can you give me an example of a drug which is incompatible to another drug?

Question

a drug which is unsuitable for use together of chemical interaction or antagonistic physiological effects

Answer 1

chemical is penicillin and garamycin ppt occur different pH pH tetracycline and calcium too physiological thyroxine and sympathomemitics

Answer 2

Drug Incompatibility

Answer 3

Katie Marie:

It looks like you asked an easy question by the list makers. If you have a specific question, I'd be happy to answer it by email. But since the list-makers know their lists, but don't seem to be up on the medicine....I have a Looooong answer.

Drug incompatibilities are easy to remember if you have some chemistry - suppose I start an IV and put a bag of normal saline (NaCl 0.9% - it has "normal" osmolality) and place 50mEq of NaHCO3 - sodium bicarbonate - in it. And someone else sees you have high K levels and wants to hang a bag of calcium - they don't have Ca-gluconate, but CaCl2 that they hang alongside my bicarb bag of NS.....and they plug it into the same IV.

The clear NS fluid will turn milky white with sediment as the two drugs mix - you form calcium carbonate (sea shells???) and just increase the concentration of NaCl as the two drugs interact. THIS IS A TRUE INCOMPATIBILITY.

All drugs used have both chemical interactions and antagonistic physiological effects. The drugs we don't use - usually poisons - have extreme toxic effects....but we tend to use other drugs which have antagonistic physiological effects to block those poisons.

Don't worry about baby aspirin, herbals, etc....DO tell your nurse, doctor, or heathcare specialist about what you take daily, but don't read these lists and avoid medications!!

Many drugs for IV use are listed as incompatible in various solutions, going through certain types of IV lines - some must be given through central venous lines. Many chemotherapy agents must be given through large ports into the big vessels - the vena cava - in order to mix with enough blood so the concentration isn't too great in a small vessel. If that were to happen - you could scar the vessel down or cause a spasm.

Here are medical antagonistic physiological effects which are not good - I'll give you two!

A man with erectile dysfunction and heart disease.....now we have phosphodiesterase 5 inhibitors which help with function - but they lower blood pressure while improving certain member blood flow. And with chest pain we give nitroglycerin under the tongue which lowers blood pressure somewhat by dilating vessels - it dilates the vessels of the heart and improves coronary blood flow which is why we give it. If someone has taken one of these in the previous 48 hours - and you give them the other drug, you can drop their blood pressure too much! You can make a heart attack worse, you can cause a stroke, you can even drop their pressure to the point of a code situation - or death.

How about an asthmatic? You use beta agonists to dilate the bronchial airways - these are beta 2 agonists. And we give beta blockers or antagonists to hypertensives to drop their blood pressure and gently slow their heart rate. If someone has really significant asthma, it will be treated with a b-2 agonist inhaler, and if you give them a NON-SPEFIC beta-blocker, their b-2 agonist inhaler will NO LONGER BE EFFECTIVE! What if we give them a selective beta-1 blocker? Usually isn't a problem, but many physicians avoid the class altogether in bad asthmatics!

So neither of these are good things. Antagonistic physiological effects. Not good to use together - either of these.

Here are some antagonisms which are compatible: Warfarin & vitamin K? Your intestinal flora makes natural vitamin K daily, you eat natural vitamin K in your diet, you take warfarin daily.....these are antagonistic, but balanced...we check your INR to make sure you are at the therapeutic range. Are they incompatible? Can't be, since they are present in everyone on warfarin or coumadin. Basic medicine!

Aspirin and Ibuprofen? Many people enjoy the synergistic effect. You may get more synergism with acetominophen and ibuprofen, but whatever. Aspirin binds to a certain enzyme and doesn't let go. Ibuprofen works on the same enzyme, but does let go. Aspirin will trump ibuprofen each and every time, but unless you overdose on either, they are not incompatible.

Milk with oral tetracyclines? Yep - renders them useless. You might as well eat snow and call it medicine.

Here is a good one - Tricyclic antidepressants, Monamine oxidase inhibitors, and cheese, wine, etc. You can get a really massive headache - or hypertension - with this combination. No, in combination they frequently work, by themselves they sometimes work - not my first choice for prescribing - but they were the first anti-depressants discovered (yeah, St. John's Wort and exercise were known centuries before). The tyramine in cheese and other foods can lead to excessive alpha-agonist production which leads to hypertension and other problems.

Remember - drugs are useful BECAUSE they are antagonistic - suppose you get sprayed with concentrated insecticide? We give you atropine to block the effect. Why? Insecticides are usually weak nerve gas compounds and atropine is an antidote! Antagonistic!!

Suppose you get heparin for a procedure? We give you protamine to reverse the effect. Suppose we don't have full doses of statin but have plenty of grapefruit juice - you can increase your grapefruit juice intake and take the lower statin dose and get the same effect - it slows the breakdown of the statin and increases the length of time at high serum levels.

In short, there are certain drugs that should never be infused in the same IV line. There are certain drugs that should not be mixed in the stomach at the same time - so you take them separated by 2 hours or so. There are certain drugs that need to be taken on an empty stomach. And there are certain drugs which should never be taken in certain circumstances: Let me mention pseudophedrine, a common decongestant. If you are pregnant, do not take pseudophedrine, or even ephedrine. These drugs can cause problems with your placental blood flow, harming your baby.

Ignore lists unless you are a nurse or EMT. If you are a pharmacist or physician, you shouldn't NEED a list, you should know all this.

Answer 4

Are you still in the military? If you are then talk to your mental health clinic asap! It always takes time to gain back the trust of superiors. Just do your best and sometimes a change of duty stations can help. Suicide is never an answer.

