OB-drug-interactions

OB-drug-interactions - DRUG INTERACTIONS IN LABOR A...

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Unformatted text preview: DRUG INTERACTIONS IN LABOR A PRACTICAL VIEW DRUG INTERACTIONS IN LABOR A PRACTICAL VIEW Dr.Mohamed El Sherbiny MD Obstetrics & Gynecology Senior Consultant Damietta General Hospital Damietta Egypt DEFINITION : Drug interaction means modification of the effect of a drug by concurrent administration of other drugs. DEFINITION : Drug interaction means modification of the effect of a drug by concurrent administration of other drugs. Basic principles: Adverse interaction includes: 1-Loss of drug action 2-Unexpected increase in drug action 3-toxicity Adverse interaction includes: 1-Loss of drug action 2-Unexpected increase in drug action 3-toxicity Beneficial interaction: e.g.. *Pethidine+ Metochlopromide(Plasil) *Naloxone+Morphia. Beneficial interaction: e.g.. *Pethidine+ Metochlopromide(Plasil) *Naloxone+Morphia. ADVERSE &BENEFICIAL INTERACTIONS I-PHARMACOKINETICS: Everything that happens to the drug in the body I-PHARMACOKINETICS: Everything that happens to the drug in the body Mechanisms Of Interactions: II-PHARMACODYNAMIC * Everything the drug does to the body II-PHARMACODYNAMIC * Everything the drug does to the body N.B Interaction outside the body (Incompatibility ) e.g. ketamine is incompatible with barbiturate & diazepam N.B Interaction outside the body ( Incompatibility ) e.g. ketamine is incompatible with barbiturate & diazepam I-PHARMACOKINETIC * Absorption * Distribution * Metabolism * Excretion * Absorption: may be interfered with e.g. Al(OH)3 In most antacid adsorb digoxin Adrenaline to local anesthesia prolong effect What happens to drugs in the body? * Distribution : affected by Competition for plasma protein binding E.g:Indomethacine displaces Warfarine . Free Warfarine --> anticoagulant effect NaHC3 pH of renal tubules absorption of Aspirin & Phenobarbital (weakly acidic) . their excretion their Effects. * Excretion : drug clearance affected by another drug e.g * Metabolism • Induction of liver micosomal Enzyme CYTOCHROME P 450 (7-10 days) e.g. Rifampicin, Phenobarbiton, Carbamaziben (Tegretol) Phenytoin : They increase the metabolism and decrease activity of other drugs e.g. Theophyllin, & Valproic acid Interfered with through liver enzymes: Interfered with through liver enzymes: Inhibitor of liver enzymes ( a rapid effect) e.g. Cemitidin,Erthromycin decrease the metabolism and increase activity of other drugs eg. Theophyllin,Anticoagulant * Metabolism Cont.. 2-PHARMACODYNAMIC Synergism 1-Addition 2+2=4 e.g. B Blockers +Thiazide 2-Potentiation 2+2=5 Trimethoprin+sulfmethexasol Antagonism(Opposing) B-Blockers Propanolol(Inderal) prevent the bronchodilator effect...
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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OB-drug-interactions - DRUG INTERACTIONS IN LABOR A...

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