Dicumarol

If die tricyclics are administered witii the MAOIs, the patient is at risk for hypertensive episodes, severe convulsions, and hyperpyretic episodes. Use of the MAOIs must be discontinued at least 2 weeks before treatment witii the tricyclics begins. The tricyclics may prevent the therapeutic effect of many antihypertensives. When the tricyclics are administered with dicumarol, the risk for bleeding increases. 

Another important function of albumin is its ability to bind various ligands. These include free fatty acids (FFA), calcium, certain steroid hormones, bilirubin, and some of the plasma tryptophan. In addition, albumin appears to play an important role in transport of copper in the human body (see below). A vatiety of drugs, including sulfonamides, penicilhn G, dicumarol, and aspirin, are bound to albumin this finding has important pharmacologic implications. 

Pearce R, Greenway D, Parkinson A (1992) Species differences and interindividual variahon in liver microsomal cytochrome P450 2A enzymes effects on coumarin, dicumarol, and testosterone oxidation. Arch Biochem Biophys 298 211-225 Pelkonen O, Sotaniemi EA, Ahokas JT (1985) Coumarin 7-hydroxylase activity in human hver microsomes. Properties of the enzyme and interspedes comparisons. Br J Clin Pharmacol 19 59-66... 

Substances that bind Ca "" ions (e. g., citrate) prevent Gla-containing factors from attaching to the membrane and therefore inhibit coagulation. Antagonists of vitamin K, which is needed for synthesis of the Gla residues (see p. 364) also have anticoagulatory effects. These include dicumarol, for example. 

Anisindione and dicumarol or their metabolites may be excreted in breast milk in... 

Drugs that may be affected by tricyclic compounds include anticholinergics, carbamazepine, clonidine, dicumarol, grepafloxacin, guanethidine, levodopa, quinolones, sparfloxacin, and sympathomimetics. 

Acetaminophen Amiodarone Carbamazepine Cardiac glycosides Corticosteroids Dicumarol Disopyramide Doxycycline Estrogens Haloperidol Methadone Metyrapone Mexiletine Oral contraceptives Quinidine Theophylline Valproic acid Cyclosporine Dopamine Furosemide Levodopa Levonorgestrel Mebendazole Nondepolarizing muscle relaxant Phenothiazines Sulfonylureas... 

Drugs that may be affected by antacids include allopurinol, amphetamines, benzodiazepines, captopril, chloroquine, corticosteroids, dicumarol, diflunisal, digoxin, ethambutol, flecainide, fluoroquinolones, histamine H2 antagonists,... 

Magnesium Oxide (Mag-Ox 400, Others) [OTC] [Antacid, Magnesium Supplement/Magnesium Salt] Uses R lace low Mg levels Action Mg supl Dose 400-800 mg/d daily-qid w/ full glass of HjO Caution [B, +] Contra UlcCTative colitis, diverticulitis, ileostomy/colostomy, heart block, renal insuff Disp Caps 140 mg tabs 400 mg (OTC) SE D, N Inter actions X Effects OF chlordiaz oxide, dicumarol, digoxin, indomethacin, INH, quinolones, tetracyclines EMS Monitor ECG for hypokalemia (flattened T waves) OD Unlikely to cause life-threatening Sxs, but may cause D, constipation, cramps, and abd pain symptomatic and supportive... 

The most common group of drugs that produce vitamin K deficiency are the coumarin anticoagulants. The hy-poprothrombinemic effects of dicumarol can be overcome by administration of vitamin K. 

Allopurinol, chloramphenicol, isoniazid Antipyrine, dicumarol, probenecid, tolbutamide... 

Tolbutamide is well absorbed but rapidly metabolized in the liver. Its duration of effect is relatively short, with an elimination half-life of 4-5 hours, and it is best administered in divided doses. Because of its short half-life, it is the safest sulfonylurea for elderly diabetics. Prolonged hypoglycemia has been reported rarely, mostly in patients receiving certain drugs (eg, dicumarol, phenylbutazone, some sulfonamides) that inhibit the metabolism of tolbutamide. 

Dicumarol Minimal No adverse side effects reported may wish to follow infant s prothrombin time. 

Chloramphenicol [NE] Decreased dicumarol metabolism (probably also warfarin). 

Hypoglycemics, oral [P] Dicumarol inhibits hepatic metabolism of tolbutamide and chlorpropamide. 

Melilotus alba Medicus M. indica (L.) All. M. suaveolens Ledeb. Be Han Cao (Clover) (whole plant) Hydroxycinnamic acid, coumarinic acid, 4-hydroxycinnamic acid, cumaric acid, umbelliferone, scopoletin, melilotoside, melilotic acid, beta-D-glucosyloxy, dicumarol, chlogogenic acid, caffeic acid, melilotic acid.48 Anticoagulant, treat bowel complaints, infantile diarrhea. A bactericide. 

Thanos CG, Liu Z, Reineke J, Edwards E, Mathiowitz E. Improving relative bioavailability of dicumarol by reducing particle size and adding the adhesive poly(fumaric-co-sebacic) anhydride. Pharm Res 2003 20(7) 1093-1100. 

In retrospect, it seems probable that the medical profession gained far more from Link s successes as an agricultural chemist than it could have from his practice of medicine. The discovery of Dicumarol and its adoption as an important clinical anticoagulant, and the synthesis of Warfarin and its development as a widely used rodenticide—these accomplishments, which will not be described in this article, alone were more than sufficient to make Karl Link an important name in science. For his work on Dicumarol, Link received the Cameron Award from the University of Edinburgh in 1952, the Lasker Award in 1955 and 1960, the John Scott Award in 1959, and the Kovalenko Medal of the National Academy of Sciences in 1967. He was a Harvey Lecturer... 

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