Answer 5

give drug incompatible drug

Answer 6

OK, here are few examples:
>>Vitamin K - warfarin (antagonistic effects)
>>Heparin - Protamine Sulfate (antagonistic effects)
>>phenytoin -intravenous dextrose (chemical interaction)
>>amphotericin B - saline solutions (chemical interaction - precipitates)
>>hydroquinones- epinephrine (chemical interaction- color changes)
>>acyclovir sodium - dopamine and epinephine (chemical interaction -color changes)
>>acyclovir sodium - HCl salts such as diltiazem HCl, meperidine HCl, morphine sulfate,etc. (chemical interaction -form precipitate)
>>Sodium Bicarb injections - cephalosporins injections (chemical interaction - carbon dioxide evolution)
>>Beta-lactam antibiotics (such as ampicillin, penicillin) - dopamine HCl
(chemical interaction - accelerated hydrolysis)

There are so many incompatibilities in different drugs, the reason why reading the leaflets of every drugs is very important before taking or mixing drugs.

Answer 7

indocin and dyazide - causes the kidneys to shut down

Answer 8

Some drugs may not do their job effectively if they’re taken with other drugs, supplements or certain foods. Here are some examples of combinations that may stop your medication from doing what you need it to do.

Drug interactions account for three to five per cent of preventable unwanted drug reactions in hospitals. Interaction occurs when one drug interferes with how another drug works.

So, what can you do? As a consumer, you need to know what drugs you should avoid or use cautiously when you are on a certain medication and to know what can happen when you combine two incompatible medications. Keep in mind that the cause of dangerous interactions is not just from taking prescription medications together. Combining over-the-counter medications, such as cough and cold products and herbal remedies such as St. John’s wort, even grapefruit juice with prescription medications can be dangerous. Here’s what you should know.

GRAPEFRUIT JUICE

Consuming one glass of grapefruit juice is enough to affect certain medications for up to three days. Eating the fruit or drinking the juice can prevent certain drugs from being broken down in the body, increasing the amount of drug present in the blood. When the amount of drug in the blood is higher than what it should be, there is an increase in unwanted side effects and an increase in the effect the drug has on your body.

Take, for example, felodipine (Renedil or Plenedil) and nifedipine (Adalat XL), drugs used to treat high blood pressure. In the presence of grapefruit juice, your blood pressure is lowered even more and can cause lightheadedness, dizziness and fainting.

Lovastatin (Mevacor), atorvastatin (Lipitor) and simvastatin (Zocor) lower blood cholesterol levels but combined with grapefruit juice, headaches, stomach upset or serious muscle pain are signs of the drug’s toxicity and requires immediate medical attention. So before you go for a drink of grapefruit juice (fresh or frozen), the fruit itself, tangelos (a hybrid fruit containing grapefruit) or sour orange juice from Seville oranges, consult with your pharmacist to ensure what you are taking is compatible. Lemons, limes, tangerines and oranges are considered safe.

BABY ASPIRIN AND HERBAL SUPPLEMENTS

Gingko, garlic and ginseng – all herbal remedies – have blood-thinning properties. Anyone taking the prescription medication warfarin or the over-the-counter baby Aspirin to thin their blood should not take gingko, garlic or ginseng supplements without discussing it with a health-care professional. The herbal supplements may increase the risk of bleeding, so if you take them along with ASA or warfarin, the likelihood of bleeding increases.

BABY ASPIRIN AND PAINKILLERS

If you use ibuprofen (Advil and Motrin) to relieve aches and pains, it can prevent ASA from doing its job. Both ASA and ibuprofen compete for the same binding site in your body. Think of the binding site as your front door. Whichever of the two drugs arrives at the door first is allowed in to do its job. The other is locked out. As ASA is taken daily to prevent a stroke, you do not want to prevent it from working. Take ASA at least two hours before you take ibuprofen in order to allow it to work. This applies to individuals who use ibuprofen occasionally, but if you take it on a regular basis, talk to your doctor as you may need to switch the ibuprofen to another pain reliever such as acetaminophen.

LEVOTHYROXINE

Levothyroxine (Eltroxin and Synthroid) is used by people who have low thyroid hormone levels. Certain minerals can prevent levothyroxine from being absorbed and working properly in the body. So if you take a calcium or iron supplement, a multiple vitamin that contains calcium and iron or a stomach remedy that contains magnesium and aluminum (such as Maalox and Mylanta), wait four hours before taking levothyroxine.

ST. JOHN’S WORT

If you are on an antidepressant such as paroxetine (Paxil) or sertraline (or Zoloft), it is important not to use St. John’s wort. A serious condition called serotonin-like syndrome may occur, which includes side effects such as dizziness, nausea, headache, tremors, anxiety, fever and confusion.

St. John’s wort can also decrease the effectiveness of the heart medication digoxin. Talk to your pharmacist to see if St. John’s wort is compatible with your present medications.

HIGH BLOOD PRESSURE MEDICATIONS

If you take medications to lower your blood pressure such as ramipril (Altace) or hydrochlorothiazide (Apo-Hydro), you need to be careful when using cough and cold preparations and some allergy medications.

These preparations may contain a decongestant (such as phenylephrine or pseudoephedrine), which elevates blood pressure. Talk to your pharmacist about what medication is right for you.

BONE BUILDERS

Many people are on alendronate (Fosamax) and risedronate (Actonel) to help strengthen their bones. Don’t consume food or take calcium or iron supplements or stomach remedies within two hours of these medications to allow ample time for the bone strengthener to be absorbed by the body.

The bottom line is that if you are on any prescription or non-prescription medication, consult with your physician or pharmacist before you add anything new. Make sure your physician and pharmacist know all the nonprescription medications you are on, including vitamins, minerals, herbal remedies, antihistamines and painkillers.