Download Drug Drug Interactions - American Association of Nurse Anesthetists

American Association of Nurse Anesthetists
222 South Prospect Avenue
Park Ridge, IL 60068-4001
Copyright ©2016 American Association of Nurse Anesthetists
All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a
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Printed in the United States of America.
Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1
The authors and publisher have done everything possible to make this book accurate, up to date, and
in accord with accepted standards at the time of publication. The authors, editors, and publisher are
not responsible for errors or omissions or for consequences from application of the book, and make
no warranty, expressed or implied, in regard to the contents of the book. Any practice described in
this book should be applied in accordance with professional standards of care used in regard to the
unique circumstances that may apply in each situation.
Library of Congress Cataloging-in-Publication Data
Names: Welliver, Mark, editor. | Bruton-Maree, Nancy, editor. | Welliver, Dawn Dalpé, editor. |
American Association of Nurse Anesthetists, issuing body.
Title: Drug/Drug interactions / edited by Mark Welliver, Nancy Bruton-Maree, Dawn Dalpé Welliver.
Other titles: Drug/Drug interactions (Welliver)
Description: Park Ridge, IL : American Association of Nurse Anesthetists, [2016] |
Includes bibliographical references.
Identifiers: LCCN 2016018800 | ISBN 9780982991244
Subjects: | MESH: Drug Interactions | Pharmacokinetics | Nurses’ Instruction
Classification: LCC RM302 | NLM QV 37.5 | DDC 615.7/045--dc23 LC record available at
https://lccn.loc.gov/2016018800
Preface
This book is targeted toward practicing Certified Registered Nurse Anesthetists and
student nurses in anesthesia training. We, the editors, want this to be as thorough a
treatment as necessary to enable anesthesia professionals to deliver the best possible,
most efficacious care to their patients.
Being cognizant of interactions and potential interactions among drugs of various
classifications is of paramount importance to each of us. At times, we anesthetists
seem like the alchemists of olden days in search of turning lead into gold. We
administer multiple medications in rapid succession, so we need to be aware of the
potential interactions among them. It might seem we are nearly like chemists giving
these numerous medications. Medications are chemicals; chemicals react and interact
with one another. At times these interactions are beneficial, but interactions may well
become detrimental, if we aren’t careful in our approach to their administration. We,
the editors of this book, wish—to the extent feasible and possible—to include in the
various chapters in vivo and in vitro interactions for the various drugs.
In vitro drug interactions are related to drug characteristics and formulary
preparations:
1. Weak acids
2. Weak bases
3. pH of solvents and pKa of drugs
4. Ionization and aqueous solubility
5. Ionized (hydrophilic) vs unionized (lipophilic) incompatibility
In vivo drug interactions fall into 2 main categories:
1. Alterations of metabolism (ADME)
2. Opposition or enhancement of effect:
Antagonism
Agonism
Each category is related to induction or inhibition of hepatic enzymes and/or potentiation or attenuation of effects due to agonism or antagonism of relevant receptors.
We are excited about working with you on this endeavor to enhance and improve
our delivery of anesthesia care.
Mark Welliver, DNP, CRNA, ARNP
Nancy Bruton-Maree, MS, CRNA
Dawn Dalpé Welliver, DNP, CRNA, ARNP
iii
Authors
Greg Bozimowski, DNP, CRNA
Nancy Bruton-Maree, MS, CRNA
Reamer L. Bushardt, PharmD, PA-C, DFAAPA
Dennis J. Cheek, RN, PhD, FAHA
Sass Elisha, EdD, CRNA
Lynn Fitzgerald Macksey, RN, MSN, CRNA
Mark Gabot, MSN, CRNA
Sarah E. Giron, PhD, CRNA
Mary Karlet, PhD, CRNA
Ryann Lavenia, MS, CRNA
Kiran Macha, MBBS, MPH
Nina McLain-Calkins, PhD, CRNA
Zulay H. Ritrosky, DNP, CRNA
Kay K. Sanders, DNP, CRNA
Allan Schwartz, DDS, CRNA
Ryan Shores, DNP, CRNA
Dawn Dalpé Welliver, DNP, CRNA, ARNP
Mark Welliver, DNP, CRNA, ARNP
Kelly L. Wiltse Nicely, PhD, CRNA
v
Contents
Preface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii
Authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
Chapter 1
Introduction to the Biochemistry of Drug Interactions . . . . . . . . . . . 1
Chapter 2
Chemistry Review of Drug Incompatibilities. . . . . . . . . . . . . . . . . . 15
Chapter 3
Inhalational Anesthetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Chapter 4
Local Anesthetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Chapter 5
Benzodiazepines and Drug Interactions. . . . . . . . . . . . . . . . . . . . . . 75
Chapter 6
Common Induction Agents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Chapter 7
Opioids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Chapter 8
Pure Opioid Antagonists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Chapter 9
Neuromuscular Blocking Agents . . . . . . . . . . . . . . . . . . . . . . . . . . 159
Chapter 10
Neuromuscular Blocking Agent Reversal Drugs . . . . . . . . . . . . . . . 173
Chapter 11
Anticholinergic Drugs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193
Chapter 12
Sympathomimetic Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
vii
Chapter 13
Antibiotics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
Chapter 14
Anticoagulant Medications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
Chapter 15
Beta Adrenergic Receptor Antagonists . . . . . . . . . . . . . . . . . . . . . . 253
Chapter 16
Calcium Channel Blocking Drugs . . . . . . . . . . . . . . . . . . . . . . . . . 263
Chapter 17
Antiepileptic Drugs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279
Chapter 18
Steroids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 295
Chapter 19
Nonsteroidal Anti-inflammatory Drugs . . . . . . . . . . . . . . . . . . . . 305
Chapter 20
Antacids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327
Chapter 21
Herbal Dietary Supplements . . . . . . . . . . . . . . . . . . . . . . . . . . . . 337
About the Editors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 375
Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 377
viii