Site icon Dr. Sagar S.

Drugs to be avoided in certain circumstances?

Drugs to be avoided in certain circumstances?

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.

Before  going  through  this  article  please go  through our article  –Drugs to be avoided in certain circumstances
For  this  article  please click on the link given below
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
Diclofenac sodium
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)
cyclopentolate (Cyclogyl)
darifenacin (Enablex)
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 –
Desipramine (Norpramin)
Imipramine (Tofranil)
Nortriptyline (Pamelor)

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.
Exit mobile version