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Ciprofloxacin is weakly bound to serum proteins (20–40%). It is an inhibitor of the drug-metabolizing enzyme cytochrome P450 1A2, which leads to the potential for clinically important drug interactions with drugs metabolized by that enzyme. [5] Ciprofloxacin is about 70% available when administered orally. [3]
In general these drugs produce stimulant and convulsant effects, and are mainly used for counteracting overdoses of sedative drugs. Examples include bicuculline , securinine and metrazol , and the benzodiazepine GABA A receptor antagonist flumazenil .
A box of Lorazepam Orion (Lorazepam) tablets. Lorazepam, sold under the brand name Ativan among others, is a benzodiazepine medication. [14] It is used to treat anxiety (including anxiety disorders), trouble sleeping, severe agitation, active seizures including status epilepticus, alcohol withdrawal, and chemotherapy-induced nausea and vomiting. [14]
Fluoroquinolones have varying specificity for cytochrome P450, so may have interactions with drugs cleared by those enzymes; the order from most P450-inhibitory to least, is enoxacin > ciprofloxacin > norfloxacin > ofloxacin, levofloxacin, trovafloxacin, gatifloxacin, moxifloxacin. [50]
Ativan – a benzodiazepine, used to treat anxiety Asendin ( amoxapine ) – an dibenzoxazepine antidepressant Azstarys ( Serdexmethylphenidate / Dexmethylphenidate ) - a long-acting CNS stimulant used to treat ADHD
Quinidine may interact with chlorpromazine to increase myocardial depression. [5] Likewise, it may also antagonize the effects of clonidine and guanethidine. [5] It also may reduce the seizure threshold and hence a corresponding titration of anticonvulsant treatments should be considered. [5]
Lormetazepam binds to the benzodiazepine receptor which in turn enhances the effect of the GABA A receptor producing its therapeutic effects as well as adverse effects. When lormetazepam binds to the benzodiazepine receptor sites in sufficient quantities it produces sedation which is used clinically as a therapeutic treatment for insomnia.