Stimulants contraindications

Extracts of ephedra contain ephedrine, a CNS stimulant contraindicated in persons who suffer from insomnia. The peripheral effects of ephedrine in overdose can be lethal. The answer is(E). 

Discuss the uses, general drug actions, general adverse reactions, contraindications, precautions, and interactions of the central nervous system stimulants. 

The CNS stimulants are contraindicated in patients with known hypersensitivity or severe hypertension, in newborns, and in patients with epilepsy or convulsive... 

The GI stimulants are contraindicated in patients witii known hypersensitivity to the drug, GI obstruction, gastric perforation or hemorrhage, or epilepsy. These drugs are secreted in breast milk and should not be used during lactation. 

The unstimulated serum cortisol and rapid ACTH stimulation tests are useful in the diagnosis of adrenal crisis (Table 42-2). The insulin tolerance test is contraindicated owing to preexisting hypoglycemia. The metyrapone test is also contraindicated because metyrapone inhibits cortisol production. 

PAD is a coronary artery disease risk equivalent, andaBPgoaloflower-extremity PAD CCBs may also be beneficial. /3-Blockers have traditionally been considered problematic because of possible decreased peripheral blood flow secondary to unopposed stimulation of a-receptors that results in vasoconstriction. However, /3-blockers are not contraindicated in PAD and have not been shown to adversely affect walking capability. 

Metformin, a biguanide derivative, can lower excessive blood glucose levels, provided that insulin is present Metformin does not stimulate insulin release. Glucose release from the liver is decreased, while peripheral uptake is enhanced. The danger of hypoglycemia apparently is not increased. Frequent adverse effects include anorexia, nausea, and diarrhea Overproduction of lactic acid (lactate acidosis, lethality 50%) is a rare, potentially fatal reactioa Metformin is used in combination with sulfony-lureas or by itself. It is contraindicated in renal insufficiency and should therefore be avoided in elderly patients. 

The half-life of 2-hexanone and its metabolites in blood plasma has not been established however, elimination from the body does appear to occur in less than 24 hours following both inhalation and ingestion exposures (DiVincenzo et al. 1977, 1978). 2-Hexanone is not known to accumulate over time in any tissues in the body (see section 2.3.4). While elimination enhancement through stimulation of metabolism of 2-hexanone may reduce some forms of toxicity, if used within the short time that 2-hexanone is retained in the body, there is the risk that these same metabolic reactions may form reactive metabolites such as 2,5-hexanedione. Furthermore, concurrent exposures to other substances may also occur for which stimulation of these same metabolic pathways is contraindicated. Therefore, the benefit of stimulating specific metabolic pathways to enhance 2-hexanone elimination is unclear and should be studied further. 

Pregnancy (ergotamine s powerful uterine stimulant actions may cause fetal harm) hypersensitivity to ergot alkaloids peripheral vascular disease (eg, thromboangiitis obliterans, leutic arteritis, severe arteriosclerosis, thrombophlebitis, Raynaud s disease) hepatic or renal impairment severe pruritus coronary artery disease hypertension sepsis. The use of potent CYP3A4 inhibitors (ritonavir, nelfinavir, indinavir, erythromycin, clarithromycin, troleandomycin, ketoconazole, itraconazole) with dihydroergotamine is contraindicated. 

Although anticholinesterase agents can be used in the treatment of atony of the bladder and adynamic ileus, they are contraindicated in cases of mechanical obstruction of the intestine or urinary tract. Caution should also be used in giving these drugs to a patient with bronchial asthma or other respiratory disorders, since they will further constrict the smooth muscle of the bronchioles and stimulate respiratory secretions. 

C. Glaucoma as a preexisting condition does not contraindicate an AChE inhibitor. The other preexisting conditions preclude the administration of AChE inhibitors. Potentiation of parasympathetic stimulation can constrict airway smooth muscle and aggravate asthma, further weaken A-V conduction, and risk perforation of the bowel if an obstruction is present. 

Pentazocine is contraindicated in the treatment of patients with acute myocardial infarction because of cardiovascular stimulation. Psychotomimetic side effects, such as hallucinations, bizarre dreams, and sensations of depersonalisation, occur in about 6-10% of patients. They are more common in elderly patients, in those who are ambulatory, and when doses above 60 mg are given. Nausea occurs in approximately 5% of patients although vomiting is less common. Other commonly reported side effects are dizziness and drowsiness. The risk of physical dependence is low. 

There is no final consensus on whether normal use of lithium, without any episode of toxicity (the vast majority of patients), may result in permanent renal impairment. Polyuria occurs in 20-40% and is due to inhibition of antidiuretic hormone (ADH) by lithium. It usually resolves on cessation of lithium as do any effects on glomerular function. Interference with thyroid function is due to inhibition of the action of thyroid stimulating hormone (TSH) and is easily managed by administration of thyroxine. Lithium is contraindicated during pregnancy (major vessel anomalies in fetus) and breastfeeding. 

Stimulation of the subthalamic nucleus or globus pallidus by an implanted electrode and stimulator has yielded good results for the management of the clinical fluctuations occurring in advanced parkinsonism. The anatomic substrate for such therapy is indicated in Figure 28-1. Such procedures are contraindicated in patients with secondary or atypical parkinsonism, dementia, or failure to respond to dopaminergic medication. 

Oxytocin is a hypothalamic nonapeptide that selectively stimulates the smooth muscle of the uterus and mammary glands. It is used in the induction or augmentation of labor and to prevent postpartum hemorrhage, and is well tolerated and effective in a wide range of infusion rates and concentrations. Contraindications to its use... 

The following interventions are contraindicated Quinidine should not be used because it displaces digoxin from binding sites, and bretylium should not be used because it releases norepinephrine. Carotid sinus stimulation should be discouraged because it may precipitate ventricular fibrillation. 

As a gastric secretagogue, alcohol stimulates the secretion of gastric juice, which is rich in acid and pepsin. Therefore, the consumption of alcohol is contraindicated in subjects with untreated acid-pepsin disease (Figure 68.2). In addition, alcohol releases histamine, which in turn releases gastric juice. This effect is not blocked by atropine. 

Contraindications Usually no undesirable side effects or hangover. Some persons experience mild headache immediately after smoking. Broom flowers are extremely toxic when ingested. Has heart-stimulating properties like digitalis. 

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