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Module 11 - Lecture notes 11

Introductory Pharmacology and Therapeutics (The University of Western Ontario)

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lOMoARcPSD|3191865

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Module 11 -

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Drugs can interact ut eachothercomponents 0
Types of drug interactions
Direotkhemical physical
④ Direct
of our diet to produce complex responses physical interactions rxnofztarugs

C) Can "
maerpaaitniotntahesw;
# " medications
⑧ most
occur if 2T
drugs are taken common is the mix of IV solutions
C) Imp In ↳ View
precipitate
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Most common type of interaction ⑧ Diazepam

drug drug
-
is problematic + shouldn't be
affect pharmacokinetics followed by other
drugs
0 There 3 possible interact : ② Pharmacokinetics
are outcomes when 2T drugs onangeota.me

① Increased effects ⑧ most common type

⑧ By either :
Absorption
A therapeutic effect A adverse effects ↳ Altered pH

÷;¥÷I¥iYiisr¥iJ # Obrugsthat affect gastrointestinal pH

alter absorption
can

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② Decreased effects Nabs that arew.B.tw

or
gastric pH i. .

⑧ By either :
abs .
of W A - .

d. therapeutic effect & adverse effects 0

can also affect abs of enteric coated .

drugs
clopidogrel anmffanagiuaanatiai ondnfkyeguiun.IT
1
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morphine -

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↳
Chelating Binding
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Omeprazole 0 Some are known to bind other
-

drugs drugs win the

intestine
used to treat OD .
respiratory depression
'
or

death

Together -

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Distribution 0
usually causes formation of insoluble complexes used to bind bile acids prevent

③ Generation of ↳
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new effect
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Altering pH that
↳ Altered blood flow
can't be absorbed

Drugs that can change

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the pH can influence 0 Drugs that WBF , dubs .

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: :*: .
to

ionization of other 0 Epinephrine ut local anesthetic

drugs
over - chronic alcoholism

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→
÷ sunning
sodium bicarbonate on causes
ABS ish
-

extracellular pH whereas abs .

of local anesthetic

Metabolism ammonium chloride dit allowing ittostayatinj site -

Omostimp t 0 Due to pH ↳ Gut

-
common type of drug partitioning , motility
int
drugs from Osome MN intestinal motility
. can be drawn
drugs can

⑧me
drugs tnmetabolismof other motility =D absorption
O laxatives A gut
inside to outsidethecellby
0
drugs by inducing (CYPS) arugmetenzymes changing it's ionization (aspirin) Opiates dgut motility =P absorption
↳ Protein ↳
Others inhibit met -

by inhibiting Alps binding Vomiting

Omostly tlinlestine Off two drugs to the O drugs that induce vomiting dabs of other
occur in liver are bound
drugs
-_
.

↳ CYP induction same site on plasma proteins Olf vomiting occurs 20-30 min after It medications

÷÷*s:: ÷÷:: : : : ÷÷a:: : :i:

,

④ synthesis it's
of CYP enzymes results co -
admin results in competition likely absorption is incomplete
in A 0 If intestine -04
drug metabolism
drug entered vomiting taking ,
another

delay by 2- todays dose

may produce toxicity
Otakestlo days to return to normal a¥¥¥i"schism:c
can result to
.
↳
Drugs that kill intestinal bacteria
in A ther effect

0 Int
.

wxicityiexcre.im
bacteria are Imp in metabolism of some
drugs
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.
.

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absorption
during enterohepatic recycling
d.

↳ CYP Inhibition th Cplasma]

Ocean inhibit CYP enzymes in 0 Antibiotics +

antifungal a HIV protease inhibit cYP34F
intestine ( liver Olf pro
-

drug given when Cyp enzymes Oomeprazok inhibits cypsela

0 Results t inhibited =D 0
in metabolism of are met .
activation Selective SSRI Inhibit cyp2Db

other
drugs metabolized Ofluvoxamine Inhibit CYPIAZ

by the same enzyme Grapefruit

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juice Inhibits cypzay