Arterial ulcers

Hepatic dysfunction active peptic ulcer arterial bleeding hypersensitivity to niacin or any ingredient. 

Synonyms Hydrogen sulfate Polydextran sulfate Sulfuric acid, dextran ester Definition Sulfuric acid ester of dextran Uses Binder in cosmetics pharmaceuticals (treatment for hyperlipidemia and ulcers, artery factor agent, blood coagulant) biotech applies. (DNA hybridization) industrial applies, (photographic emulsion additive)... 

These drugp are contraindicated in patients with known hypersensitivity to die drugs, asthma, peptic ulcer disease, coronary artery disease, and hyperthyroidism. Bethanecol is contraindicated in those with mechanical obstruction of die gastrointestinal or genitourinary tracts. Fhtients with secondary glaucoma, iritis, corneal abrasion, or any acute inflammatory disease of the eye should not use die ophtiialmic cholinergic preparations. 

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). 

Hemorrhage is the most common complication of PUD and may occur when an ulcer erodes the wall of a gastric or duodenal artery. Bleeding occurs in approximately 15% of PUD patients and is more frequently seen in patients greater than 60 years of age, particularly those who ingest NSAIDs. Up to 20% of patients who develop a PUD-related hemorrhage do not have prior symptoms. 

Superior mesenteric artery syndrome Enteric infections Inflammatory bowel diseases Pancreatitis Appendicitis Cholecystitis Biliary colic Gastroparesis Postvagotomy syndrome Intestinal pseudo-obstruction Functional dyspepsia Gastroesophageal reflux Peptic ulcer disease Hepatitis Peritonitis Gastric malignancy Liver failure... 

The most common adverse events reported with sirolimus are leukopenia (20%), thrombocytopenia (13% to 30%), and hyperlipidemia (38% to 57%).11,31 Other adverse effects include delayed wound healing, anemia, diarrhea, arthralgias, rash, and mouth ulcers. Sirolimus has an FDA black-box warning in newly transplanted liver and lung recipients.11 In liver transplant recipients, use of sirolimus immediately after transplant is associated with an increased risk of hepatic artery thrombosis, graft loss, and death. In lung transplant... 

Although the risk of GI complications is relatively small with short-term therapy, coadministration with a proton pump inhibitor should be considered in elderly patients and others at increased GI risk. NSAIDs should be used with caution in individuals with a history of peptic ulcer disease, heart failure, uncontrolled hypertension, renal insufficiency, coronary artery disease, or if they are receiving anticoagulants concurrently. 

Therapeutic applications. PG derivatives are used to induce labor or to interrupt gestation (p. 126) in the therapy of peptic ulcer (p. 168). and in peripheral arterial disease. 

Special risk Use with care in patients with a bleeding diathesis, uncontrolled arterial hypertension, or a history of recent Gl ulceration or bleeding, diabetic retinopathy, hemorrhage, and severe liver or kidney insufficiency. 

Bethanechol should not be used in patients with possible mechanical obstruction of the bladder or gastrointestinal tract or when contraction of smooth muscles in these tissues may be harmful (e.g., recent intestinal resection). It is also contraindicated in patients with bronchial asthma, peptic ulcer disease, coronary artery disease, gastrointestinal hypermotility or inflammatory disease, hypotension or marked bradycardia, hyperthyroidism, parkinsonism, or epilepsy. Care should be exercised in administering pilocarpine to elderly patients because it can enter the CNS and affect memory and cognition, even when applied topically to the eye. 

Contraindications Active or latent bronchial asthma, acute inflammatory GI tract conditions, anastomosis, bladder wall instability, cardiacorcoronary artery disease, epilepsy, hypertension, hyperthyroidism, hypotension, mechanical GI or urinary tract obstruction or recent GI resection, parkinsonism, peptic ulcer, pronounced bradycardia, vasomotor instability... 

I Contraindications Active peptic ulcer disease, arterial hemorrhaging, hepatic dysfunction, hypersensitivity to niacin ortartrazine (frequently seen in patients sensitive to aspirin), severe hypotension... 

Atherosclerosis can result in ischemia of peripheral muscles just as coronary artery disease causes cardiac ischemia. Pain (claudication) occurs in skeletal muscles, especially in the legs, during exercise and disappears with rest. Although claudication is not immediately life-threatening, peripheral artery disease is associated with increased mortality, can severely limit exercise tolerance, and may be associated with chronic ischemic ulcers and susceptibility to infection. 

First- and second-trimester abortion Cervical reopening Induction of labor Augmentation of labor Postpartum hemorrhage Ectopic pregnancy Lactation suppression In gastrointestinal disease Peptic ulceration Liver transplantation Chemotherapy-induced mucosal lesions In cardiovascular disease Congenital cardiac malformations Raynaud s syndrome Chronic obstructive pulmonary disease Adult respiratory distress syndrome Pulmonary hypertension Arterial occlusive disease Extracorporeal circulation In urology Erectile dysfunction... 

Nizankowski R, Krolikowski W, Bielatowicz J, Szczeklik A. Prostacyclin for ischemic ulcers in peripheral arterial disease. A random assignment, placebo controlled study. Thromb Res 1985 37(l) 21-8. 

Nelson EA, Bradley MD. Dressings and topical agents for arterial leg ulcers. Cochrane Database Syst Rev. 2003 CD001836. 

More serious conditions for which people take herbal drugs include depression, irregular heartbeat and other heart problems, arthritis, arteriosclerosis (hardening of the arteries), asthma, high blood pressure, various cancers, diabetes, epilepsy, gallstones, sexually transmitted diseases, hepatitis, jaundice, malaria, measles, obesity, tetanus, tuberculosis, and ulcers. 

Intensive pharmacologic treatment of diabetes is known to decrease the risk for microvascular events such as nephropathy and retinopathy, but there is less evidence that it decreases macrovascular disease (28,29). DCCT/EDIC trial, however, demonstrated reduction in CVD (nonfatal Ml, stroke, death from CVD, confirmed angina, or the need for coronary-artery revascularization) in patients with type I diabetes assigned to intensive diabetes treatment compared with conventional treatment by 42% (p = 0.02) (30). Patients with lower extremity PAD and both type I and type 2 diabetes should be treated to reduce their glycosylated hemoglobin (Hb AIC) to less than 7%, per the American Diabetes Association recommendation (31). Subanalysis of the UKPDS showed no evidence of a threshold effect of Hb AIC a I % reduction in Hb Al C was associated with a 35% reduction in microvascular endpoints, an 18% reduction in Ml, and a 17% reduction in all-cause mortality. Frequent foot inspection by patients and physicians will enable early identification of foot lesions and ulcerations and facilitate prompt referral for treatment (32). 

Atherosclerosis mainly affects large- and mediumsized arteries. Extracranial manifestations at the carotid bifurcation statistically dominate the intracranial arteries. Besides typical manifestations at the carotid siphon or the vertebrobasilar junction, atherosclerosis is occasionally also found in peripheral intracranial vessel segments. Typical sequelae of atherosclerosis are stenosing plaque formations, ulcerations, dilatations or the evolution of fusiform aneurysms, which can be accompanied by extensive formation of thrombus. 

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