An article summarizing 7 commonly used drugs for cardiovascular disease! Medication Safety Alert for the Frail Elderly

The pace of population ageing is accelerating, and multimorbidity is also serious in the elderly population; multimorbidity leads to polypharmacy, with the proportion of polypharmacy increasing with age. The incidence of frailty in the elderly increases with age. Multiple medication use in the frail elderly is associated with an increase in serious adverse events and has become an important issue in current geriatrics.
Frailty is defined as a decline in physiologic reserve in older adults resulting in increased vulnerability and dysfunction of multiple organs, including loss of muscle mass and strength, decreased exercise tolerance, cognitive impairment, and decreased physiologic reserve, leading to poor health and reduced stress tolerance. Weakness usually progresses slowly and can be dynamic.
An article organizing safety warnings for 7 classes of drugs commonly used in cardiovascular system disorders in the debilitated elderly ↓

01 Beta-blockers

Beta blockers in combination with verapamil and diltiazem carry a risk of heart block and severe bradycardia;

Increased risk of postural hypotension and even cardiac arrest with combination of Priorolol with rifampicin and haloperidol;

Combination of Priorolol with phenobarbital and rifampicin accelerates their clearance and diminishes their efficacy;

Combination of Priorolol with aminophylline and cimetidine slows its clearance, increases blood concentration and enhances its action;

Increased risk of bradycardia when metoprolol is combined with cimetidine, paroxetine, fluoxetine, and sertraline;

Non-cardioselective beta-blockers in patients with chronic obstructive pulmonary disease with an increased risk of bronchospasm.

02a-blockers

The a-blockers, terazosin, doxazosin, and prazosin, in combination with sildenafil, increase the risk of hypotension;

Doxazosin in combination with nifedipine increases the risk of hypotension;

the combination of prazosin with a beta-blocker enhances its first-dose antihypertensive effect; the antihypertensive effect of uradil is enhanced by combining it with cimetidine;

Urapidil should not be combined with angiotensin-converting enzyme inhibitors; caution should be exercised in combining with beta-blockers and calcium channel blockers.

03ACEI/ARB

Combination of angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor antagonists (ARB) with NSAIDs is likely to result in sodium retention, diminished antihypertensive effect, and increased risk of renal damage.

04 Calcium channel blockers

Combination of dihydropyridine calcium channel blockers with itraconazole, fluconazole, and clarithromycin enhances antihypertensive effects and predisposes to hypotension;

Combined with rifampicin, carbamazepine, phenytoin sodium, etc., the antihypertensive effect is weakened and the blood pressure is extremely unstable.

05 digitalis drugs

Digoxin and proton pump inhibitors, H2 receptor antagonists, quinidine, verapamil, amiodarone, dronedarone, propafenone, cytarabine, cyclophosphamide, ketoconazole, itraconazole, and macrocyclic lactone antibiotics, easy to lead to digoxin poisoning, resulting in severe bradycardia or even cardiac arrest.

06 Antiarrhythmic drugs

The combination of amiodarone with quinidine and propafenone aggravates the prolongation of Q-T interval on ECG, and is prone to serious ventricular arrhythmia (tip-twist type ventricular tachycardia);

Combination of dronedarone with dabigatran etexilate, increased dabigatran etexilate blood concentration, increased risk of bleeding.

07 Antithrombotic drugs

Antiplatelet drugs Aspirin increases the risk of gastrointestinal bleeding when combined with nonsteroidal anti-inflammatory drugs; clopidogrel decreases antiplatelet effects and increases the risk of cardiovascular events when combined with omeprazole and esomeprazole; there is no evidence of interaction with lansoprazole, rabeprazole, and pantoprazole at this time;

Increased antiplatelet effect and increased risk of bleeding when combined with rifampin;

Increased risk of bleeding with antithrombotic drugs such as aspirin, clopidogrel, and warfarin in patients with concomitant bleeding disorders.