This document discusses drug interactions, which occur when one drug affects another drug's effectiveness or safety. It describes the main types of interactions: absorption, distribution, metabolism, and elimination. Absorption interactions can affect how quickly or how much of a drug is absorbed. Distribution interactions can change protein binding in the blood and alter tissue distribution. Metabolism interactions involve one drug inducing or inhibiting the enzymes that break down other drugs. Elimination interactions can change how drugs are removed from the body, usually through the kidneys or liver. Understanding these interaction mechanisms is important for predicting and avoiding negative outcomes when multiple drugs are taken together.

1. PRESENTED BY :- SAJAL KUMAR CHOWDHURY
B. PHARM
4TH YEAR

2.  Introduction
 Classification
 Absorption interactions
 Distribution interactions
 Metabolism interactions
 Elimination interactions
 References

3.  A drug interaction is an interaction between a drug and some other
substance , such an another drug or a certain type of food , which
leads to interaction that could manifest as interaction or decrease in
the effectiveness
 Mostly undesirable
 Rarely desirable
 The drug whose activity is effected by such an interaction is called
as a Object drug .
 The agent which precipitate such as interaction is referred to as the
Precipitant .

4.  Altered concentration , pharmacokinetic drug
interactions occur when one drug changes the
systemic concentration of another drug , altering
how much and for how long it is present at the
site of action

5. Altered effect pharmacodynamic drug interactions occure
when interacting drugs have either additive effects , in
which case the overall effect in increased or opposing
effect , in which case the overall effect is decreased or
even cancelled out .

6.  Absorption interactions
 Distribution interactions
 Metabolism interactions
 Excretion interactions

7.  Absorption interaction are those where the absorption of
the object drug altered .
 Since the oral route is one , most frequently used to
administer drugs , interactions influencing absorption are
more likely to occur within the gastrointestinal tract
 The net effect of such an interaction is
 Faster or slower drug absorption .
 More or less drug absorption.

8.  Drug distribution interactions are those where the distribution
pattern of the subject drug is altered.
 The major mechanism for distribution interaction is alteretion in
protein – drug binding .
 Many drugs interact by displacement of each others binding to
plasma proteins.
 Acidic drugs are known to have an affinity to bind to plasma proteins
,hence when two or more are given concomitantly ,competetive
binding for the same site or receptor may displace one drug from
the protein binding site increasing the amount of the displaced free
drug in plasma and verious tissues

9.  Certain drugs stimulation the activity of hepatic microsomal
enzymes. This effect is referred as enzyme indication
 The increase activity is due to enhanced enzyme synthesis results
in increased amounts of drug metabolizing enzyme
 Enzyme induction will result in increased metabolism and excretion
and reduced effect of agent which is metabolised by the hepatic
enzymes
 Eg : Warfarin and Phenobarbitol

10.  Drug elimination reactions are those where the excreation pattern of
the object drug is altered
 The major routes for elimination the drugs remain kidney and bile ,
but there are no significant drugs- drug interactions through bile
elimination , but only drug – disease ones .
 Some drugs are excreted from the body unchanged in the active
form usually in the urine or via the biliary tract in the faeces.

11.  D.M. Barahmankar , S.B.Jaiswal Biopharmaceutics and
pharmacokinetics , Vallabh Prakashan , Second edition P. No. 224-
233
 Prativa Nand , R.K. Khar, Hospital and Clinical pharmacy .. Birla
Publication , Thirteenth edition , P.no. 270-280

12. THANK YOU