Question

Please select two drugs or drug classifications and explain the adverse reactions of each and potential drug interactions. Please note any connections between the drug and the side effects/adverse reactions.

Answer 1

Antihypertensive drugs

· Calcium channel blockers (verapamil,nifeipine)

· Beta adrenergic blockers (labetalol)

· Alpha adrenergic blockers(prazosin,terazosin)

· Central sympatholytics(clonidine)

· Vasodailators(minoxidil,hydralazine)

· Diuretics (hydrochlorothiazide)

· ACE inhibitors (captopril)

Adverse effects

• Extra urination
• Erection problems in men
• Weackness ,leg cramps ,fatigue
• Intense and sudden foot pain
• Constipation
• Dizzinees
• Palpitations
• Swollen ankles

Central agonists may lead to

• · Dry mouth
• · Erection problem
• · Fever

Important drug interactions of antihypertensives

1. Diuretics:hypokalemia opposed by concurrent ACE inhibitors
2. Alpha blockers :risk of fluid retention with heart failure opposed by concurrent diuretics
3. Aldosterone blockers :during co therapy with spironolactone for hypertensive heart failure ,danger of hyperkalemia

NSAIDs

Non selective cox inhibitors

· Salycilix acid derivative (aspirin)

· Para aminipheniol derivative (paracetamol)

· Pyralazone derivatives (ketorolac)

· Indol acetic acid derivative (indomethacin)

· Aryl acetic acid derivative (diclofenac)

· Propionic acid derivative (ibuprofen)

· Fenamates

· Oxicams

· Alkanones

·Selecteive cox inhibitors

Prefrentical COX-2 inhibitors

Adverse drug effects

Stomach problems are the most common problem by this drug

• · Irritation or pain
• · Heart burn
• · Gas
• · Constipation or diarrhea
• · Vomiting
• · Nausea

Kidney problems

• · Fluid retention
• · Swollen ankles and feet

Allergic reactions

• · Swollen tips
• · Rash
• · Bruising

Other side effects

• · Dizziness
• · Balance problem
• · Trouble concentrating

Important drug interactions of NSAIDs

• · most NSAIDs do not have clinically important interactions with oral hypoglycemic agents whereas phenylbutazone, azaprozone & aspirin prolong their half-life
• · Lithium clearance may be decreased by indomethacin, piroxicam, phenylbutazone and diclofenac
• · Methotrexate (MTX) may be displaced from its binding protein sites by NSAIDs

Interaction of antihypertensive drugs with anti-inflammatory drugs

We know that NSAIDs can induce an increase in blood pressure and may potentially reduce the efficacy of several high BP drugs.the main mechanism of action is inhibition of prostaglandin synthesis since NSAIDs have higher propensity to increase BP as te regulation of BP is is more PG dependant .But actually in contrast NSAIDs do not interact with calcium antagonist and central acting drugs . NSAIDs may counteract the PG-dependent vasodilatory tone in renal and extrarenal vascular beds that mediate the antihypertensive action of some drugs.