Pharmacokinetics of drug

interactions

Contents :

• Definition
• epidemiology
• Risk factors
• Outcomes of drug interaction
• Mechanism of drug interaction
 Drug interaction
• Drug interaction is an interaction between a
drug and some other substance,such as
another drug or certain type of food , which
leads to interaction that could manifest as an
increase or decrease in the effectiveness or an
adverse reaction or a totally new side effect
that is not seen with other drug alone that can
be severe enough to alter the clinical
outcome.
Every time a drug is administered with any other prescription medicine OTCproducts , herbs, or
even food we expose ourselves to the risk of a potentially dangerous interaction.
• Understanding these potentials reactions and their mechanism help us to investigate the
hazardous effects of combining drugs with other medicines, food, herbs and vitamins with
confidence.

Object drug:
The drug whose activity is effected by such an interaction is called as a object drug .
percipitant:
The agent which percipitates such an interaction is referred to as the percipitant.
Drug interactions are thus :
• Mostly undesirable
• Rarely desirable: eg enhancement of activity of penicillins when administered with
probenecid.
 Epidemiology
Clinical problems owing to drug interactions
were first diagnosed in the early 1960s.
Although the pharmacological concepts of
antagonism, synergism and potentiation at the
receptor site were known to prescribers,it came
as surprise that drugs could also interact by
changing each others absorption , metabolism
and renal elimination. First metabolic drug
interaction was reported drug-food interaction.
During the 1960s, hypertensive crises, in some cases fatal, were reported in several patients
treated for depression with MAO inhibitors , after they had eaten certain cheeses. It was
Shown that these cheeses had a very high content of tyramine ,an amine with pressor effects
and their intestinal metabolism was inhibited by MAO inhibitors
RISK FACTORS:

• Factors contributing to drug interactions are :

• Multiple drug therapy

• Multiple pharmacological effects of drug
• Multiple disease illness

• Multiple prescribers
• Poor patient compliance
• Advancing age patient
• Drug related factors
• Narrow therapeutic drugs
 OUTCOMES OF DRUG INTERACTION

• Toxicity
• Therapeutic failure
• Beneficial effects (eg: additive and potentiation or antagonism )

• Chemical or physical interaction

MECHANISM OF DRUG INTERACTION

Three mechanism by which an interaction can develop are:

1. Pharmaceutical interactions
2.Pharmacokinetic interactions

3.Pharmacodynamic interaction
 PHARMACEUTICAL INTERACTIONS

Pharmaceutical interaction drug-drug interaction is a physiochemical interaction that occurs

when drugs are mixed in i.v. infusions causing precipitation or inactivation of active principles
before it is administered. For example , precipitation of sodium thiopentene and vecuronium
within an intravenous giving set .example;ampicillin, chlorpromazine, and babiturates interact
with dextran solution and are brokrn down or form chemical compounds.

PHARMACOKINETICS DRUG –DRUG INTERACTION

Pharmacokinetic drug –drug interaction occur when one drug changes the systemic
concentration of another drug , altering how much and for how long it is present at the
site of action.
PHARMACO DYNAMIC INTERACTIONS
Pharmacodynamic drug-drug interactions occur when interacting drugs have either
additive effects, in which case the overall effect is increased, or opposing effects ,
in which case overall effect is decreased or even cancelled out .