Drug Interaction

What are drug interactions:

A drug interaction occurs when a patient responds to a drug that is modified by food, nutritional supplements, formulation experience, environmental factors, and other drugs or diseases. Interactions between drugs, drug-drug interaction may be beneficial or harmful. Harmful drug-drug interactions are important because they may cause 10-20% of the adverse drug interactions requiring hospitalization and they can be avoided. The interaction is largely unpredictable because various factors like age, lifestyle, diet, and underlying disease of an individual can affect the likeliness that the drug will interact. Now the question that arises is who is at the risk?

The answer is:

• People who are taking multiple medications for extended periods of time.
• Patients with renal or hepatic impairments because of their metabolism and excretion will be Impaired.

Definition and basic of Drug Interaction.

A drug interaction is an interaction between a drug and some other substance such as another drug or a certain type of food that prevents the drug from working correctly. In order to understand Food-drug and drug nutrition interaction, it is important to understand how drugs work in the body. There are four stages of drug actions for medicines administered orally.

1. Stage 1: The drug dissolves into a usable form in the stomach.
2. Stage 2: The drug is absorbed into the blood and is transported to its site of action.
3. Stage 3: The body responds to the drug and the drug performs its function.
4. Stage 4: The drug is excreted from the body either by the kidney, liver, or both.

An interaction can either increase or decrease the effectiveness and/or the side effects of a drug or it can create a new side effect not previously seen before. The consequences of drug interactions can be:

• Reduce the desired effect of the drug.
• Increase the adverse effects of a drug.
• Result in unnecessary pain and suffering.

However, on the other hand, Drug interaction may increase the beneficial effects of a drug and can decrease the adverse effects of a drug.

Functioning of Drug Interaction:

The drug interaction may occur in the following conditions:

1. Increase or decrease in the absorption of the drug into the body. Distribution of the drug in the body. Changes made to the drug through the metabolism if the body elimination of the drug from the body.
2. When two drugs have either additive or canceling effects on the body are taken at the same time. When one drug alters the concentration of the substance that normally occurs with the body. Thus reducing or enhancing the effects of another. The overall drug-drug interactions may be classified in the following categories:
   • Behavioral drug-drug interaction: These occur when one drug alters the patient's behavior to modify compliance with another drug.
   • Pharmaceutic drug-drug interactions: These interactions occur when the formulation of one drug is altered by another before its administration.
   • Pharmacokinetic interactions: It means what the body does to the drug pharmacokinetics is the quantitative study of the drug movement in through a d out of the body. These interactions occur when one drug perpetrator enters the concentrations of another drug the objective with clinical consequences.
   • Interactions during absorption: The rate and extent of drug absorption after oral administration may be grossly altered by another agent. Absorption of a drug is the function of a drug's ability to diffuse from the lumen of the gastrointestinal tract into the systemic circulation changes in intestinal Ph may profoundly affect drug diffusion as well as dissolution of doses of various forms.
   • Chelation: The process of forming complexes by this process is another mechanism by which a drug interaction may lead to the reduced oral toxin. Calcium and iron form an insoluble complex that results in the reduced absorption of both the antibiotic and the -metal interaction the decrease in the rate of absorption may be of little importance.
   • Direct Chemical interactions: Iron and tetracycline formed complex antacids like aluminum or magnesium chelate with tetracycline which decreases the bioavailability of tetracycline college tyramine interfere with absorption of digoxin barf errand and therapy.

Influence of Alcohol on drug interactions:

Chronic use of alcoholic beverages may increase the rate of metabolism of drugs such as warfarin and phenytoin, probably by increasing the activity of hepatic enzymes.

• Acute use of alcohol by nonalcoholic individuals may cause inhibition of hepatic enzymes.
• The use of alcoholic beverages with sedatives and other depressants drugs could result in an excessive depressant response.

Influence of Food on drug interactions:

• Food affects the rate and extent of absorption of drugs from the GI tract.

  For example, Many antibiotics should be given at least 1hr before or 2hr after meals to achieve optimal absorption.

• The type of food may be important with regard to absorption of concurrently administered drugs.

  For example, Dietary items such as milk and other dairy products that contain calcium may decrease.

• Diet also may influence urinary pH values.

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