Pharmacology

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Author:
amgomez
ID:
107071
Filename:
Pharmacology
Updated:
2011-10-07 03:07:39
Tags:
Cardiovascular System Drugs
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Description:
Food & Drug Interactions
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  1. What drugs or food have the potential to interact with the fibrate drug gemfibrozil (Lopid)?
    • Statin antilipemics greatly increase risk for myopathy.
    • Warfarin with fibrates increases risk for bleeding.
    • Taken with antidiabetic drugs, fibrates increase risk for hypoglycemia.
  2. What drugs or food have the potential to interact with the angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten)?
    • Potassium-sparing diuretics, potassium supplements, or use of salt substitutes increase risk for hyperkalemia.
    • Antihypertensive drugs, diuretics, and nitrates (such as nitroglycerin) increase risk for hypotension.
    • NSAIDs may decrease effectiveness.
    • Food decreases absorption.
    • ACE inhibitors may cause lithium toxicity.
  3. What drugs or food have the potential to interact with the alpha/beta blocker carvedilol (Coreg)?
    • Increases risk for hypoglycemia with insulin or oral hypoglycemic.
    • May increase risk for digoxin toxicity.
    • MAOI antidepressants cause bradycardia or hypotension.
    • Cimetidine increases blood levels.
    • Use with other antihypertensive drugs may increase risk for hypotension
  4. What drugs or food have the potential to interact with the cardiac glycoside digoxin (Lanoxin)?
    • Erythromycin and some other antibiotics increase digoxin levels.
    • Other antidysrhythmics (verapamil, quinidine, amiodarone, flecainide) increase digoxin levels; decrease digoxin dosage for concurrent administration.
    • Diuretics increase risk for digoxin toxicity by decreasing potassium levels.
    • Herbal ginseng increases risk of digoxin toxicity.
    • St. John's wort decreases digoxin levels.
    • This is not a complete list. Check for other interactions
  5. What drugs or food have the potential to interact with the nitrate drugs nitroglycerin (Nitrostat, Nitro-Dur, Nitro-Bid) and isosorbide dinitrate (Isordil)?
    • Increased hypotension may result when used with other antihypertensive drugs or with alcohol.
    • PDE5 inhibitors, such as sildenafil (Viagra) may cause severe hypotension.
    • Beta blockers and calcium channel blockers decrease tachycardia caused by nitroglycerin.
  6. What drugs or food have the potential to interact with the calcium channel blocker (dihydropyridine) nifedipine (Adalat, Procardia)?
    • Use with beta blockers may increase risk for heart failure; however, they can prevent reflex tachycardia.
    • Melatonin increases blood pressure, pulse rate.
    • Ginkgo biloba and ginseng increase blood levels.
    • St. John's wort decreases blood levels.
    • Grapefruit juice may increase blood levels.
  7. What drugs or food have the potential to interact with the direct acting vasodilator (hydralazine) drug hydralazine (Apresoline)?
    • MAOI antidepressants may cause severe hypotension.
    • Other antihypertensive drugs may cause hypotension.
  8. What drugs or food have the potential to interact with the class IA/sodium channel blocker drugs quinidine (Apo-Quinidine, Novo-Quinidine) and procainamide (Pronestyl)?
    • Anticholinergic drugs cause increased anticholinergic symptoms (such as tachycardia) ; cholinergic drugs may decrease therapeutic effect.
    • Antidysrhythmics may increase adverse or therapeutic effects; amiodarone increases risk for heart block.
    • Antihypertensives may increase risk for hypotension.
    • Quinidine increases digoxin levels and risk for digoxin toxicity; it also increases risk for warfarin toxicity.
    • Large amounts of grapefruit juice may cause toxicity.
  9. What drugs or food have the potential to interact with the loop diuretic furosemide (Lasix)?
    • Digoxin toxicity is a high risk with hypokalemia.
    • Other diuretics increase the diuretic effect.
    • NSAIDs may decrease diuretic effect.
    • Neuromuscular blocking agents may have prolonged effect.
    • Lithium toxicity may occur.
    • Amphotericin B and corticosteroids increase risk for hypokalemia.
  10. What drugs or food have the potential to interact with the centrally acting alpha2 agonist clonidine (Catapres)?
    • Central nervous system (CNS) depressants increase CNS adverse effects.
    • Tricyclic antidepressants (TCAs) may decrease effectiveness.
  11. What drugs or food have the potential to interact with the class IB/sodium channel blocker lidocaine (Xylocaine)?
    • Beta blockers, procainamide and quinidine increase lidocaine effects.
    • Phenytoin increases hypotension, bradycardia.
  12. What drugs or food have the potential to interact with the direct renin inhibitor aliskiren (Tekturna)?
    • Other antihypertensive drugs have an additive effect with aliskiren.
    • Potassium-sparing diuretics and other drugs that increase potassium levels increase the risk for hyperkalemia.
    • The drug decreases the blood level of furosemide (Lasix).
    • Atorvastatin (Lipitor) and ketoconazole (Nizoral) increase blood levels.
    • Irbesartan (Avapro) decreases blood levels.
  13. What drugs or food have the potential to interact with the class II/beta adrenergic blocker propranolol (Inderal)?
    • Use with other antihypertensive drugs may increase risk for hypotension.
    • Antacids may decrease absorption.
    • Digoxin has an additive effect and may increase bradycardia.
