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Major CYP 450 Inducers
- PS PORCS
- PhenytoinSmokingPhenobarbitalOxcarbazepineRifampinCarbamazepineSt. John's Wort
Major CYP 450 Inhibitors
- G PACMAN
- Azole Antifungals
- Non-DHP CCBs
Must decrease dose 30-50% when starting amiodarone
Antifungals with pH dependent absorption: High pH causes decreased absorption
Digoxin is mostly _____ cleared and partially _____ cleared.
Hypokalemia (K+< 3.5 mEq/mL) will ________ digoxin levels.
Increased risk of severe rash. Use caution and titrate slowly.
Increases Lithium levels
- Decreased salt intake
- Dehydration (caution with diuretics)
Decreases Lithium levels
- Salt intake
Decreases levels of OCs
- St. John's Wort
Chelate with Al, Mg, Ca, Fe, and Zn
Anticoagulant that is neither a substrate, inhibitor, or inducer of CYP 450 enzymes
QT prolonging agents
- Class Ia and III antiarrhythmics
- Anticancer agents
- Protease inhibitors
- Antidepressants (TCAs, SSRIs, SNRIs, trazodone)
- 5-HT3 blockers
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