Drug interaction nonsteroidal anti-inflammatory drugs

Which best describes the mechanism of interaction of nonsteroidal anti-inflammatory drugs (NSAlDs) with lithium salts ... 

Ragheb, M. (1990) The clinical significance of lithium-nonsteroidal anti-inflammatory drug interactions. / Clin Psychopharmacol 10 350-354. 

Renal clearance of lithium is reduced about 25% by diuretics (eg, thiazides), and doses may need to be reduced by a similar amount. A similar reduction in lithium clearance has been noted with several of the newer nonsteroidal anti-inflammatory drugs that block synthesis of prostaglandins. This interaction has not been reported for either aspirin or acetaminophen. All neuroleptics tested to date, with the possible exception of clozapine and the newer atypical antipsychotics, may produce more severe extrapyramidal syndromes when combined with lithium. 

Nonsteroidal anti-inflammatory drugs [P] Indomethacin reduces antihypertensive response other prostaglandin inhibitors probably also interact. 

El-Sheikh AA, van den Heuvel JJ, Koenderink JB, et al. Interaction of nonsteroidal anti-inflammatory drugs with multidrug resistance protein (MRP) 2/ABCC2- and MRP4/ABCC4-mediated methotrexate transport. J Pharmacol Exp Ther 2007 320 229-235. 

Phelan KM, Mosholder AD, Lu S. Lithium interaction with the cyclooxygenase 2 inhibitors rofecoxib and cele-coxib and other nonsteroidal anti-inflammatory drugs. J Clin Psychiatry 2003 64 1328-34. 

Greig GM, Francis DA, Falgueyret JP, Ouellet M, Percival MD, Roy P, Bayly C, Mancini JA, O Neill GP. The interaction of arginine 106 of human prostaglandin G/H synfliase-2 wifli inhibitors is not a universal component of inhibition mediated by nonsteroidal anti-inflammatory drugs. Mol. Pharmacol. 1997 52 829-838. 

For a displacement interaction to become clinically important, a second mechanism usually operates sodium valproate can cause phenytoin toxicity because it both displaces phenytoin from its binding site on plasma albumin and inhibits its metabolism. Similarly aspirin and probenecid (and possibly other nonsteroidal anti-inflammatory drugs) displace the folic acid antagonist methotrexate from its protein-binding site and reduce its rate of active secretion by the renal tubules the result is serious methotrexate toxicity. 

Pignatello, R. Eerro, M. Puglisi, G. Preparation of solid dispersion of nonsteroidal anti-inflammatory drugs with acryhc polymers and studies on mechanisms of drug-polymers interactions. AAPS Pharm Sci Tech 2002,5, 1-11. 

The antihypertensive effect of beta-blockers can be impaired by the concurrent administration of some nonsteroidal anti-inflammatory drugs (NSAIDs), possibly because of inhibition of the synthesis of renal vasodilator prostaglandins. This interaction is probably common to all beta-blockers, but may not occur with aU NSAIDs for example, sulindac appears to affect blood pressure less than indometacin (405-407). 

MasudaS, Saito H, Inui Kl. Interactions of nonsteroidal anti-inflammatory drugs with rat renal organic anion transporter, OAT-K1. J Pharmacol Exp Ther 1997 283 1039-1042. 

Celis H,Thijs L, Staessen JAet al. Interaction between nonsteroidal anti-inflammatory drug intake and calcium-channel blocker-based antihypertensive treatment in the Syst-Eur trial. Journal of Human Hypertension 2001 5 613-618. 

Altman RD, Perez GO, SfakianakisGN. Interaction ofcyclosporine Aand nonsteroidal anti-inflammatory drugs on renal function in patients with rheumatoid arthritis. Am J Med 1992 93 396-402. 

In two of the five spontaneous bleeding episodes described in Heading 4, medications that can affect platelet function or prothrombin time (PT) (i.e., aspirin and warfarin) were involved. Because GB is known to be an inhibitor of PAF (41), in theory GB could interact with antiplatelet drugs (e.g., aspirin, nonsteroidal anti-inflammatory drugs, clopidogrel, ticlopidine, dipyridamole) or anticoagulants (e.g., warfarin, heparin). EGb 761 was shown to potentiate the antiplatelet effect of ticlopidine in rats (42). However, in two studies in humans, the coadministration of GB with warfarin had no effect on either international normalized ratio or warfarin metabolism (43,44). 

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