Adverse effects cardiovascular

The Class I agents have many similar side effects and toxicities. The anticholinergic side effects include dry mouth, constipation, and urinary hesitancy and retention. Common gastrointestinal (GI) side effects include nausea, vomiting, diarrhea, and anorexia. Cardiovascular adverse effects are hypotension, tachycardia, arrhythmias, and myocardial depression, especially in patients with congestive heart failure. Common central nervous system (CNS) side effects are headache, dizziness, mental confusion, hallucinations, CNS stimulation, paraesthesias, and convulsions. 

The cardiovascular adverse effects associated with quinidine therapy are hypotension and tachycardia, both of which are related to its a-adrenoceptor blocking actions. The tachycardia may be a reflex adjustment to the fall in blood pressure or may also be a direct action of the dmg on sympathetic nerve terminals leading to an increased release of NE. Quinidine also produces ringing in the ears (cinchonism) (1,2). 

The important adverse effects of the various antidepressants are often a function of their underlying pharmacologic profiles7,8 (Table 35-3). TCAs cause problematic sedative, anticholinergic, and cardiovascular adverse effects owing to their interaction with dirty receptors. While these adverse effects generally are considered to be common and bothersome, they can be quite serious in certain cases. For example, constipation in its... 

The SSRIs produce fewer sedative, anticholinergic, and cardiovascular adverse effects than the TCAs and are less likely to cause weight gain than the TCAs. The primary adverse effects include nausea, vomiting, diarrhea, headache, insomnia, fatigue, and sexual dysfunction. A few patients have anxiety symptoms early in treatment. 

There are few absolute contraindications, but several points should be considered. Medications that produce changes in sinus node or AV nodal conduction may potentiate the cardiovascular adverse effects of the a2 agonists. This may be particularly relevant for concomitant administration of beta-blockers, which, similar to the agonists, have been used to treat aggression. 

This report highlights the risk of cardiovascular adverse effects with short courses of glucocorticoid therapy in elderly patients with inflammatory bowel disease, even with rather low-dosage regimens. Acute myocardial infarction occurred in an old man with coronary insufficiency and giant cell arteritis after treatment with prednisolone (SEDA-10, 343) but could well have been coincidental. 

In a randomized study of men treated hormonally for prostatic cancer (3), cardiovascular adverse effects were reported more often in patients treated with diethylstilbestrol than in those treated with cyproterone acetate. The risk was highest during the first 6 months of treatment. 

The most common cardiovascular adverse effects are palpitations, tachycardia, and elevated blood pressure. The most common adverse CNS reactions are over-stimulation, restlessness, dizziness, insomnia, euphoria, dyskinesia, tremor, and headache. The most common adverse gastrointestinal reactions are dryness of mouth, unpleasant taste, diarrhea, and constipation. Other adverse reactions can include urticaria, impotence, and/or changes in libido (137). 

Amphetamines and similar central nervous system stimulants have been available for many years, but the substantial abuse liability and potential cardiovascular adverse effects have largely limited their use to the treatment of narcolepsy and attention-deficit-hyperactivity disorder. There has also been some utilization of amphetamines to combat sleepiness during military operations. 

A randomized comparison of brofaromine with imi-pramine in inpatients with major depression showed that brofaromine was as effective as imipramine in the treatment of major depression but had a different adverse effects profile (1). Brofaromine was more likely to cause sleep disturbances but lacked the anticholinergic and certain cardiovascular adverse effects of imipramine. 

Venlafaxine Bicyclic cyclohexanol Serotonin and noradrenaline uptake inhibitor Nausea, sexual dysfunction, and cardiovascular adverse effects... 

One of the putative benefits of mianserin is its alleged safety in overdose, which may be related to a reduced risk of cardiovascular adverse effects and convulsions. Data from the UK Committee on Safety of Medicines suggest that mianserin accounts for 11% of reported convulsions and 5.8% of use, putting it intermediate between amitriptyline and maprotiline (15). On the other hand, in the London Poisons Unit survey, involving 84 patients who took mianserin alone (up to 1000 mg), there were no deaths and no patients with convulsions, although this could represent a frequency of up to 3.6% (12). 

Of 86 439 patients who had been exposed to neuroleptic drugs, 59 developed a cardiovascular adverse effect (116). Among the commonly used neuroleptic drugs, the highest rate of cardiovascular adverse effects was found for... 

Buckley NA, Sanders P. Cardiovascular adverse effects of antipsychotic drugs. Drug Saf 2000 23(3) 215-28. 

In a retrospective review, 33 mentally retarded patients were evaluated adverse effects were mild and transient, constipation being the most common (n = 10) (12). There were no significant cardiovascular adverse effects and no seizures no patient discontinued treatment because of agranulocytosis. Small sample sizes, short durations of treatment, and lack of controls in these studies preclude definite conclusions. 

Hypotension is the most commonly observed cardiovascular adverse effect of neuroleptic drugs, particularly after administration of those that are also potent alpha-adrenoceptor antagonists, such as chlorpromazine, thioridazine, and clozapine (34). A central mechanism involving the vasomotor regulatory center may also contribute to the lowering of blood pressure. 

Data from an open study (n = 329) have suggested that patients aged 55-64 years may have a better response to clozapine than those aged 65 and older, but there were no significant differences between the two age groups in the number of patients remaining on clozapine therapy and the number in whom therapy was discontinued (n = 134) (223). The mean duration of clozapine therapy was 278 days. The most common adverse effects that required withdrawal were sedation (n = 12), hematological adverse effects (n = 7), and cardiovascular adverse effects (n = 6). 

Hypotension is the most commonly observed cardiovascular adverse effect of neuroleptic drugs, particularly after administration of those that are also potent alpha-... 

The respiratory and cardiovascular adverse effects of topical therapy with timolol or betaxolol have been studied in a randomized, controlled trial in 40 elderly patients with glaucoma (83). Five of the 20 allocated to timolol discontinued treatment for respiratory reasons, compared with three of the 20 patients allocated to betaxolol There were no significant differences in mean values of spirometry, pulse, or blood pressure between the groups. This study confirms that beta-blockers administered as eye-drops can reach the systemic circulation and that serious adverse respiratory events can occur in elderly people, even if they are screened before treatment for cardiac and respiratory disease. These events can occur using either the selective betaxolol agent or the non-selective timolol. 

Nausea, vomiting, bradycardia, backache, shivering, and hypotension can occur with a similar incidence to that of Udocaine (SED-12, 256) (1). It has been suggested that bucricaine is more potent than Udocaine and has few cardiovascular and nervous system adverse effects in animals, at high doses. One study in humans suggested that bucricaine may be associated with fewer cardiovascular adverse effects than Udocaine, but there are insufficient data to confirm this impression (2). 

Long-term use and cardiovascular adverse effects of cardiac glycosides... 

With doses up to eight times the EDgs no cardiovascular adverse effects were observed (8) and in other studies cisatracurium had only minor cardiovascular adverse effects (9,11,12). Patients with coronary artery disease undergoing myocardial revascularization tolerated cisatracurium doses up to several fold the EDgs well hemodynamic changes from pre- to postinjection were minimal (13,14). 

Tachycardia is the most common cardiovascular adverse effect of clozapine, and atrial fibrillation has also been reported (SEDA-22, 57) (20). 

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