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    Pharmacokinetic drug interactions can occur when multiple drugs are administered and affect absorption, distribution, metabolism, or excretion of the drugs. Absorption can be affected by interactions with antacids, cholestyramine, metoclopramide, and liquid paraffin. Distribution is affected when one drug displaces another from plasma protein binding sites. Metabolism is primarily affected by the CYP450 enzyme system through induction or inhibition of these enzymes. Renal excretion can be affected when one drug decreases or increases the excretion of another drug by the kidneys.

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    Miscellaneous

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    Pharmacokinetic drug interactions can occur when multiple drugs are administered and affect absorption, distribution, metabolism, or excretion of the drugs. Absorption can be affected by interactions with antacids, cholestyramine, metoclopramide, and liquid paraffin. Distribution is affected when one drug displaces another from plasma protein binding sites. Metabolism is primarily affected by the CYP450 enzyme system through induction or inhibition of these enzymes. Renal excretion can be affected when one drug decreases or increases the excretion of another drug by the kidneys.

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    Pharmacokinetic drug interactions can occur when multiple drugs are administered and affect absorption, distribution, metabolism, or excretion of the drugs. Absorption can be affected by interactions with antacids, cholestyramine, metoclopramide, and liquid paraffin. Distribution is affected when one drug displaces another from plasma protein binding sites. Metabolism is primarily affected by the CYP450 enzyme system through induction or inhibition of these enzymes. Renal excretion can be affected when one drug decreases or increases the excretion of another drug by the kidneys.

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    Miscellaneous

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    saqlain18148
    Pharmacokinetic drug interactions can occur when multiple drugs are administered and affect absorption, distribution, metabolism, or excretion of the drugs. Absorption can be affected by interactions with antacids, cholestyramine, metoclopramide, and liquid paraffin. Distribution is affected when one drug displaces another from plasma protein binding sites. Metabolism is primarily affected by the CYP450 enzyme system through induction or inhibition of these enzymes. Renal excretion can be affected when one drug decreases or increases the excretion of another drug by the kidneys.

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    of 3

    Q.

    At times, a patient may require administration of multiple drugs for any


    disease due to which drug interactions may occur. What are different types of
    Pharmacokinetic drug-drug interactions? Give examples.

    AFFECTING ABSORPTION

    1. Antacids containing Ca or Al – tetracyclines.


    2. Cholestyramine – digitalis & thyroxine.
    3. Metoclopramide – cimetidine.
    4. Liquid paraffin – Vit D.
    5. Rate of absorption of paracetamol is reduced by anticholinergics & increased by
    metoclopramide.

    AFFECTING DISTRIBUTION

    Drug displaces the other from plasma protein binding site.

    1. Indomethacin, tolbutamide, sulfonamides displace warfarin.


    2. Sulfonamides, salicylates displace tolbutamide.
    3. Sulfonamide displace bilirubin.

    AFFECTING METABOLISM

    I. CYP450 family is the major metabolizing enzyme in phase I (oxidation process).

    • Enzyme induction.

    • Enzyme inhibition.

    II. Xanthine oxidase inhibitor.

    AFFECTING RENAL EXCRETION

    1. Probenecid decreases tubular secretion of Penicillins, Dapsone


    2. Aspirin increases toxicity of Methotrexate.
    3. Sodium bicarbonate increases excretion of Aspirin & Barbiturates.
    4. Ammonium chloride increases excretion of Amphetamine.

    Q. A 28-year-old man working in a semi-conductor factory presented in OPD with


    complaints of fatigue, nausea, conjunctivitis, skin irritation, and hair loss. On
    examination, she has “milk and roses” complexion. What is your diagnosis and
    how will you treat the patient?

    Chronic Arsenic Poisoning. Chelator: Dimercaprol


    Q. Define the following terms and give one example for each:

    1. Antiseptic

    Antimicrobial agents applied to living tissues to reduce possibility of infection.

    E.g.; Alcohols (Ethanol and isopropyl alcohol), Povidone-iodine or Iodine tincture,


    Chlorhexidine, Merbromin, Silver nitrate, Silver sulfadiazine, Potassium permanganate,
    Hydrogen peroxide, Cetrimide, Benzalkonium chloride, Cetylpyridinium chloride, Dyes
    (Gentian violet, brilliant green, Acriflavine), Boric acid, Acetic acid.

    2. Astringents

    Agents that precipitate surface proteins but don’t penetrate the cells; affecting
    superficial layers only.

    They toughen surface making it mechanically stronger and decrease exudation. E.g.;
    Tannic acid and tannins, Ethanol, methanol, Mineral astringents (Al and Zn salts).

    3. Demulcents

    Agents that form soothing film over a mucous membrane, relieving minor pain and
    inflammation of membrane. OR Mucoprotective agents. E.g.; Gum acacia, Gum
    tragacanth, Glycyrrhiza, Methyl cellulose, Glycerin, Propylene glycol.

    Q. Enlist the following:

    1. Demelanizing agents

    Hydroquinone, Mequinol, Monobenzone, Azelaic acid, Glycolic acid, Kojic acid, Lactic acid,
    Tretinoin.

    2. Trichogenic agents

    Minoxidil, Bimatoprost, Finasteride.

    3. Keratolytic agents

    Salicylic acid, Urea, Propylene glycol, Podophyllum resin, Fluorouracil, Ingenol mebutate.

    4. Anti-seborrheic agents

    Selenium sulfide, Zinc pyrithione, Corticosteroids, Ketoconazole, Coal tar, Sulphur,


    Resorcinol, Salicylic acid
    Q. Enlist Ectoparasiticides.

    1. Permethrin
    2. Lindane (hexachlorocyclohexane)
    3. Malathion
    4. Ivermectin
    5. Crotamiton
    6. Sulfur
    7. Benzyl alcohol
    8. Spinosad

    Q. Name the antidotes for overdosage of the following drugs:

    DRUGS ANTIDOTES

    Acetaminophen N-acetylcysteine

    β-blockers Glucagon

    Benzodiazepines Flumazenil

    Heparin Protamine sulfate

    Iron salts Deferoxamine, Deferasirox

    Opioids Naloxone, Naltrexone

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