Drug Interaction (DI)

1.
Drug Interaction
2.
Drug Interaction
fatal
drug interaction
3. 6 6
66
fatal drug
interaction 6
6

1.
2.
3.

4.

5.

1. 6
Drug Interaction
F Drug
66
Interaction 6

6 D
66 2. 6D6

drug interaction

3.

6
Drug
Drug Interaction
Interaction

Drug
Interaction
666D
6D6
Drug Interaction

Update: 2556

( Drug Interaction 2

Drug interaction (DI)

6 2 6
6 66
Fatal Drug Interaction
P6

6P Fatal DI 6
- P
- 1
- Major 6P

Fatal DI
1. Contraindication Fatal Drug Interaction Fatal DI
1 6 major 666

2. Monitoring Fatal Drug Interaction Fatal DI 1

6 major 66
66D6
Onset ()
P 2
- Rapid 24 6 6
P666
- Delayed 6P
P66
Severity

6 Major
6D6

2
(2)
1 Fatal drug interaction: 666D6 6
66
1
2
onset severity
Effect & Management
1. Amiodarone
Ritonavir
delayed major Amiodarone
Indinavir
66
Lopinavir/ritonavir
Atazanavir
2. Alteplase (rtPA) Warfarin
rapid
major 66
Heparin
3. Carbamazepine Clarithromycin
rapid
major
Erythromycin
Carbamazepine 6

4. Clozapine
Ritonavir
delayed major 66 Clozapine
Toxicity 66
5. Ergotamine
Protease inhibitors
delayed major ergotamine toxicity
peripheral vasospasm,
- Indinavir
ischemia 66
- Lopinavir/ritonavir
6. Nitrates
Sildenafil
rapid
major 6
(Isosorbide

dinitrate,
isosorbide
mononitrate,
nitroglycerin)
7. Propranolol
Thioridazine
delayed major cardiac
arrhythmia
8. Thioridazine
Fluoxetine
delayed major 6 prolong QT interval

Torsade de pointes
ECG 6

 2 Fatal drug interaction: 66666 66

6D6
1
2
onset severity
Effect & Management
1. Amiodarone
Fentanyl
rapid
major bradycardia , sinus arrest ,
hypotension 6

2. Aspirin
Methotrexate
rapid
major Methotrexate 6

6
3. Atracurium
Amikacin
rapid
major 6P
Cisatracurium
Gentamicin
nondepolarized
Pancuronium
Streptomycin
muscle relaxants
Vercuronium
Kanamycin
6D
Halothane
rapid
major neuromuscular blockade
Isofurane
66 2
4. Digoxin
Amiodarone
delayed major serum digoxin P
Clarithromycin

Erythromycin
serum digoxin
Verapamil

5. Dopamine
Phenytoin
rapid
major BP (cardiac arrest)
()
6. Gentamicin
Furosemide
rapid
major Ototoxicity 6
Kanamycin

Streptomycin
7. Warfarin
Amiodarone
delayed Major anticoagulant
Aspirin
bleeding 6
Clopidogrel
PT, INR 2-4
Metronidazole

Propylthiouracil
Methimazole
Levothyroxine
Erythromycin
Clarithromycin

2
Cotrimoxazole
Sulfasalazine
Fluconazole
Itraconazole
Ketoconazole
Fenofibrate
Gemfibrozil
Phenobarbital
AMA
(amobarbital)

onset

severity

Effect & Management

delayed

major

Warfarin 66
Warfarin 6
Benzodiazepine