. Alteration of Gut flora

c. Alteration of GI Motility

d. Distribution

e. Metabolism

f. Excretion

[Classify]

Lithium + Loperamide

a. Alteration of gastric pH

b. Alteration of Gut flora

c. Alteration of GI Motility

d. Distribution

e. Metabolism

f. Excretion

c. Alteration of GI Motility

[Classify]

Levodopa + Metoclopramide

a. Alteration of gastric pH

b. Alteration of Gut flora

c. Alteration of GI Motility

d. Distribution

e. Metabolism

f. Excretion

c. Alteration of GI Motility

[Classify]

Tirzepatide + Any oral drug

a. Alteration of gastric pH

b. Alteration of Gut flora

c. Alteration of GI Motility

d. Distribution

e. Metabolism

f. Excretion

d. Distribution

[Classify]

Warfarin + Phenylbutazone

a. Alteration of gastric pH

b. Alteration of Gut flora

c. Alteration of GI Motility

d. Distribution

e. Metabolism

f. Excretion

e. Metabolism

[Classify]

Enzyme Inducer

a. Alteration of gastric pH

b. Alteration of Gut flora

c. Alteration of GI Motility

d. Distribution

e. Metabolism

f. Excretion

e. Metabolism

[Classify]

Enzyme Inhibitor

a. Alteration of gastric pH

b. Alteration of Gut flora

c. Alteration of GI Motility

d. Distribution

e. Metabolism

f. Excretion

f. Excretion

[Classify]

ASA + Bicarbonate

a. Alteration of gastric pH

b. Alteration of Gut flora

c. Alteration of GI Motility

d. Distribution

e. Metabolism

f. Excretion

f. Excretion

[Classify]

Methamphetamine + Ammonium chloride

a. Alteration of gastric pH

b. Alteration of Gut flora

c. Alteration of GI Motility

d. Distribution

e. Metabolism

f. Excretion

f. Excretion

[Classify]

Methamphetamine + Base

a. Alteration of gastric pH

b. Alteration of Gut flora

c. Alteration of GI Motility

d. Distribution

e. Metabolism

f. Excretion