Pharmacology 2060A/B Lecture Notes - Sulbactam, Ampicillin, Warfarin

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Drug interactions interact with each other drugs or food from diet. 2+ drugs, linear increase with number of drugs increase effect, decrease effect, whole new effect. Elderly over 65 age take 7 meds on average. Most common drug interaction are those affecting pharmacokinetics. Increase effect increased therapeutic effect: ampicillin poor therapeutic response, antibiotic inactivated by bacterial enzymes, sulbactam inhibitor of bacterial enzyme that inactivates ampicillin, ampicillin + sulbactam increased therapeutic activity of ampicillin. Increased adverse effect: warfarin anticoagulant used to thin blood, aspirin analgesic also thins blood, warfarin alone effective blood thinner, warfarin + aspirin excessive bleeding (potentially life threatening) Disulfiram treat chronic alcoholism: alcohol acetaldehyde acetic acid (dehydrogenase both times, disulfiram blocks acetaldehyde dehydrogenase. Severe hangover symptoms within minutes, nausea, vomiting, Direct physical interactions: direct chemical/physical between 2+ drugs/iv solutions (precipitate, benzodiazepine drug (diazepam) treat anxiety, easily soluble. Dangerous to mix: sodium bicarbonate followed by calcium gluconate precipiate form in blood.

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