The link you used to metoclopramide receptor site here is faulty. It’s an excellent idea to let the link owner know.

Sie können Ihre Anzeigeneinstellungen jederzeit ändern. US community pharmacy study revealed 4. Pharmacodynamics are related to the pharmacological activity of the interacting drugs E. H2 antagonists Therefore, these drugs must be separated by at least 2h in the time of administration of both . Antibiotics kill a large number of the normal flora of the intestine Increase digoxin conc. Inhibit absorption of several drugs eg. Displaced protein binding It depends on the affinity of the drug to plasma protein.

The most likely bound drugs is capable to displace others. The free drug is increased by displacement by another drug with higher affinity. Altered metabolism The effect of one drug on the metabolism of theother is well documented. The liver is the major site of drugmetabolism but other organs can also do e.

Enzyme induction A drug may induce the enzyme that is responsiblefor the metabolism of another drug or even itself e. It is the decrease of the rate of metabolism of a drug by another one . This will lead to the increase of the concentration of the target drug and leading to the increase of its toxicity . Erythromycin inhibit metabolism of astemazole and terfenadine Increase the serum conc. Onset of drug interaction It may be seconds up to weeks for example in case of enzyme induction, it needs weeks for protein synthesis, while enzyme inhibition occurs rapidly.

The onset of action of a drug may be affected by the halflives of the drugse. First-pass metabolism: Oral administration increases the chance for liver and GIT metabolism of drugs leading to the loss of a part of the drug dose decreasing its action. This is more clear when such drug is an enzyme inducer or inhibitor. It occurs in the proximal tubules.

The drug combines with a specific protein to pass through the proximal tubules. When a drug has a competitive reactivity to the protein that isresponsible for active transport of another drug . Excretion and reabsorption of drugs occur in the tubules By passive diffusion which is regulated by concentration and lipid solubility. Ionized drugs are reabsorbed lower than non-ionized ones Ex1. Pharmacodynemic interaction It means alteration of the dug action without change in its serum concentration by pharmacokinetic factors. Dose related events may be managed by changing the dose of the affected medicine.

The potential severity of some interaction require immediate Cessation of the combination. The proposal of the study was approved by the ethical committee of the shaheed beheshti medical university. At first questionnaries was designed for collecting data. A total number of 116 patients of ICU ward were visited during the study and one questionnaire was filled for each visit. Data for total number of 567 prescriptions were recorded. All of the potential pharmacokinetic drug interactions were extracted and classified in terms of mechanism, significance, onset, severity .

Onset shows how rapidly the clinical effects of interaction can occur. From 567 prescriptions, 413 pharmacokinetic interactions were identified. Interaction between Number in 413 Percentage in 413 cases of cases of interactions interactions1 Ciprofloxacin- Sucralfate 137 33. Whenever a patient receives multiple drug therapy, the possibility of a pharmacokinetic interaction exists. Study showed the higher the number of drugs in prescriptions, the higher the number of interactions. Therefore, polypharmacy should be avoided as much as possible .

Text book of Clinical pharmacy by Parth sarthi. Iranian journal of p’ceutical research . 215-218,2006 by school of pharmacy shahid baneshti university of medical science and health services. Sie haben Ihre erste Folie geclippt!