CYP Interactions Exam 4 (Seizure, schizophrenia, depression, bipolar) Flashcards Preview

Pharmacotherapy III > CYP Interactions Exam 4 (Seizure, schizophrenia, depression, bipolar) > Flashcards

Flashcards in CYP Interactions Exam 4 (Seizure, schizophrenia, depression, bipolar) Deck (20)
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1
Q

What anticonvulsants decrease the efficacy of estrogen-containing oral contraceptives through inducing CYP 3A4?

A

Lamotrigine, carbamazepine, clobazam, oxcarbazepine, phenobarbital, phenytoin, primidone, topiramate
Less pronounced: eslicarbazepine, felbamate, rufinamide

2
Q

What anticonvulsants are are a bad choice for smokers due to the induction of CYP 1A2 by tobacco?

A

Carbamazepine, phenobarbital, phenytoin, primidone

3
Q

What anticonvulsants interact with warfarin by inducing CYP 2C9?

A

Carbamazepine, phenobarbital, phenytoin, primidone

4
Q

What anticonvulsants interact with clopidogrel by INDUCING CYP 2C19?

A

Carbamazepine, phenobarbital, phenytoin, primidone

5
Q

What anticonvulsants interact with clopidogrel by INHIBITING CYP 2C19?

A

Eslicarbazepine, lacosamide, oxcarbazepine, topiramate

6
Q

What anticonvulsant interacts with SSRIs and SNRIs by inhibiting CYP 2D6?

A

Clobazam

7
Q

What anticonvulsant interacts with lamotrigine through inhibiting UGT?

A

Valproate

8
Q

What anticonvulsants interact with lamotrigine by inducing UGT?

A

Carbamazepine, eslicarbazepine, phenobarbital, phenytoin, primidone

9
Q

What antipsychotics are CYP 1A2 substrates and therefore are not ideal in patients who smoke?

A

Asenapine, clozapine, olanzapine

10
Q

What antipsychotics are CYP 3A4 substrates and may require dose adjustments when given with 3A4 inhibitors/inducers?

A

Aripiprazole, brexpiprazole, cariprazine, iloperidone, lurasidone, quetiapine

11
Q

What antipsychotics are CYP 2D6 substrates and therefore may require dose adjustments when given with CYP inhibitors/induces?

A

Aripiprazole, brexpiprazole, iloperidone, risperidone (produces paliperidone)

12
Q

What antipsychotic has no significant CYP metabolism but must be given with food to improve bioavailability?

A

Ziprasidone, paliperidone (already metabolized form)

13
Q

What antidepressants are substrates of CYP 3A4?

A

Escitalopram, vilazodone, levomilnacipran, venlafaxine, trazodone

14
Q

What antidepressant has a metabolite that strongly inhibits CYP 3A4?

A

Fluoxetine–norfluoxetine inhibits

15
Q

What antidepressants interact with clopidogrel through being a substrate of CYP 2C19?

A

Citalopram, escitalopram, fluoxetine, sertraline, imipramine

16
Q

What antidepressants inhibit CYP 1A2 and therefore interact with duloxetine, a substrate of CYP1A2?

A

Fluoxetine, fluvoxamine, tranylcypromine

17
Q

What antidepressants inhibit CYP 2D6, an enzyme important for degrading many SSRIs, duloxetine, venlafaxine, and trazodone?

A

Paroxetine, trazodone, tranylcypromine

18
Q

What antidepressants have no significant CYP interactions?

A

Desvenlafaxine, milnacipran, isocarboxazid, phenelzine,

19
Q

What drugs increase the risk of toxicity from lithium?

A

Thiazide diuretics, ACE/ARBs, NSAIDs

20
Q

What drugs decrease the levels of lithium?

A

Caffeine, osmotic diuretics, sodium bicarbonate, and high sodium intake