安徽医科大学：《临床药理学 Clinical Pharmacology》课程教学资源（授课教案，英文版）Chapter 15 Drug Interactions

安徽医科大学国际教育学院教案与讲稿 Teaching Plan for International Students,AHMU Title of the course: Drug Interactions Chapter:15 Teacher's name: Qiong Huang Grade:2013 Department:Clinical Medicine,School of International Education Time:14:30-16:50 Date (D/M/Y): 3/16/2016 1.Recognize the concept of drug interactions. Teaching 2.Recognize the types of drug interactions. Objectives; 3.Recognize the context of pharmacokinetics and pharmacodynamics drug Teaching interactions. Requirements 4.Master the drug interaction and the results. 1.Introduction to the definition of drug interactions. 2.The types of drug interactions. Teaching 3.The influencing factor of pharmacokinetics drug interactions. Content 4.The influencing factor of pharmacodynamics drug interactions. 5.Questions and discussion. Teaching Focus:The context of pharmacokinetics and pharmacodynamics Teaching drug interactions. Focus; Difficult Problems:The influencing factor of pharmacokinetics and Difficult pharmacodynamics drug interactions. Problems Solutions:Give examples of drug-drug interactions (including influencing and their factor in drug absorption,distribution,metabolism and excretion)and related Solutions to the drug's effects in the body,and one drug modulates the pharmacologic effect of another:additive,synergistic,or antagonistic. Introduction to drug interactions 5min Time The types of Drug Interactions 5min Allotment Pharmacokinetic Drug Interactions 13min Pharmacodynamics Drug Interactions 13min Questions and discussion 4min 1 Drug interaction and the results. Assignment 2 Give an example to explain drug metabolism interactions. 3 Pharmacodynamics Drug Interactions. Reference 1.Principle of Clinical Pharmacology(Second Edition);Arthur J.Atkinson Text 2.Basic Clinical Pharmacology;Bertram G.Katzung 3.Drug interaction facts;Tatro DS. Memo 1

安徽医科大学国际教育学院教案与讲稿 1 Teaching Plan for International Students, AHMU Title of the course: Drug Interactions Chapter: 15 Teacher’s name: Qiong Huang Grade: 2013 Department: Clinical Medicine, School of International Education Time: 14:30—16:50 Date (D/M/Y): 3/16/2016 Teaching Objectives; Teaching Requirements 1. Recognize the concept of drug interactions. 2. Recognize the types of drug interactions. 3. Recognize the context of pharmacokinetics and pharmacodynamics drug interactions. 4. Master the drug interaction and the results. Teaching Content 1. Introduction to the definition of drug interactions. 2. The types of drug interactions. 3. The influencing factor of pharmacokinetics drug interactions. 4. The influencing factor of pharmacodynamics drug interactions. 5. Questions and discussion. Teaching Focus; Difficult Problems and their Solutions Teaching Focus: The context of pharmacokinetics and pharmacodynamics drug interactions. Difficult Problems: The influencing factor of pharmacokinetics and pharmacodynamics drug interactions. Solutions: Give examples of drug-drug interactions (including influencing factor in drug absorption, distribution, metabolism and excretion) and related to the drug’s effects in the body, and one drug modulates the pharmacologic effect of another: additive, synergistic, or antagonistic. Time Allotment Introduction to drug interactions 5min The types of Drug Interactions 5min Pharmacokinetic Drug Interactions 13min Pharmacodynamics Drug Interactions 13min Questions and discussion 4min Assignment 1 Drug interaction and the results. 2 Give an example to explain drug metabolism interactions. 3 Pharmacodynamics Drug Interactions. Reference Text 1. Principle of Clinical Pharmacology (Second Edition); Arthur J. Atkinson 2. Basic & Clinical Pharmacology; Bertram G. Katzung 3. Drug interaction facts; Tatro DS. Memo

安徽医科大学国际教育学院教案与讲稿 Teaching Plan for International Students,AHMU Title of the course:Drug Interactions Chapter:15 Teacher's name:Qiong Huang Grade:2013 Department:Clinical Medicine,School of International Education Time:14:30-16:50 Date(D/M/Y):3/16/2016 Lecture Notes: [MODULES] 2min MODULE 1:Introduction to drug interactions MODULE 2:The types of Drug Interactions MODULE 3:Pharmacokinetic Drug Interactions MODULE 4:Pharmacodynamics Drug Interactions MODULE 5:Questions and discussion JINTRODUCTION TO DRUG INTERACTIONSI 3min 1.DRUG INTERACTIONS:The pharmacological result,either desirable or undesirable,of drugs interacting with themselves or with other drugs,with endogenous chemical agents,with components of the diet,or with chemicals used in or resulting from diagnostic tests. 2.RESULT OF DRUG INTERACTION To increase theraputic efficacy and decrease toxicity To decrease theraputic efficacy and increase toxicity [TYPES OF DRUG INTERACTIONS] 5min 1.Pharmacokinetic What the body does with the drug One drug alters the concentration of another by altering its absorption,distribution. metabolism,or excretion Usually (but not always)mediated by cytochrome P450(CYP) 2.Pharmacodynamic Related to the drug's effects in the body One drug modulates the pharmacologic effect of another:additive synergistic,or antagonistic 3.Interaction in vitro intravenous admixture [PHARMACOKINETIC DRUG INTERACTIONSI 13min 1.absorption ·pH Anion exchange resins ·Food 2.distribution Protein Binding Interactions 2

