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Drug leaflets

9 important questions on Drug leaflets

Why do people with renal problems have a higher chance at getting lactic acidosis after taking metformin?

Metformin and lactic acid are both excreted by the kidney. Renal disease or renal dysfunction can lead to accumulation of metformin, because the excretion is decreased. Metformin affects the electron transport chain which results in an higher lactate production. When this accumulates, it can cause lactic acidoses.

How is diarrhoea caused by metformin?

This is caused by an osmotic effect. Because less glucose is taken up form theGI-tract, the osmotic value of its contents will go up. This keeps/attracts water and causes more watery faeces.

Metformin can cease deficiency of a micronutrient, which one?

Vitamin B12, of which the uptake form the GI-tract is reduced, most likely by different factors including interference with Intrinsic Factor, the GI microbiota, mobility etc.
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Pantoprazolone main indications? (belongs to proton pump inhibitors)

-reduction of serious complaints of heartburn and short-term treatment of erosive espphagitis associated with gastroesopageal reflux disease. (GERD)
-protection of the duedenal and gastric mucosa against irritating agents such as NSAIDs
-regression of duodenal and/or gastric uclers.

Pantoprazole belongs to the proton pump inhibitors (PPIs). mechanism of action?

PPIs irreversibly inhibit the enzyme H+/K+-ATPase (proton pump) in the parietal cells of the stomach, as a result, they significantly inhibit both basal and stimulated gastric acid secretion.

What is the difference in the anti-blood clotting mechanism between rivaroxaban (a directly acting anticoagulant) and acetylsalicylic (aspirin)?

Direct-acting Oral anicoagulants (DOACs) directly inhibit the activated coagulation factor Xa. This interrupts both the intrinsic and extrinsic pathways of the blood coagulation cascade, preventing the formation of thrombus. Acetylsalicyclic acid inhibits the aggregation of platelets by inhibiting COX-1. This leads to reduced formation od thromboxane A2 which okays an important role in platelet aggregation.

High riks of bleeding when combining rivaroxaban with medicinal products that inhibit CYP3A4 and P-glycoproteins? Why

CYP3A4 and P-glycoproteins are involved in the metabolism and excretion of rivaroxaban. Co-administration of these drugs with rivaroxaban inhibits the metabolism and excretion of rivaroxaban, which causes increased rivaroxaban plasma concentrations. The higher the rivaroxaban plasma concentration, the larger its anticogulating effect. -> patients are at higher risk of bleeding.

Why is it advised to take simvastatin once per day, eventhough is has a short halftime of 4,5 hours?

During the night, the endogenous cholesterol synthesis is the highest. Despite its short half-life this has shown to give a good effect-side-effect balance.

Avoid grapefruit and simvastin together. May cause myalgia. Why?

Simvastatin is a substrate of CYP3A4, which converts the drug into inactive metabolites. As a result, inhibition of CYP3A4 can also lead to more side-effects. Including myalgia (muscle aches and pain).
grapefruit inhibits this enzyme

The question on the page originate from the summary of the following study material:

Pharmacology and Nutrition

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