It can be helpful for physicians to keep files on prescribing information for new agents, maintain frequent contact with local pharmacists and have drug interaction resources readily available in the office. deVries JD. If combination therapy is necessary, recommend use of alternative contraceptive method during cycle.Have the patient take an oral contraceptive pill with a higher estrogen content or recommend alternative method of contraception.Prolongation of QT interval along with arrhythmias secondary to inhibited cisapride metabolismAvoid. Neborsky RJ. Documentation: Interaction is possible 4: No action needed: 5: Severity: Minor Documention: possible OR Severity: Major, Moderate or Minor Documentation: interaction is unlikely 5: No interaction: A. Tatro DS (ed). We comply with the HONcode standard for trustworthy health information - As a result, serum lithium levels increase secondary to enhanced reabsorption.If coadministration is necessary, the dosage of lithium should be reduced by 50 percent when a diuretic or an NSAID is added.
Gardner DM, Nearly 30 million prescriptions are written annually for the vitamin K antagonist that has been the mainstay anticoagulant treatment for patients with atrial … The cyclooxygenase-2 inhibitors: safety and effectiveness.
Dr. Bertolino completed a residency in family medicine at Latrobe Area Hospital and a fellowship in academic family medicine at the University of Missouri–Columbia School of Medicine.JAMES L. LISZEWSKI, M.D., is an instructor in family medicine at Latrobe Area Hospital.
Thus, patients should be encouraged to consider using an alternative method of contraception for the duration of the cycle.Troglitazone (Rezulin) has been reported to reduce the plasma concentrations of oral contraceptives by 30 percent through an unknown mechanism.Potentially fatal interactions can occur with coadministration of cisapride (Propulsid) and other drugs. Consider whether metoclopromide (Reglan) therapy is appropriate for the patient.Avoid. Skates SJ, Griffin MR.
Daugherty JR, Serum antiepileptic drug levels should be monitored in patients who receive any of these combinations.Lithium therapy is useful for indications ranging from bipolar disorder to migraine headaches, but several interactions must be considered. If combination therapy is necessary, monitor the patient for signs and symptoms of serotonin syndrome.Use lowest possible acetaminophen dosage and monitor INR.Limit aspirin dosage to 100 mg per dayand monitor INR.Avoid concomitant use if possible; if coadministration is necessary, use a cyclooxygenase-2 inhibitor and monitor INR.Clinical significance has not been established. Object drugs in common use include warfarin, fluoroquinolones, antiepileptic drugs, oral contraceptives, cisapride and 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors. Boyer WF, Dr. Ament earned his doctor of pharmacy degree at Duquesne University School of Pharmacy, Pittsburgh, and completed a residency in hospital pharmacy at Mercy Hospital of Pittsburgh.JOHN G. BERTOLINO, M.D., M.S.P.H., is director of the family medicine residency program at Latrobe Area Hospital. Most pharmacies have drug-interaction software programs with their dispensing package. Consider whether metoclopromide (Reglan) therapy is appropriate for the patient.Avoid.
Tyler DL, Drugs with a narrow therapeutic range or low therapeutic index are more likely to be the objects for serious drug interactions. Effect of erythromycin in patients receiving long-term warfarin therapy.
Bredle DL, Several agents can substantially reduce the absorption of fluoroquinolones, thereby causing treatment failure.Divalent cations (calcium and magnesium) and trivalent cations (aluminum and ferrous sulfate) can form insoluble complexes in the gut if they are taken concurrently with fluoroquinolones.Almora, Citrate of Magnesia, Mag-Ox 400, Milk of Magnesia, Slow-Mag, Uro-MagAlmora, Citrate of Magnesia, Mag-Ox 400, Milk of Magnesia, Slow-Mag, Uro-MagStudies have shown that the absorption of fluoroqinolones is reduced by 60 to 75 percent when these antibiotics are administered concomitantly with divalent or trivalent cations.Carbamazepine (Tegretol), phenobarbital and phenytoin (Dilantin) are commonly prescribed for the management of epilepsy and other disorders.
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