NSAIDs Sildenafil

Isosorbide Dinitrate Hydralazine (BiDil) [Antianginal, Antihypertensive/Vasodilator, Nitrate] Uses HF in African Amer-icans improve survival functional status, prolong time between hospitalizations Action Relaxes vascular smooth muscle peripheral vasodilator Dose Initially 1 tab tid PO (if not tol ated reduce to 1/2 tab tid), titrate >3-5 d as tolerated Max 2 tabs tid Caution [C, /-] recent MI, syncope, hypovolemia, hypotension, hep impair Contra For children, concomitant use w/ PDE5 inhibitors (sildenafil) Disp Tabs SE HA, dizziness, orthostatic hypotension, sinusitis, GI distress, tach, paresthesia, amblyopia Interactions t Risk of severe hypotension W/ antihypertensives, ASA, CCBs, MAOIs, phenothiazides, sildenafil, tadalafil, vardenafil, EtOH X pressor response Wf i -1- effects W7 NSAIDs EMS Use ASA, antihypertensives and CCBs w/ caution, may t hypotension concurrent Viagra-type drug use can lead to profound hypotension concurrent EtOH use can t effects OD May cause N/V, profound hypotension, skin flushing, HA from ICP, bradycardia, confusion, and circulatory collapse activated charcoal may be effective, epi use is contraindicated... 

Nonsteroidal anti-inflammatory medications (NSAIDs) are used for many aches and pains and are available over the counter in such forms as ibuprofen (brand names Motrin and Advil, as well as a generic form), naproxen (brand name Aleve and a generic form), and others. There have been reports of depression, anxiety, paranoia, psychosis, and confusion with these medications. Sildenafil (brand name Viagra), used for male sexual dysfunction, has been reported to cause aggression, delusions, hallucinations, mania, paranoia, and confusion in rare cases. Therapists will treat patients who are taking steroids, over-the-counter NSAIDs, and Viagra. When these patients have mental health symptoms, they need to be evaluated by their physician to see if the medication is contributing to the psychiatric symptoms. 

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