Franklin ic-168 Benutzerhandbuch

local anesthetics, are not included here. Interactions useful in
therapy, such as increased plasma concentration of penicillin
with concurrent use of probenecid, are also not included.

Common additive effects, such as occur with use of two
antihypertensive agents or two central nervous system
depressants, are generally not listed. Effects expected from the
mechanism of a drug’s action, such as that of potassium on
digitalis glycosides or calcium on calcium-entry blockers, and
useful antagonist effects, such as that between a poison and an
antidote, are also not included. Most interactions of drugs with
foods, beverages, or other nutrients are not listed, but foods
interacting with monoamine oxidase inhibitors are included.

Mechanisms of Interaction—Genetic differences can affect
drug metabolism and interactions. Drugs can interact by
changing the metabolism of other drugs, either through
inhibition or induction of any of several hepatic enzyme
activities or through alterations in hepatic blood flow; by altering
the binding of other drugs to plasma proteins or tissue
receptors; by altering the distribution of drugs to active receptor
sites; by delaying or enhancing excretion; or by causing additive
or synergistic effects.

Recommendations—Monitoring is most important when one of
the interacting drugs is stopped or started. Some experienced
clinicians may prefer to monitor the patient’s clinical status
rather than follow serum concentrations of drugs. Concurrent
use of drugs from the same group, e.g., aspirin and other
NSAIDS, should be avoided.