Drug prescription and drug interaction MSD

 A drug-drug interaction may increase or decreases the effect of one or both

drugs.
Clinically significant interactions are often predictable and usually undesired.
‫كارلێككردن‬ ‫چاوەڕوانكراو‬

 May make drug less effective.

 May cause unexpected side effect.
 Increases the action of a particular drug.
 Some drug interaction can even be harmful.

(Asprin)

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Some extra note (not in the lecture just for explanation):-

Drug interaction: is alteration of pharmacological activity of one drug by

concomitant use of another drug or by presence of other substances.

Drug Interactions may be:

A- So serious that it is contradicted

Example: Ibuprofen + cidofovir

Cidofovir (antiviral agent) is nephrotoxic drug, concurrent use with ibuprofen (an
NSAID which is also nephrotoxic), by synergistic effects, causes serious
nephrotoxicity.

B- May be serious but without contraindications

Example: NSAID + warfarin

Concurrent use of anticoagulant with NSAIDS may increase the risk for bleeding.
In this case patient should be closely monitored for signs of bleeding.

Mechanism of interaction: Some NSAIDS my displace anticoagulants from plasma

protein binding sites.

Example: Celecoxib + Methotrexate

Mechanism of interaction: Celecoxib will inhibit methotrexate clearance, and so

increase the renal and hepatic toxicity of methotrexate.
C- Some drug interactions have moderate interaction, so there is no need for
using an alternative drug, just monitoring of patients is needed.

Example: Orphenadrine + tramadol

There’s moderate interaction which may cause additive CNS depressive effects, so
they should be use with caution