Drugs to be avoided in certain circumstances.
Drugs to be avoided in certain circumstances include: -Extreme cold: which may make your lips numb and cause mental confusion. -Dry air: which can dry your throat, making swallowing difficult. -Dust: breathing in dust particles can irritate the lungs and airways. Sometimes, we avoid a drug just because it is known to be unsafe. Sometimes there are no known side effects and other times it may seem that the side effects may pale in comparison to the benefits. The list below contains drugs that we should probably avoid taking if we have certain circumstances.
How to Drugs avoided in certain circumstances?
How to Drugs avoided in certain circumstances? Drugs to be avoided in certain circumstances people often ask the question, of how to avoid drug use or drug addiction. You can always choose not to use drugs. But there are situations that can cause you to use drugs. Therefore, we wrote this comprehensive article about the various types of drugs, including information about how to avoid them, especially for those who are entering college.
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Steroids should be avoided in diabetes patients.
Steroids increase blood sugar levels (hyperglycemia).
Diabetes patients already have high blood sugar levels and this can worsen their diabetes.
Mechanism of hyperglycemia by steroids –
Liver produces more sugar during steroid treatment.
This can cause hyperglycemia even in a normal individual.
In case of a diabetic individual it becomes difficult to control blood sugar with the usual doses of oral hypoglycemics or by insulin.
Steroids make the liver resistant to insulin.
Steroids stimulate the liver to produce glucose and inhibit the peripheral uptake of glucose by the cells.
If the pancreas is not able to make enough insulin to compensate then hyperglycemia results.
Steroids cause insulin resistance by direct interference with signalling cascades -mainly the GLUT-4 transporter in muscle cells .
In some patients admitted to hospital it is compulsory to give u steroids in the form Of methylprednisone.
In that case, the MD General Medicine doctor in charge of the patient will adjust the dosage of insulin so as to keep the blood sugar under control.
But in case of steroids need to be given on an opd basis, then the MD General Medicine doctor will first advise a random blood sugar, and then only here will decide about steroid treatment.
If steroids need to be given to a diabetic patient on an opd basis, then the MD General Medicine doctor will first check the random blood sugar and then adjust the dosage of oral hypoglycemic agents or insulin before starting steroid treatment.
Also, frequent monitoring of the blood sugar during steroid treatment may be required.
NSAIDs(Nonsteroidal anti-inflammatory drugs)-
These should be avoided in patients with hypertension as they affect the renal function, cause a decrease in glomerular filtration rate, and hence sodium retention, thus leading to increased blood pressure. So it becomes difficult to control the blood pressure in an hypertensive patient who is already on treatment with antihypertensive agents.
Commonly used NSAIDs are Ibuprofen,
Mefenamic acid
Etoricoxib
Diclofenac sodium
Naproxen
Whenever you visit any MD General Medicine doctor you should inform him of any preexisting illness, so that he will avoid giving you certain drugs.
Mostly he will ask you about any past medical history, but if he is too busy in his schedule it is your duty to remind him.
Drugs to be avoided in certain situations and are called contraindicated. While others can be taken in the right circumstances, like narcan, but some of them should never be used by yourself. Narcan is not approved by the FDA for use as an emergency treatment or to reverse addiction or overdose.
Ibuprofen and Diclofenac sodium –
These should be avoided in patients with bronchial asthma as they cause bronchospasm and hence can aggravate the symptoms of bronchial asthma.
Long-term use of benzodiazepines-
This should be avoided in patients with bronchial asthma as they aggravate bronchial asthma as well as the mortality after aggravation.
Long-term use of NSAIDS in gastric and duodenal ulcers and hyperacidity, and acidity patients should be avoided –
These drugs cause a topical irritant effect on the surface of the epithelium of the gastric and duodenal mucosa.
These drugs impair the barrier properties of the mucosa.
They suppress the prostaglandin synthesis by the gastric mucosa.
They cause a reduction in the amount of blood flowing to the gastric mucosa who is one of the reasons for the development of gastric and duodenal ulcers.
The repairs of superficial injury to the gastric mucosa are interfered with by NSAIDs.
