Knollmann PowerPoint PPT Presentations

A brief discussion on the need for better methods for representing and communicating drug-drug interaction knowledge. An excerpt from a talk given by Richard Boyce in 2009 at the AHRQ-sponsored conference "Generating, Evaluating, and Implementing Evidence for Drug-Drug Interactions in Health Information Technology to Improve Patient Safety: A Multi-Stakeholder Conference"

Alpha-glucosidase inhibitors interact with drugs such as Digoxin, Warfarin, Sulfonylureas, Neomycin, Guar gum, Pancreatin, Amylase, Activated charcoal, Antimuscarinics, Paracetamol and Nifedipine.

Metformin interacts with Cationic drugs, Carbonic anhydrase inhibitors, Injection of iodinated contrast materials, phenprocoumon, dofetilide, rifampin, colesevelam, enalapril, trandolapril, guar gum and glycopyrrolate.

DPP 4 Inhibitors interact with CYP3A4 inducers, CYP3A4 inhibitors and P-Glycoproteins inhibitors.

Mechanisms of all the reactions of OTC Analgesics are dealt in easy way.

The substrates, inducers and inhibitors of P glycoproteins are dealt in this presentation.

¢ Drug interactions of Meglitinides (Repaglinide & Nateglinide) are dealt in this presentation. ¢ Repaglinide is metabolized by the CYP3A4 and CYP2C8 and hence it interacts with Gemfibrozil, Azole antifungals, Dabrafenib, Montelukast, Macrolide antibiotics and Rifampicin. ¢ Nateglinide is metabolized by CYP2C9 (70%) and CYP3A4 (30%) and it interacts with Amiodarone and Macrolide antibiotics. It also interacts with NSAIDs, MAOIs, Trandolapril, Non selective beta blockers Thiazide diuretics, Corticosteroids, Danazol, Sympathomimetics, Phenytoin and St.John’s wort.

Pharmacodynamic drug interactions such as receptor mediated and non receptor mediated interactions are dealt in this presentation.

Pharmacokinetic drug interactions are dealt in this presentation.

Thiazolidinediones interact with Abiraterone, Pixantrone, Azole Antifungals, Fibrates, Teriflunomide, Dabrafenib and Rifampin. Pioglitazone also interacts with Calcium channel blockers (Nifedipine, Amlodipine), Cobicistat, Piperaquine, Ifosfamide, Tolvaptan, Midazolam, Tipranavir/Ritonavir, Macrolide antibiotics, Sulphonamides, Amiodarone, Topiramate, Oral contraceptives, Atorvastatin, Danazol and Trandolapril.

This presentation is dealt with the general introduction of Drug interactions such as factors affecting DIs, Cosequences, Types and Mechanisms of DIs.

Sulfonylureas may interact with Azole antifungals (Fluconazole), Fibrates (Gemfibrozil), Sulphonamides (Trimethoprim), Macrolide antibiotics (Erythromycin), Rifampin, Bosentan, Antacids, Alpha glucosidase inhibitors, Bile-acid binding resins (Colestyramine, colestipol, and colesevelam), ACE inhibitors, Allopurinol and Alcohol.

Drug interactions of Incretin mimetics (Exenatide) with other drugs like Warfarin, Digoxin, Paracetamol, Antibacterials, Thyroid hormones, Danazol and ACE inhibitors are dealt in this presentation. The interactions of Amylin analogue (Pramlintide) with other drugs such as Alpha glucosidase inhibitors, Danazol, ACE inhibitors, Thyroid hormones, Paracetamol and Antimuscarinics are also dealt in this presentation.

Diabetic patients take Insulin and/or other oral hypoglycemic and antihyperglycemic drugs to control their blood sugar levels. Along with antidiabetic medicines they may take drugs such as OTC medicines, prescription medicines, etc.to treat other illnesses which may interact with them. Drug interactions of Insulin with other drugs like Fluoroquinolones, Betablockers, Aspirin, Thiazolidinediones, Antipsychotics, Androgens, Antimalarials and Orlistat are dealt in this presentation. The interactions of Insulin with Complementary and alternative medicines (CAM) such as Bitter melon, Ginkgo, Ginseng, Gymnema, Licorice and Fenugreek with smoking and with alcohol are also dealt in this presentation.

Cytochrome P450 enzyme inducers and inhibitors are dealt in this presentation.

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Department of Pharmacology Overview

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Mr. Mike Knollmann Director Defense Research and Engineering DDR