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INTRODUCTION

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Drug interactions occur when one drug modifies the actions of another drug in the body. Drug interactions can result from pharmacokinetic alterations, pharmacodynamic changes, or a combination of both. Interactions between drugs in vitro (eg, precipitation when mixed in solutions for intravenous administration) are usually classified as drug incompatibilities, not drug interactions.

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Although hundreds of drug interactions have been documented, relatively few are of enough clinical significance to constitute a contraindication to simultaneous use or to require a change in dosage. Some of these are listed in Table 61–1. In patients taking many drugs, however, the likelihood of significant drug interactions is increased. Elderly patients have a high incidence of drug interactions because they commonly take multiple medications and they often have age-related changes in drug clearance.

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Table Graphic Jump Location
TABLE 61–1Some important drug interactions.

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