NSAIDs cause inhibition of several growth factors which are required for mucosal repair and defense.
An alternative to NSAIDs lies in Ayurvedic and homeopathic medicines for which consultation must be done with qualified and experienced MD General medicine doctors as well as with Ayurvedic and Homeopathic doctors.
The use of painkiller NSAIDS should be done only and only when it is absolutely essential.
Long-term use of NSAIDs should be avoided in patients with renal failure.
NSAIDs can cause sudden renal failure or progressive renal damage.
They affect renal function, reduce the glomerular filtration rate (GFR), and cause sodium retention.
Due to retention of sodium they can increase the blood pressure and should be cautiously used in patients with hypertension under treatment.
In patients on diuretics, they should be taken only by advice of a physician (MD General medicine) or Nephrologist as diuretics increase the glomerular filtration rate and NSAIDS decrease and so they have opposing actions.
NSAIDs should be used cautiously and with the advice of a qualified and experienced physician (MD-General Medicine ) in patients above 65 yrs of age.
What can I do to prevent renal damage?
Kidney disease caused by analgesics is often preventable.
The following things should be done for this –
NSAIDs should not used for analgesia for more than 10 days for pain or more than three days for fever.
If you have pain or fever for a longer time, you should consult a MD General Medicine doctor.
Avoid prolonged use of analgesics that contain a mixture of analgesic ingredients, like aspirin, acetaminophen, and caffeine mixtures in single tablets.
If you are taking analgesics, increase the amount of water you drink to six to eight glasses a day.
If you are taking analgesics, avoid consumption of alcohol
If you have kidney disease, consult the MD General Medicine doctor before taking an analgesic, particularly NSAIDs and higher dose aspirin.
Use NSAIDs under your doctor’s supervision if you have heart disease, high blood pressure, kidney disease, or liver disease or if you take diuretic medications or are over 65 years of age
Make sure your doctor knows about all medicines you are taking, even over-the-counter medicines.
Always read the warning label before using any over-the-counter analgesics.
Avoid anticholinergics in a patient with stress incontinence –
Anticholinergics block the action of acetylcholine.
Acetylcholine sends impulses to the brain that is necessary for causing contractions of the urinary bladder when it is full of urine.
Examples of anticholinergics-
Atropine (Atropen)
belladonna alkaloids.
benztropine mesylate (Cogentin)
clidinium.
cyclopentolate (Cyclogyl)
darifenacin (Enablex)
dicylomine.
fesoterodine
Tricyclic antidepressants are contraindicated in arrhythmias
The reason for this is that they can result in orthostatic hypotension.
If given in high doses they can result in arrhythmias.There are drug interactions between tricyclic antidepressants and other drugs.
Lot of care has to be taken in using these drugs in patients of heart disease.
They should be given under the consultation of a Physician (MD General Medicine ), or a Cardiologist
Examples of tricyclic antidepressants used in the field of Medicine –
Amitriptyline.
Amoxapine.
Desipramine (Norpramin)
Doxepin.
Imipramine (Tofranil)
Nortriptyline (Pamelor)
Protriptyline.
Trimipramine.
Digoxin is contraindicated in AV block –
The reason for this is that digoxin has vagus-like effects on the AV node.
It stimulates the parasympathetic nervous system thus slowing down the conduction along the AV node.
Thus the heart rate is reduced.
When there is already an AV block problems get enhanced when a drug like digoxin is used.
Theophylline is contraindicated in insomnia –
The reason for this is that insomnia is a sign of theophylline toxicity.
And so it is a wise decision to avoid theophylline in insomnia.
Long-term benzodiazepines are contraindicated in depression –
The reason for this is that they cause depression or exacerbate depression.
Calcium channel blockers like Diltiazem should be avoided in constipation because they relax the smooth muscles of the blood vessels and lower blood pressure, but at the same time, they also relax the smooth muscles of the gut, due to which peristalsis cannot take place effectively so constipation results.
Long-term use of NSAIDs should be avoided in patients with osteoarthritis as they cause inhibition of PGE2 synthesis in chondrocytes thereby stopping the body’s inflammatory repair mechanism.
