Precautions cardiovascular

General precautions for each medication that has been used for smoking cessation are listed in the sections describing each medication. All FDA-approved first-line medications for smoking cessation have a relatively good safety profile. Consensus opinions on the safety of the various medications for persons with cardiovascular disease, other medical conditions, and pregnancy are beyond the scope of this chapter but can be found elsewhere (Society for Research on Nicotine and Tobacco 2003). 

The conclusion that can be drawn from these studies is Putting the patient on cardiac monitoring is a legitimate precaution that allows the doctor to act immediately in case of cardiovascular complication. On the other hand, not monitoring the patient does not necessarily make the prognosis for complications any worse, and most of the time they seem to resolve spontaneously. 

The three marketed phosphodiesterase inhibitors differ in their pharmacokinetic profiles, drug-food interactions, and adverse effects, and precautions are necessary in patients with cardiovascular disease (Table 81-5). Because sildenafil has been marketed longer and is better studied, it is emphasized in this section, with important differences among the three drugs highlighted as appropriate. 

As for nearly all beta antagonists, the main cardiovascular indications for pindolol are hypertension, angina pectoris, and arrhythmias. The usual warnings and precautions for beta antagonists also apply to pindolol (see also Figure 69). 

ADVERSE EFFECTS AND PRECAUTIONS The adverse effects of minoxidil can be severe and are divided into three major categories fluid and salt retention, cardiovascular effects, and hypertrichosis. 

Precautions An alkoloid (group of nitrogenous organic compounds, mostly used as pain relievers such as cocaine, quinine, caffeine) from tobacco. A deadly human poison. A human teratogen (abnormal fetal development) by swallowing, causes developmental abnormalities of the cardiovascular system. Causes blood pressure effects. Can be absorbed by intact skin. 

Toxicology LD50 (oral, rat) 1480 mg/kg corrosive to eyes, by ingestion irritating to skin, mucous membranes poisoning may affect liver, kidneys, circulatory, cardiovascular, and central nervous systems Precaution Incompat. with alkalis arsenic trioxide and sodium nitrate (spontaneously combustible mixt.) methyl isocyanoacetate (may dec. violently at 25 C)... 

Cardiovascular Transient acute decompensated heart failure occurred in a 19-year-old patient after administration of intravenous propofol 150 mg and fentanyl 100 micrograms [81 ]. Additional precautions should be taken when such drug combinations are used, even in those with normal left ventricular function. 

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