Renal angina

As with all antidepressants, the TCAs are used cautiously in patients witii hepatic or renal impairment. The tricyclics are used cautiously in patients witii heart disease, angina, paroxysmal tachycardia, increased intraocular pressure, prostatic hypertrophy, or a history of seizures. 

Angina is a common problem in older adults When an older adult requires an antianginal drug, the dosage maybe reduced to compensate for impaired renal function or heart disease. Older patients are at increased risk for postural hypotension. Blood pressure and ability to ambulate should be monitored closely. 

Niacin is contraindicated in patients with known hypersensitivity to niacin, active peptic ulcer, hepatic dysfunction, and arterial bleeding. The drug is used cautiously in patients with renal dysfunction, high alcohol consumption, unstable angina, gout, and pregnancy (Category C). 

Uses Acute migraine Action S otonin 5-HTi rec tor antagonist Dose 1—2.5 mg PO once r eat PRN in 4 h 5 mg/24 h max -1- in mild renal/hepatic insuff, take w/ fluids Caution [C, M] Contra Sev e renal/hepatic impair, avoid w/ angina, ischemic heart Dz, uncontrolled HTN, cerebrovascular synds, CTgot use Disp Tabs SE Dizziness, sedation, GI upset, paresthesias, ECG changes, coronary vasospasm, arrhythmias Interactions T Effects W/ MAOIs, SSRIs T effects OF CTgot drugs X effects W7 nicotine EMS May T PR or CyT int val, monitor ECG OD May cause profound HTN and cardiac ischemia symptomatic and supportive... 

Dosage in renal impairment (Hypertension) 2.5 mg/day. (Angina) 5 mg/day. Contraindications Severe hypotension Side Effects... 

Dosage in renal impairment Clearance of enoxaparin is decreased when creatinine clearance is less than 30 ml/min. Monitor patient and adjust dosage as necessary. When enoxaparin is used in abdominal, hip, or knee surgery or acute illness, the dosage in renal impairment is 30 mg once a day. When enoxaparin is used to treat DVT, angina, or MI the dosage in renal impairment is 1 mg/kg once a day. 

Toxicities include elevation of liver enzymes with some risk of liver damage, renal impairment, and teratogenic effects. A low frequency of cardiovascular effects (angina, tachycardia) was reported in clinical trials of leflunomide. 

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