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- W2261314242 abstract "Since patients with type 2 diabetes are often taking many different classes of medications, addition of further prescription and non-prescription agents can sometimes result in dangerous interactions. The classes of medication responsible for most of the dangerous special adverse effects and interactions in patients with diabetes are hypoglycaemic agents, hypotensive agents, hypolipidaemic agents and other drugs (usually cardiovascular agents, non-steroidal anti- inflammatory agents [NSAIDs] or antidepressants) which may cause postural hypotension and/or nephrotoxicity. Hyopglycaemia and lactic acidosis are the major dangerous adverse effects of sulphonylureas and metformin, respectively. Accumulation of metformin can occur in patients with renal impairment, a condition which is easily missed in older people because their plasma creatinine may not be particularly abnormal. In addition to insulin and sulphonylureas, drugs which may increase the risk of hypoglycemia include beta-blockers, sulphonamides, angiotensin converting enzyme(ACE) inhibitors, salicylates (in high doses), perhexilene and ethanol. Assessing and avoiding the risks of postural hypotension and falling should be part of the routine management of older people with long-standing diabetes. Diabetes predisposes to hyperkalaemia in many ways. Particular care is necessary when patients with diabetes are treated with ACE inhibitors, NSAIDs, potassium-sparing diuretics or potassium supplements. All antihypertensive agents can cause hypotension and many can have important adverse metabolic effects. Addition of a macrolide can precipitate rhabdomyolysis in patients taking statins. Several medications that can precipitate rhabdomyolysis with statins are likely to be used in diabetes. Because of the combined effects of age, vascular disease, hyperglycaemia and hypertension, kidney function is frequently, although not always obviously, impaired in people with diabetes. Drugs with anticholinergic side-effects frequently cause problems in older patients with diabetes. (author abstract)" @default.
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- W2261314242 date "1999-01-01" @default.
- W2261314242 modified "2023-09-23" @default.
- W2261314242 title "Dangerous drugs and diabetes" @default.
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