Prezentace aplikace PowerPoint

1
Clinical importance of interactions
2
Combinations

• Possitive interaction summation
• 112
• potentiation
• 113
• Negative interaction effect reduction

3
Factors increasing the risk of drug interactions

• Polypharmacy
• Polymorbidity
• Prolonged treatment
• Chronic disease
• Combination of drugs with similar effect
• Low therapeutic index
• Simultaneous ordination of more drugs by
  different physicians
• Inappropriate habits
• Self treatment

4
Drugs with high risk

• Peroral antidiabetics
• Peroral anticoagulants
• Heart glykosides
• Antiepileptics
• Antimanics
• NSAIDs
• Antibiotics

5
Division

• According to the level at which they arise
• Pharmaceutic physical and chemical
  incompatibilities
• Pharmacocinetic absorption
  distribution
  biotransformation
  excretion
• Pharmacodynamic

6
Absorption

• pH in GIT antacids
• GIT motility procinetics
• antidiarrheals
• 
  

7
Distribution

• Lack of plasmatic proteins hepatopathy
• Binding to plasmatic proteins
• Benzodiazepin site
• Warfarin site

8
Biotransformation

• Ensyme system CYP 450
• Inductors
• E.g. barbiturates, hydantoinic antiepileptics ...
• Also smoke from cigarettes
• Inhibitors
• E.g. azolic antimycotics, diltiazem ...
• Also grapefruit juice

9
Pharmacodynamic interactions

• Most frequently potentiation of depressing effect
  on CNS (benzodiazepines and alcohol)
• Also potentiation of effect on bradycardia
  (verapamil a betablockers)
• Risk of simultaneous administration of warfarin
  and aspirin