Anti-inflammatory effect drug interactions

This xanthine derivative is an only a modest bron-chodilator in COPD, and because of its narrow therapeutic range, frequently seen adverse effect and drug interactions, it is becoming less frequently used, some patients experience side effects even within the therapeutic range. The non-bronchodilator effects of theophylline such as systemic and pulmonary vascular dilatation, central nervous system stimulation, improvement of the strength and effectiveness of respiratory muscles and possibly anti-inflammatory effects are of disputed clinical significance at usual therapeutic levels. 

Aspirin produces an antipyretic and anti-inflammatory effect primarily by irreversibly inhibiting cyclooxygenase (thus having similar effects to NSAIDs). It possesses an antiplatelet effect that may have additive effect with other drugs with a similar effect (e.g, selective serotonin reuptake inhibitors) and those which affect other aspects of blood clotting. The risk of interactions and adverse effects are reduced by using a lower dose (e.g. 75 mg) fortunately, a full antiplatelet effect is seen at this dose. This is considered in Part 1, Cardiovascular Drugs. 

The quaternary isoquinoline alkaloid berberine (28) is widely used in Asia as a drug. Among other maladies, diarrhea, dysentry, cholera, and eye infections are indications for which berberine or plant extracts containing this alkaloid are applied, because of the antimicrobial activity of berberine (472,506). Berberine interacts with DNA, but this does not seem to be related to its antimicrobial activity (506). Berberine contracts also uterine muscle and is used to stop uterine bleeding. Furthermore berberine has an anti-inflammatory effect (507). In Japan berberine and in particular extracts of dried rhizomes of Coptis japonica Makino var. dissecta (Yatabe) Nakai (Ranunculaceae) are widely used as a stomach tonic. 

Important drug interactions include those with potassium supplements or potassium-sparing diuretics, which can result in hyperkalemia. Nonsteroidal anti-inflammatory drugs may impair the hypotensive effects of ACE inhibitors by blocking bradykinin-mediated vasodilation, which is at least in part, prostaglandin mediated. 

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