NSAIDs Tricyclic antidepressants

Antipsychotics, bromocriptine, carbamazepine, chlorpropamide, cyclophosphamide, desmopressin, ecstasy, lamotrigine, monamine oxidase inhibitors, NSAIDs, oxcarbazepine, oxytocin, tricyclic antidepressants, selective serotonin reuptake inhibitors, vasopressin, vinblastine, and vincristine... 

FIGURE 30-2. Pain algorithm. AED, antiepileptic drug APAP, acetaminophen NSAID, non-steroidal antiinflammatory drug SNRI, serotonin-norepinephrine reuptake inhibitor SSRI, selective serotonin reuptake inhibitor TCA, tricyclic antidepressant. 

SSRIs, selective serotonin reuptake inhibitors TCAs, tricyclic antidepressants NSAIDs, non-steroidal anti-inflammatory drugs. 

Agents Acetaminophen or NSAID combinations with opioids Adjuncts Tricyclic antidepressants Anticonvulsants Radiopharmaceuticals (Bone pain) Acetamnophen (See above) Opioids Titrate Amitriptyline 10-50 mg Imipramine 10-50 mg NSAIDs (See above) Gabapentin (Neurontin) 3.6 g... 

Drugs that may be affected by SSRIs Drugs that may be affected by SSRIs include alcohol, benzodiazepines, beta blockers, buspirone, carbamazepine, cisapride, clozapine, cyclosporine, diltiazem, digoxin, haloperidol, hydantoins, lithium, methadone, mexiletine, nonsedating antihistamines, NSAIDs, olanzapine, phenothiazines, phenytoin, pimozide, procyclidine, ritonavir, ropivacaine, sumatriptan, sulfonylureas, sympathomimetics, tacrine, theophylline, tolbutamide, tricyclic antidepressants, and warfarin. 

Altered homeostasis in older persons can lead to important and common adverse drug effects the less robust homeostatic milieu may be stressed by drugs, causing adverse effects. Examples include orthostatic hypotension due to antihypertensives and other agents that cause a-adrenergic blockade (e.g. terazosin, doxazosin, tricyclic antidepressants and phenothiazines) in those with barorecep-tor dysfunction. Diuretics can cause hyponatraemia or hypokalaemia in older patients, whereas ACE inhibitors and NSAIDs can cause hyperkalaemia. 

Antihypertensives, diuretics, antipsychotics, tricyclic antidepressants, levodopa, dopamine agonists, a-blockers Corticosteroids NSAIDs, anticoagulants -Blockers (non-selective)... 

The cause of the pain should first be assessed. A tricyclic antidepressant is appropriate for neuropathic pain due to neoplastic extension to peripheral nerves, a corticosteroid for nerve entrapment, an opioid for a liver distended with metastatic disease, a NSAID for bony secondaries. 

ACE-I, indicates angiotensin converting-enzyme inhibitor BP, blood pressure CNS, central nervous system GI, gastrointestinal INR, international normalization ratio K+, potassium NSAID, non-steroidal anti-inflammatory drug SSRI, selective serotonin receptor inhibitor TCA, tricyclic antidepressant. 

Clinically important, potentially hazardous interactions with aminophylline, amiodarone, antacids, antineoplastics, arsenic, bepridil, bismuth, bismuth subsalicylate, bretylium, calcium salts, cocoa, didanosine, disopyramide, duloxetine, erythromycin, iron, magnesium salts, meptazinol, methylxanthines, NSAIDs, phenothiazines, procainamide, quinidine, rasagiline, sotalol, sucralfate, tizanidine, tricyclic antidepressants, zinc... 

Chronic pain Surgery, NSAIDs, opiates, tricyclic antidepressants, antiepileptic drugs Sedation, pain relief... 

CGRP calcitonin gene-related peptide GABA y-aminobutyric acid 5-HT serotonin, 5-hydroxytryptamine IHS International Headache Society MAOIs monoamine oxidase inhibitors NSAIDs nonsteroidal anti-inflammatory drugs SSRI selective serotonin reuptake inhibitor TCA tricyclic antidepressant... 

The major receptor-mediated adverse effect is water intoxication, which can occur with desmopressin or vasopressin. Many drugs, including carbamazepine, chlorpropamide, morphine, tricyclic antidepressants and NSAIDs, can potentiate the antidiuretic effects of these peptides, while lithium, demeclocycline and ethanol can attenuate the antidiuretic response to desmopressin. Desmopressin and vasopressin should be used cautiously when a rapid increase in extracellular water may impose risks (e.g., in angina, hypertension, and heart failure) and should not be used in patients with acute renal failure. Patients receiving desmopressin to maintain hemostasis should be... 

B. Selective serotonin reuptake inhibitors. Studies have shown that citalopram and serotonin in doses of 20 0 mg/day are effective in the treatment of painful diabetic neuropathy but not as efficacious as tricyclic antidepressants [29], However, they do have less adverse effects, and accordingly they are recommended to be given to patients that do not tolerate tricyclic antidepressants. Upper gastric bleeding is a reported adverse effects and concomitant use of NSAID increases this risk. 

NSAIDs nonsteroidal anti-inflammatory drugs, SSRI selective serotonin reuptake inhibitors, TCA tricyclic antidepressants Wang et al. (2014)... 

ICI 58834) is an oxazine chemically distinct from the tricyclics and tetracyclics monoamine uptake inhibitors, and has been used as an oral ANTIDEPRESSANT, viloxazine hydrochloride viloxazine, viminol [inn] is a pyrrole, and is a nsaid analgesic and... 

Consider also Opioids + Phenothiazines , p.l80, Opioids + NSAIDs , p.l77, and Opioids + Tricyclic and related antidepressants , p.l87. 

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