Clinical pharmacology Essay Example | Topics and Well Written Essays - 1000 words

Clinical pharmacology - Essay Example2010).Antibiotics especially co-trimoxazole, metronidazole, macrolides, fluroquinolones As farther as sulpha drugs which cause enhanced effect of warfarin resulting in bleeding, in the absence of proven mechanism of action, it has been hypothesized by clinicians that systematic administration of much(prenominal) antibiotics results in reduced production of Vitamin K caused by intestinal flora. Same mechanism of action applies to macrolides that include Azithromycin etc and quinolones such as ciprofloxacin (Medication Management Home).As for metronidazole, it interferes with metabolism of S enatiomer of Warfarin. As for, Rifampin, it induces hepatic enzymes thus increasing metabolism of Warfarin (Horton and Bushwick, 1999).Antidepressants Two theoretical hypotheses about Warfarins potential interactions with antidepressants are that because Warfarin is protein bound, antidepressants which are also protein bound, their interaction can result in d isplacement of Warfarin from its binding sites as stated by Sansone and Sansone (2009). They at the same succession point out the observation of Sayal et al (2000) that there is no clinical evidence to that effect. Selective Serotonin Reuptake Inhibitors (SSRIs), are found to potentially appropriate Warfarin metabolism through their isoenzymes 2C9 and 1A2. However Sertraline and Citalopran are not likely to cause interaction. While Paroxetine has low-to-moderate risk, fluvoxamine and fluoxetine have the potential to effects of Warfarin. maidenhair tree biloba has properties capable of inhibiting platelet aggregation, if taken with Warfarin, it will enhance the toxic effects monamine oxidase inhibitors. However, Ginkgo on its own is capable of causing bleeding complications (Dharmananda). Dong qual increases the decoagulant action of Warfarin. St Johns Wort induces P450 pathways resulting in lowering of INR. This increases the metabolism of Warfarin.