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A drug interaction is a situation in which a substance affects the activity of a drug, i.e.
the effects are increased or decreased, or they produce a new effect that neither produces
on its own. Typically, interaction between drugs come to mind (drug-drug interaction).
However, interactions may also exist between drugs & foods (drug-food interactions), as
well as drugs & herbs (drug-herb interactions).
Generally speaking, drug interactions are avoided, due to the possibility of poor or
unexpected outcomes. However, drug interactions have been deliberately used, such as
co-administering probenecid with penicillin prior to mass production of penicillin.
Because penicillin was difficult to manufacture, it was worthwhile to find a way to
reduce the amount required. Probenecid retards the excretion of penicillin, so a dose of
penicillin persists longer when taken with it, and it allowed patients to take less penicillin
over a course of therapy.
Drug interactions may be the result of various processes. These processes may include
alterations in the pharmacokinetics of the drug, such as alterations in the Absorption,
Distribution, Metabolism, and Excretion (ADME) of a drug. Alternatively, drug
interactions may be the result of the pharmacodynamic properties of the drug, e.g. the co-
administration of a receptor antagonist and an agonist for the same receptor.
The examples described above may have different outcomes depending on the nature of
the drugs. For example, if Drug B is a prodrug, then enzyme activation is required for the
drug to reach its active form. Hence, enzyme induction by Drug A would increase the
effectiveness of the drug B by increasing its metabolism to its active form. Enzyme
inhibition by Drug A would decrease the effectiveness of Drug B.