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carvidelol part 2

 محاضرة 5
تكملة    carvidelol


Carvedilol disease Interactions















Bradyarrhythmia :A disturbance of the heart's rhythm resulting in a rate
under 60 beats per minute.






Av Block
occurs when atrial depolarizations fail to reach the ventricles or
when atrial depolarization is conducted with a delay











Hypotension(abnormally low blood pressure)
Cardiogenic Shock:is a state in which a suddenly weakened heart
isn't able to pump enough blood to meet the body's needs.









Diabetes










is a method for removing waste products such as creatinine and
urea, as well as free water from the blood when the kidneys are in renal failure.


























Peripheral vascular disease












means high lipid levels
























Intraocular pressure

is the fluid pressure inside the eye

 

 

 









is a disease characterized by ischaemia (reduced blood supply) of the heart muscle,


chronic autoimmune neuromuscular disease characterized by varying degrees
of weakness of the skeletal (voluntary) muscles of the body






is a condition in which the heart's function as a pump is
inadequate to meet the body's needs.











the kidneys fail to adequately filter toxins and
waste products from the blood.








DRUG INTERACTIONS

*allergy treatments
*cyclosporine(Immunosuppresant)
*fluconazole(antifungal drug)
*insulin or oral diabetes medication;
*Inducers/Inhibitors of Hepatic Metabolism( rifampin)
*an antidepressant drug
*heart or blood pressure medicine such as β-blocking

*a heart rhythm medication (Digitalis Glycosides)

*HIV or AIDS medicine
*medicine to prevent or treat nausea and vomiting
*medicine to treat psychiatric disorders
*a narcotic drug

 

*Catecholamine-depleting agents (eg, reserpine(antipsychotic and antihypertensive drug):
Monitor for hypotension or severe bradycardia.


*Inhibitors of CYP2D6: Expected to increase carvedilol blood levels.


*Rifampin:May reduce carvedilol plasma levels, decreasing the pharmacologic effect.

*Salicylates (eg, aspirin):Increased risk of hypertension due to inhibition
of prostaglandin biosynthesis by salicylates.

*SSRIs) antidepressants(  :Increased risk of excessive beta
blockade (bradycardia) due to increased beta-blocker
serum levels resulting from inhibition
of beta-blocker metabolism (CYP2D6).

*Proton Pump Inhibitorsمضادات للحموضة المعدة

 

*Anesthesia تخدير


Carvedilol Alcohol & Food Interactions




Carvedilol and Alcohol (Ethanol)

 

 

 






Carvedilol and multivitamins with minerals

 

 

 

 

 

 

High Cholesterol (Hyperlipoproteinemia, Hypertriglyceridemia, Sitosterolemia)

 

 

 






 

Carvedilol side effects

Get emergency medical help if you have any of these signs of an allergic
reaction: hives; difficulty breathing; swelling of your face,
lips, tongue, or throat. Call your doctor at
once if you have a serious side
effect such as:
feeling like you might pass out;
slow or uneven heartbeats







bronchospasm (wheezing, chest tightness,
trouble breathing(











feeling short of breath, even with mild exertion










swelling, rapid weight gain










numbness or cold feeling in your hands and feet








high blood sugar (increased thirst, increased urination, hunger, dry
mouth, fruity breath odor, drowsiness, dry
skin, blurred vision, weight loss).






Less serious side effects may include:
dizziness, drowsiness
Drowsiness refers to feeling abnormally sleepy during the day








nausea, vomiting, diarrhea









dry eyes








feeling weak or tired










joint pain










Cough











decreased sex drive, impotence, or difficulty having an orgasm.


Patient Information

Advise patient that medication is started at a low dose and gradually
increased as needed and tolerated.





Instruct patient not to interrupt therapy or
discontinue drug abruptly.








Remind patient to take each dose with food to reduce
risk of orthostatic hypotension.








Caution patient to avoid sudden position changes to prevent orthostatic
hypotension.orthostatic hypotension: is a form of hypotension
in which a person's blood pressure
suddenly falls when the person
stands up or stretches 


.







Instruct patient to lie or sit down if experiencing dizziness
or light-headedness when standing.






Instruct patient in BP and pulse measurement skills.
Instruct CHF patient to measure and record BP, pulse, weight, and symptoms
daily and to report abnormal measurements. Take
record to each follow-up office visit.







Emphasize importance of a healthy lifestyle (eg, weightcontrol,
 regular exercise, smoking cessation, moderate intake  
of alcohol and salt) to hypertensive patient.
Advise patient to separate the administration of this medication from alcohol consumption, including ethanol-containing prescription and
 OTC medicines, by at least 2 h.









Instruct patient not to crush or chew this medication and to swallow whole. Alternatively, capsules may be opened and the beads sprinkled
 over a spoonful of applesauce.
اوعى تمضغ الاقراص  ولو كبسول ممكن يتفتح و يتحط فى عصير
Instruct diabetic patient to monitor blood glucose more frequently
 when dose is changed or drug is stopped. Patient should
 inform health care provider of any changes in readings.





Advise patients who wear contact lenses that drug may cause
decreased tearing and dry eyes.






Instruct patient to report any of these symptoms to health care provider:
 bradycardia, dark urine, fainting or persistent dizziness when arising
 from a sitting or lying position, fatigue, increasing shortness
of breath, persistent anorexia, pruritus, right upper quadrant
 tenderness, swelling of feet or ankles, unexplained flu-like
symptoms, or weight gain.


Caution patient that drug may cause dizziness or fainting and to
avoid driving or performing other hazardous tasks
 until tolerance is determined.





Remind CHF patients that they should be seen by health care provider
 before each dose change and to keep appointments.


 

 

 

Contraindications

*Bronchial asthma or related bronchospastic conditions. Deaths from status
asthmaticus have been reported following single doses of Carvedilol.



*Second- or third-degree AV block.
*


 Sick sinus syndrome. is a group of abnormal heart rhythms















*Severe bradycardia (unless a permanent pacemaker is in place).


 



 Patients with cardiogenic shock or who have decompensated heart failure
requiring the use of intravenous inotropic therapy.
Such patients should first be weaned from intravenous
therapy before initiating Carvedilol.
*Patients with severe hepatic impairment.









*Patients with a history of serious hypersensitivity reaction
 (e.g. Stevens-Johnson Syndrome, anaphylactic reaction,
 angioedema) to any component of this medication or
 other medications containing Carvedilol.
*a serious heart condition such as heart block, sick sinus syndrome, or slow
heart rate (unless you have a pacemaker).

*diabetes (taking carvedilol can make it harder for you to tell when you
have low blood sugar)
*angina (chest pain);
*low blood pressure
*kidney disease;
*liver disease;
*a thyroid disorder;
*pheochromocytoma (tumor of the adrenal gland);
*circulation problems (such as Raynaud's syndrome)
*a history of allergies.



لينكات المحاضرات السابقة



Reference
Drugs.com


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