-
Major CYP 450 Inducers
- PS PORCS
- PhenytoinSmokingPhenobarbitalOxcarbazepineRifampinCarbamazepineSt. John's Wort
-
Major CYP 450 Inhibitors
- G PACMAN
- Grapefruit
- PIs
- Azole Antifungals
- Cimetidine
- Macrolides
- Amiodarone
- Non-DHP CCBs
-
Must decrease dose 30-50% when starting amiodarone
- Digoxin
- Warfarin
- Quinidine
- Procainamide
-
Antifungals with pH dependent absorption: High pH causes decreased absorption
-
Digoxin is mostly _____ cleared and partially _____ cleared.
-
Hypokalemia (K+< 3.5 mEq/mL) will ________ digoxin levels.
Increase
-
Increased risk of severe rash. Use caution and titrate slowly.
-
Increases Lithium levels
- Decreased salt intake
- NSAIDs
- ACEI/ARBs
- Dehydration (caution with diuretics)
-
Decreases Lithium levels
- Salt intake
- Caffeine
- Theophylline
-
Decreases levels of OCs
- Antibiotics
- Anticonvulsants
- St. John's Wort
- Anti-retrovirals
- Smoking
-
Chelate with Al, Mg, Ca, Fe, and Zn
-
Anticoagulant that is neither a substrate, inhibitor, or inducer of CYP 450 enzymes
Dabigatran
-
QT prolonging agents
- Class Ia and III antiarrhythmics
- Quinolones
- Macrolides
- Azoles
- Anticancer agents
- Protease inhibitors
- Antidepressants (TCAs, SSRIs, SNRIs, trazodone)
- 5-HT3 blockers
- Antipsychotics
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