631. Acetylcholine slows the heart, but norepinephrine stimulates the heart.
632. Glucose levels for diabetic patients:- (plasma glucose)
- Random PG ≥ 11.1 mmol/L
- Fasting PG ≥ 7 mmol/L (≥ 8 hours without food?.
- PG ≥ 11.1 mmol/L (2 hours after 75 g oral glucose)
633. Schizophrenia and its treatment are risk factors for diabetes.
634. HbA1c is ≥ 9 % in hyperglycemic patients, HbA1c should be tested every 3-4 months. Normal HbA1c is 3-5 %.
635. Some drug-drug interactions:-
- Benzodiazepines (BDZs) cause poor memory, confusion, falls, urinary retention when they are given with opiates, antipsychotics, and anticholinergic drugs.
- Elevated serum creatinine or potassium (K), due to NSAIDs.
- Gatifloxacin + calcium and antacids may cause the absorption of gatifloxacin decreases.
- Ciprofloxacin + olanzapine; ciprofloxacin inhibits CYP1A2 increasing olanzapine levels, so increase rigidity and falls.
- Ciprofloxacin + glibenclamide may cause hypoglycemia.
- Anticholinergics decrease donepezil effect (antagonism).
- Low albumin + phenytoin more free phenytoin, so more side effects like somnolence (drowsiness), ataxia, and confusion.
- Ginkgo biloba + aspirin decrease platelet function and adhesion, the risk of bleeding.
- Alcohol + BDZ more sedation and increase risk of falls.
- Metoclopramide + Parkinson’s disease increase the block of dopamine receptors, worse the case.
- Corticosteroids + sulfonylurea antagonism ( CTs cause hyperglycemia)
- Terfenadine displaces carbamazepine from protein binding increases free drugs, increases side effects.
- CCBs + cyclosporine decrease the metabolism of cyclosporine, so increase its immunosuppressant effect.
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