Sunday 13 July 2014

Drug Interactions of OTC Analgesics (Part 2):

Drug Interactions of Aspirin:




More presentations from Naina Mohamed Pakkir Maideen

Ø Aspirin or Acetyl salicylic acid (ASA) is an OTC analgesic which can cause potentially serious adverse effects when used in combination with other common medications such as anticoagulants, corticosteroids, or antihypertensive agents.
Ø Coadministration of the Ketorolac and aspirin is contraindicated, because of the cumulative risks of serious NSAID-related adverse events (peptic ulcers, gastrointestinal bleeding, and/or perforation).
Ø It is contraindicated to use live influenza virus vaccine and aspirin in children 2 to 17 years of age due to the potential for Reye's syndrome.
Ø The risk of Reye's syndrome is also enhanced by the use of aspirin within six weeks of Varicella vaccine administration.
Ø The risk of bleeding is increased by aspirin in patients taking Warfarin, Heparin, Low Molecular Weight Heparins (LMWHs) (Enoxaparin, Dalteparin, Tinzaparin, etc.), Coumarins and other anticoagulants (Acenocoumarol, Dicumarol, Phenprocoumon, Anisindione, Phenindione), Antiplatelets (Clopidogrel, Prasugrel, Ticagrelor, Ticlopidine, Dipyridamole, Abciximab, Eptifibatide, Tirofiban), Tissue Plasminogen Activators (Alteplase, Reteplase), Direct thrombin inhibitors (Dabigatran, Desirudin, Lepirudin, Bivalirudin, Argatroban), Direct factor Xa inhibitors (Apixaban, Rivaroxaban), Anagrelide, Cilostazol, Selective serotonin reuptake inhibitors (SSRIs) (Escitalopram, Fluvoxamine, Paroxetine, Vortioxetine,  Sertraline, Nefazodone, vilazodone) and Selective serotonin and norepinephrine reuptake inhibitors (SNRIs) (Venlafaxine, Desvenlafaxine, Duloxetine, Milnacipran, Levomilnacipran, Sibutramine).
Ø The risk of gastrointestinal adverse effects (ulceration, bleeding, perforation) is increased by the concomitant use of aspirin and NSAIDs (Ketoprofen, Naproxen, Meloxicam, Piroxicam) and Corticosteroids (Betamethasone, Prednisone, Prednisolone, Methyl prednisolone, Dexamethasone, Paramethasone, Triamcinolone).
Ø Due to additive hypoglycemic effect of aspirin, it may increase the risk of Hypoglycemia in patients taking Antidiabetics (Insulin, Sulfonylureas).
Ø Concomitant use of aspirin and ACE Inhibitors (Captopril, Enalapril, Imidapril, Temocapril, Delapril, Ramipril, Perindopril, Cilazapril) and Angiotensin II receptor blockers (ARBs) (Losartan, Valsartan, Telmisartan) may leads to decreased antihypertensive effects.
Ø Ethanol consumption should be avoided within 12 hours of aspirin ingestion to prevent gastrointestinal blood loss.
Ø Aspirin is not recommended during pregnancy, particularly in the third trimester due to reported teratogenic and other effects.
Ø Aspirin is considered unsafe during breastfeeding, due to its association with Reye's Syndrome in children.
Ø Patients should thoroughly read the labels of all over-the-counter and prescription medicines.
Ø Patients should talk to their doctor or pharmacist before taking any new prescription or over the counter medication.
Ø Physicians should be aware of potential drug interactions with OTC medicines when prescribing new medications.
Ø Pharmacists can be instrumental in assisting patients with using OTC medications safely and effectively.
Ø Pharmacists should warn consumers of the risks of misusing OTC pain relievers.

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Drug Interactions of Thiazide Diuretics:

https://www.researchgate.net/publication/342864519_Pharmacodynamic_interactions_of_thiazide_diuretics http://www.ijmdc.com/?mno=51031...