    • Beta blockers with oral hypoglycemic agents may increase risk for hypoglycemia, and propranolol may mask tachycardia caused by hypoglycemia.
    • Beta blockers may increase effect of neuromuscular blockers.
    • Antimuscarinic and anticholinergic drugs may decrease beta blocker effects.
  14. What drugs or food have the potential to interact with the class III/potassium channel blocker amiodarone (Cordarone)?
    • CYP3A4 inhibitors, including grapefruit juice, azole antifungal drugs, and erythromycin increase risk for toxicity.
    • CYP34A inducers, such as St. John's wort, and phenytoin decrease blood levels.
    • Diuretics and drugs that increase QT interval increase risk for dysrhythmias.
    • Beta blockers and calcium channel blockers increase risk for bradycardia.
    • Amiodarone increases blood levels of quinidine, procainamide, phenytoin, digoxin, diltiazem, warfarin, and some statin drugs.
  15. What drugs or food have the potential to interact with the class IV/calcium channel blocker verapamil (Calan)?
    • Digoxin levels are increased and risk for atrioventricular (AV) block increases with use of digoxin.
    • Beta blockers increase risk for bradycardia and heart failure.
    • With other antihypertensives, risk for hypotension is increased.
    • IV calcium decreases effects.
    • Levels of lithium and cyclosporine may be increased.
    • Large amounts of grapefruit juice may increase blood levels
  16. What drugs or food have the potential to interact with the class IC/sodium channel blockers flecainide (Tambocor) and propafenone (Rythmol)?
    • Increases digoxin levels.
    • Beta blockers and calcium channel blockers potentiate cardiac effects.
  17. What drugs or food have the potential to interact with the alpha1 adrenergic blocker doxazosin (Cardura)?
    Sildenafil (Viagra) and other phosphodiesterase inhibitors may increase risk for hypotension.
  18. What drugs or food have the potential to interact with the HMG-CoA reductase inhibitor (statin) drug simvastatin (Zocor)?
    • Concurrent use of a fibrate or other drug to lower cholesterol can increase risk for myopathy or liver toxicity.
    • Drugs that inhibit CYP3A4, such as erythromycin, azole antifungal drugs, and HIV protease inhibitors, increase blood levels of some statins (especially lovastatin and simvastatin).
    • Drinking large amounts of grapefruit juice also inhibits CYP3A4 and can increase risk for adverse effects.
    • Warfarin with a statin increases risk for bleeding and increased prothrombin (PT) levels.
  19. What drugs or food have the potential to interact with the angiotensin receptor blocker (ARB) losartan (Cozaar)?
    • Antihypertensive drugs increase risk for hypotension.
    • Phenobarbital decreases serum levels of losartan.
  20. What drugs or food have the potential to interact with the potassium-sparing diuretic spironolactone (Aldactone)?
    • Counteracts adverse effect (hypokalemia) of loop and thiazide diuretics (may be the desired effect).
    • Angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), direct renin blockers, potassium supplements, salt substitutes increase risk of hyperkalemia.
  21. What drugs or food have the potential to interact with the phosphodiesterase inhibitor milrinone (Primacor)?
    • The antidysrhythmic drug disopyramide (Norpace) may cause severe hypotension.
    • Incompatible in solution with furosemide and procainamide.
  22. What drugs or food have the potential to interact with the sympathomimetic drug dobutamine (Dobutrex)?
    • MAOI and tricyclic antidepressants cause toxicity with greatly increased risk for tachydysrhythmias (decrease dobutamine dosage).
    • General anesthetics also may cause dysrhythmias.
    • Beta blockers decrease effects of dobutamine.
  23. What drugs or food have the potential to interact with the beta adrenergic blockers atenolol (Tenormin) and metoprolol (Lopressor)?
    • Use with other antihypertensive drugs may increase effects.
    • Antacids may decrease absorption.
    • Digoxin has an additive effect and may increase bradycardia.
    • Beta blockers with oral hypoglycemic agents may increase risk for hypoglycemia.
    • Beta blockers may increase effect of neuromuscular blockers.
    • Antimuscarinic and anticholinergic drugs may decrease beta blocker effects.
  24. What drugs or food have the potential to interact with the thiazide diuretic hydrochlorothiazide (HydroDIURIL)?
    • Lithium toxicity may occur.
    • Increased risk of digoxin toxicity with potassium or magnesium deficiency.
    • Corticosteroids and amphotericin B increase risk for hypokalemia.
    • Decreased absorption with cholestyramine (Questran) or colestipol (Colestid).
    • Increased blood glucose with insulin and oral sulfonylurea antidiabetic drugs
  25. What drugs or food have the potential to interact with the adrenergic neuron blocker reserpine (Serpalan and Sk-Reserpine)?
    • Use with MAOI antidepressants within 14 days may cause hypertensive crisis.
    • Antihypertensive drugs may increase risk for hypotension.
    • Digoxin increases risk for bradycardia.
    • St. John's wort may increase risk for hypotension.
  26. What drugs or food have the potential to interact with the aldosterone antagonist spironolactone (Aldactone)?
    • Drugs that inhibit CYP3A4, such as ketoconazole, erythromycin, and verapamil may greatly increase risk for toxicity and hyperkalemia.
    • Drugs that raise potassium levels, such as angiotensin-converting enzyme (ACE) inhibitors and potassium-sparing diuretics increase risk for hyperkalemia.
    • May cause lithium toxicity.

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