Development adverse effects

Sildenafil and vardenafil decrease systolic/diastolic blood pressure by 8 to 10/5 to 6 mm Hg for 1 to 4 hours after a dose. Although most patients are asymptomatic, multiple antihypertensives, nitrates, and baseline hypotension increase the risk of developing adverse effects. Although tadalafil does not decrease blood pressure, it should be used with caution in patients with cardiovascular disease because of the inherent risk associated with sexual activity. 

Antipsychotics are a chemically diverse group of drugs having in common the ability to ameliorate psychotic symptoms. Unfortunately, a significant percentage of patients fail to respond adequately or may develop adverse effects such as acute EPS, various tardive syndromes (e.g., TD, dystonia, etc.), and, less commonly, even more serious adverse events such as NMS and agranulocytosis. 

In 33 patients with type 2 diabetes treated with sulfo-nylureas and insulin who took miglitol 50 mg bd for 1 week and then over the next month increased the dose to 50 mg tds, 15% developed adverse effects (6% diarrhea, 6% abdominal distension), which disappeared within 3 weeks of continuing therapy (42). 

Four patients developed adverse effects attributable to combinations of benzodiazepines with tricyclic antidepressants, including exacerbations of delusional thought disorders (167). 

However, in severe hepatic disease, not only is hepatic blood flow reduced but the degree of liver damage may influence intrinsic clearance to the extent that it also affects total drug clearance. Consequently, patients with hepatic disease are at particular risk of developing adverse effects to high extraction ratio drugs. 

Negative reactors, who develop adverse effects when given a placebo, exist but, fortunately, are fewer. 

Young patients are more likely to develop adverse effects in the skin (223). 

Overdose, which may be absolute or relative (due to impaired renal excretion or in elderly patients who develop adverse effects at lower dosages), leads to severe hypotonia, mental confusion and somnolence, respiratory depression, and eventually apnea, bradycardia, cardiac conduction abnormalities, hypotension, and coma. Convulsions can occur and hypertension has been reported. It is possible that during recovery the picture may be complicated by an acute withdrawal syndrome, with agitation, psychosis, tremor and dystonic movements, convulsions, and hallucinations (SEDA-11, 126) (36 0). 

Most individuals can consume 400 mg of glycyrrhizin daily without adverse effects, but some individuals develop adverse effects following regular daily intake of as little as 100 mg of glycyrrhizin (33). 

Of 56 patients with autoimmune diseases who received high dosages of intravenous immunoglobulin, 20 had at least one adverse effect after one or more courses of treatment (12). The most frequently reported adverse effects were low-grade fever, headache, and chills. The authors concluded that the occurrence of adverse effects with intravenous immunoglobulin was not related to the clinical response to treatment. However, patients who developed adverse effects during the first course of treatment were more at risk of adverse effects during subsequent courses. 

The adverse effects of somatropin differ between adults and children. In adults, adverse effects are commoner in men, in heavier patients, and in adult-onset growth hormone deficiency. Efficacy is no greater in those who develop adverse effects. The higher rate of adverse effects is due to the higher dose of somatropin when calculated according to body weight, and also to lower sensitivity to somatropin in women than in men (2-4). Rapid dose... 

Data on the co-administration of benzodiazepines with mociobemide have revealed contradictory results some reports suggest that there are no clinically significant interactions with the combined use, but other studies suggest a greater risk (incidence increasing by up to 100%) of developing adverse effects, usually related to moclobemide (mainly sedation). 

A report describes both an increase and a decrease in serum cycloserine levels in some subjects, which were apparently caused by isoniazid however, the mean level of cycloserine was not significantly changed. Only one out of 11 patients taking cycloserine alone developed adverse effects (drowsiness, dizziness, unstable gait), but when isoniazid was added, 9 of the 11 developed these effects. The manufacturers recommend monitor-... 

The concurrent use of a tricyclic antidepressant and lithium can be successful in some patients, but others may develop adverse effects, a few of them severe. Cases of neurotoxicity, the serotonin syndrome and the neuroleptic malignant syndrome have been reported. 

Isolated reports describe two patients taking phenelzine who developed adverse effects (including headache and insomnia) after taking ginseng. 

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