Drug Interaction & Adverse Drug Reactions

One drug intensifies the effects of the other, one drug reduces the effects of the othe, this combo produces a new response not seen with either drug alone

Drug-drug interactions

increases therapeutic effects, increased adverse effects

Intensification (potentiative) effects

reduced therapeutic effects, reduced adverse effects

Reduction (inhibitory) effects

metabolizes faster, levels will go down, not as much of the med will be available

enzyme induction

slows down metabolism, not enough break down, can cause drug toxicity

enzyme inhibition

what are the 2 pharmacodynamic interactions:

- drugs that act as the same site
- drugs that act as separate sites

both cannot bind, one will win out (opioids and narcan)

drugs that act as the same site

at two different receptors but can cause an interaction (morphine and Manx)

drugs act at separate sites

mixing food and drugs can either:

decrease or increase absorption

taking medicine on an empty stomach is considered:

1 hour before or 2 hours after eating

What is the grapefruit effect?

taking a drug with grapefruit juice can cause toxic drug levels

an effect other than the desired therapeutic effect that may occur during drug therapy

adverse effect

usually refers to a minor effect such as nausea, nearly unavoidable secondary drug effect produced at therapeutic dosing

side effect

caused by excessive dosing

Toxicity

an immune response, must have had a prior sensitization, not determined by the size of the dose but by the degree of sensitization

Allergic Reactions

most serious allergic reaction, medical emergency, systemic reactions, contraction of smooth muscles in the airway causing it to close, increased vascular permeability causes swelling

Anaphylaxis

unusual, abnormal or peculiar response to a drug, occur because of genetic enzyme deficiencies that alter drug metabolism

Idiosyncratic drug response

opposite of an intended drug response

Paradoxical response

a disease that occurs as a result of medical care or treatment, can be result of drug

iatrogenic disease

a state which the body has adapted to prolonged drug exposure in such a way that abstinent syndrome will result if drug use is discontinued

Physical Dependence

patient gets physically ill due to drug

Abstinence syndrome

ability of certain medications and environmental chemicals to cause cancer

Carcinogenic effect

drug induced birth effects

tetrogenic effect

the brain is sensitive to small amounts of toxic substances, can occur after exposures to drugs and other chemicals and gases, causes changes in LOC, auditory and visual disturbances, tonic - clonic seizures

Neurotoxicity

chemically induced kidney damage (nephrotoxicity) is manifested as...

acute tubular necrosis

wide variety of drugs that can effect the immune system, may cause immunosuppression or destroy immune systems

Immunotoxicity

irregularities in cardiac rhythms and conduction and possible heart damage may result from an adverse effect known as...

cardiotoxicity

drugs affects the 8th cranial nerve and result is inner ear or auditory nerve damage, structure of the inner ear may be affected

ototoxicity