Cardiovascular system | | |
Diuretic monotherapy for heart failure | Suboptimal treatment | Consider ACE inhibitor |
Verapamil or diltiazem in heart failure | Aggravation of heart failure | Stop drug |
Non-selective beta-blocker (e.g. eye drops) in heart failure, asthma | Bradycardia; bronchospasm | Consider selective beta-blocker |
Concurrent use of ACE inhibitor, potassium supplement, or potassium sparing diuretic | Hyperkalaemia | Check serum potassium |
Concurrent use of diuretic or antihypertensive and NSAID | Fluid retention, reduced antihypertensive effect | Consider plain analgesic, e.g. paracetamol |
Central nervous system | | |
Concurrent use of multiple psychoactive drugs | Increased effect | Revise indication and regimen |
Amitryptiline, doxepine | Strongly anticholinergic, excessive sedation | Consider SSRI |
Long term use of antipsychotics for non-psychotic indications | Limited efficacy, cognitive deterioration, extrapyramidal and anticholinergic side effects | Stop drug |
Concurrent use of antiparkinsonian agents and phenothiazine antipsychotics | Treatment of avoidable ADR | Revise regimen |
Long acting benzodiazepines | Excessive sedation, cognitive deterioration | Stop drug |
Benzodiazepine anxiolytic and benzodiazepine hypnotic concurrently | Pharmacological duplication, excessive sedation | Stop (one) drug |
Alimemazine, promethazine | Strong anticholinergic and extrapyramidal side effects | Stop drug |
Propoxyphene, pentazocine | Cardiotoxic, nephrotoxic, confusion, hallucinations | Consider other opioid analgesic |
Miscellaneous | | |
NSAID (e.g. indomethacin) | Confusion, gastrointestinal side effects | Consider e.g. paracetamol |
Iron supplement and NSAID or antithrombotics | Treatment of avoidable ADR | Reconsider regimen |
Nutritional supplements for iron deficiency anaemia | Ineffective treatment | Consider iron supplement |
Vitamin C monotherapy for cystitis prophylaxis | Ineffective treatment | Consider oestrogen, metenamin |