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    Ati pharmacology midterm proctored exam (ichs)

    Which of the following best describes how grapefruit juice typically interacts with medications?

    Explanation & Rationale

    A. It increases the metabolism of drugs in the liver: Grapefruit juice actually inhibits, rather than increases, the activity of liver enzymes particularly CYP3A4 resulting in slower drug metabolism and higher plasma concentrations of certain medications. B. It decreases the absorption of medications: Grapefruit juice does not generally reduce drug absorption. In fact, by inhibiting intestinal enzymes, it can increase the absorption and bioavailability of some drugs, potentially raising them to toxic levels. C. It only affects medications taken in the morning: The interaction is not time-specific. Grapefruit juice can affect drug metabolism even when consumed hours apart from the medication, as enzyme inhibition can persist for up to 24–72 hours. D. It blocks the action of enzymes, leading to increased drug levels in the blood: Grapefruit juice inhibits cytochrome P450 enzymes especially CYP3A4 in the intestinal wall. This results in decreased drug breakdown and higher systemic concentrations, increasing the risk of adverse effects and toxicity.

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