10291 - 1000 Drug Interactions 1000 Drug Interactions That...

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Unformatted text preview: 1000 Drug Interactions 1000 Drug Interactions That You Didnt Know That You Didnt Know You Knew You Knew Paul Starr, M.D. Paul Starr, M.D. Department of Family Medicine Department of Family Medicine Louisiana State University Louisiana State University Introduction Introduction Drug interactions were once thought to represent an insidious threat to public health. Although initial estimates predicted huge numbers of dangerous drug interactions, in practice they do not appear to be as menacing as they once appeared Epidemiology Epidemiology Unknown incidence Still a preventable cause of morbidity Pivot Table Pivot Table Aspirin Cimetidine Digoxin Erythromycin Fluconazole Iron Nifedipine Phenytoin Propranolol Terfenadine Warfarin war tet ter pro phe nif iro flu ery dig cim asp Pivot Table Pivot Table Aspirin Cimetidine Digoxin Erythromycin Fluconazole Iron Nifedipine Phenytoin Propranolol Terfenadine Warfarin war tet ter pro phe nif iro flu ery dig cim asp Pivot Table Pivot Table Aspirin Cimetidine Digoxin Erythromycin Fluconazole Iron Nifedipine Phenytoin Propranolol Terfenadine war tet ter pro phe nif iro flu ery dig cim ( Dont forget to turn the corner!) Learning objectives for Learning objectives for improving awareness of improving awareness of drug interactions drug interactions A. Evaluate medications B. Famous interactions C. Group medications D. Hear your patient Medications for this lecture Medications for this lecture Aspirin Cimetidine Digoxin Erythromycin Fluconazole Iron Nifedipine Phenytoin Propranolol Terfenadine Warfarin Consider the Medications Consider the Medications passage through the body passage through the body Consider the Medications passage through the body Absorption Absorption a. Chelation : Divalent cations such as calcium or iron can bind to certain medications and prevent their absorption I. iron with (H.C. Heinrich and KH Oppitz, inhibits iron absorption in man. Naturwissenschaften, 60:524, 1973) Absorption Absorption b. Absorption pH: Weak acids need to be absorbed at a low pH. Raising the pH with antacid medication considerably hinders absorption. I. iron with cimetidine (R Esposito, Cimetidine and iron-deficiency anaemia. Lancet, 2:1132, 1977) II. cimetidine with aspirin (W Khoury, et.al., The effect of cimetidine on aspirin absorption....
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10291 - 1000 Drug Interactions 1000 Drug Interactions That...

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