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Chapter 25. Drug Interactions. Drug Interactions. A drug interaction can be defined as the action of an administered drug on either the effectiveness or the toxicity of another drug that is administered early, simultaneously, or later.

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Chapter 25

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Chapter 25

Drug Interactions


Drug Interactions

  • A drug interaction can be defined as the action of an administered drug on either the effectiveness or the toxicity of another drug that is administered early, simultaneously, or later.

  • Not every potential drug interaction occurs in all patients.

  • Not every drug interaction is clinically significant.

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Drug Interactions

  • Many dental drug patients take more than one drug which can increase the risk for a drug interaction.

  • Drug interactions may already be accounted for, and drug doses and timing are adjusted accordingly.

  • Over-the-counter drugs can interact with all other drugs.

  • A complete medical and drug history can help to minimize the problems associated with drug interactions.

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Drug Interactions

  • Most drug interactions involve an alteration in the pharmacokinetics of the drug.

  • Drug Absorption

    • Drug interactions can either delay the onset of drug action or increase or decrease the amount of drug absorbed.

    • Rate of drug absorption is a concern when a fast onset of absorption is necessary.

    • An example of this would be analgesics. A rapid response is often desired when the patient is in pain.

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Drug Interactions

  • Absorption

    • Extent of drug absorption is of concern when a drug is administered over a long period of time.

    • This is important because it can ultimately affect drug levels.

  • Distribution

    • Drugs that are highly protein bound can be displaced from their binding sites.

    • This small amount of extra drug in the bloodstream can lead to toxicity.

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Drug Interactions

  • Metabolism

    • Many different drugs can stimulate or inhibit the metabolism of other drugs.

    • This can cause an increase or decrease of drug plasma levels and can lead to toxicity or reduced therapeutic effect.

  • Excretion

    • Drug interactions that involve excretion can affect the amount of drug that is either secreted or reabsorbed.

    • This can lead to an increased effect (toxicity) or decreased therapeutic effect.

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Drug Interactions

  • Pharmacodynamic drug interactions usually occur at drug receptor sites.

  • They can have an antagonistic effect where no drug effect is seen.

  • They can have a synergistic effect where two or more drugs can come together and enhance a therapeutic or side effect.

  • They can have an additive effect where both drugs come together and produce an expected therapeutic or side effect.

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