Question

1-Which of the following combinations is contraindicated?

Diltiazem and atenolol

Sildenafil and nitroglycerin

Nifedipine and diltiazem

Diltiazem and isosorbide mononitrate

2-A patient got severe thrombocytopenia as a result to treatment with UFH and still requires parenteral anticoagulant drugs. The patient will most probably be treated with which of the following?

Plasminogen

Abciximab

Vitamin K

Tirofiban

Argatroban

Answer 1

1- sildenafil and nitroglycerin are contraindicated because nitroglycerin is a potent vasodilator and sildena fil decrease the consumption of cAMP causing decrease in blood pressure this combined effect will leads to hypotensive crisis that is an emergency condition.

Rest of the combination do not have any advrese drug reaction hence not contraindicated.

2-argatroban

In case of heparin induced thrombocytopenia , direct thrombin inhibitors like argatroban is usd to treat the condition.

Rst of the drugs are not used as they worsen thrombocytopenia.

Hope this helps. Al the best?