安徽医科大学国际教育学院教案与讲稿 2 Teaching Plan for International Students, AHMU Title of the course: Drug Interactions Chapter: 15 Teacher’s name: Qiong Huang Grade: 2013 Department: Clinical Medicine, School of International Education Time: 14:30—16:50 Date (D/M/Y): 3/16/2016 Lecture Notes: [MODULES] 2min MODULE 1: Introduction to drug interactions MODULE 2: The types of Drug Interactions MODULE 3: Pharmacokinetic Drug Interactions MODULE 4: Pharmacodynamics Drug Interactions MODULE 5: Questions and discussion [INTRODUCTION TO DRUG INTERACTIONS] 3min 1. DRUG INTERACTIONS: The pharmacological result, either desirable or undesirable, of drugs interacting with themselves or with other drugs, with endogenous chemical agents, with components of the diet, or with chemicals used in or resulting from diagnostic tests. 2. RESULT OF DRUG INTERACTION
To increase theraputic efficacy and decrease toxicity
To decrease theraputic efficacy and increase toxicity [TYPES OF DRUG INTERACTIONS] 5min 1. Pharmacokinetic
What the body does with the drug
One drug alters the concentration of another by altering its absorption, distribution, metabolism, or excretion
Usually (but not always) mediated by cytochrome P450 (CYP) 2. Pharmacodynamic
Related to the drug’s effects in the body
One drug modulates the pharmacologic effect of another: additive,
synergistic, or antagonistic 3. Interaction in vitro
intravenous admixture [PHARMACOKINETIC DRUG INTERACTIONS] 13min 1. absorption
pH
Anion exchange resins
Food 2. distribution
Protein Binding Interactions

安徽医科大学国际教育学院教案与讲稿 Drug B Plasma Tissue Drug A protein bound 川 Drug A DrugA free free Drugs Aand B both bind to the same plasma protein Drug Transport Proteins:Induction of P-glycoprotein by rifampin increases intestinal secretion of talinolol 3.Metabolism Drug Metabolism Interactions:Induction Warfarin Diazepam CYP2C9 Beneficial Use of Induction Drug Metabolism Interactions:Inhibition Gefitinib AUC83%↓ AUC80%↑ ⊙ Rifampin CYP3A4 Itraconazole O-desmethyl-gefitinib 4.excretion Drug A increases or reduces the excretion (usually renal)of Drug B. Blood levels of B fall below or rise above normal therapeutic range. Becomes either ineffective or toxic. IPHARMACODYNAMICS DRUG INTERACTIONSI 13min 1.Synergistic combinations ● Pharmacologic effect>than the summation of the 2 drugs Beneficial:aminoglycoside penicillin Harmful:barbiturates alcohol 2.Antagonism Pharmacologic effect than the summation of the 2 drugs Beneficial:naloxone in opiate overdose

安徽医科大学国际教育学院教案与讲稿 3
Drug Transport Proteins: Induction of P-glycoprotein by rifampin increases intestinal secretion of talinolol 3. Metabolism
Drug Metabolism Interactions: Induction
Beneficial Use of Induction
Drug Metabolism Interactions: Inhibition 4. excretion
Drug A increases or reduces the excretion (usually renal) of Drug B.
Blood levels of B fall below or rise above normal therapeutic range.
Becomes either ineffective or toxic. [PHARMACODYNAMICS DRUG INTERACTIONS] 13min 1. Synergistic combinations
Pharmacologic effect > than the summation of the 2 drugs
Beneficial: aminoglycoside + penicillin
Harmful: barbiturates + alcohol 2. Antagonism
Pharmacologic effect < than the summation of the 2 drugs
Beneficial: naloxone in opiate overdose

安徽医科大学国际教育学院教案与讲稿 Harmful:zidovudine stavudine 3.Additivity Pharmacologic effect=than the summation of the 2 drugs Beneficial:aspirin acetaminophen Harmful:neutropenia with zidovudine ganciclovir JQUESTIONS AND DISCUSSION] 4min 1.Drug interaction and the results. 2.Give an example to explain drug metabolism interactions. 3.Pharmacodynamics Drug Interactions

安徽医科大学国际教育学院教案与讲稿 4
Harmful: zidovudine + stavudine 3. Additivity
Pharmacologic effect = than the summation of the 2 drugs
Beneficial: aspirin + acetaminophen
Harmful: neutropenia with zidovudine + ganciclovir [QUESTIONS AND DISCUSSION] 4min 1. Drug interaction and the results. 2. Give an example to explain drug metabolism interactions. 3. Pharmacodynamics Drug Interactions