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L31: Groups Vulnerable to ADRs (Medications (Anticoagulants (Warfarin,…

- - - - :arrow_down:Renal Function
        
        Drug Clearance:arrow_down:
        
        Drug Half-Life :arrow_up:
        
        Drug Concentration :arrow_up:
        
        Digoxin :!:
        
        allopurinol
        
        bisphosphonates
      - Altered Volume of Distribution (Vdist)
        
        Increase body fat, Lipophilic drug, Vdist :arrow_up:
        
        Diazepam
        
        Hydrophilic Drug, Vdist :arrow_down:
        
        Digoxin :!:
      - Hepatic Function :arrow_down:,1st Pass Metabolism :arrow_down:
        
        Drug Clearance :arrow_down:
        
        Drug Concentration :arrow_up:*Opposite for pro-drugs
        
        GTN
        
        morphine
        
        Propranolol
    - - Efficiency of Blood-Brain Barrier reduced
        
        Increase susceptibility to sedatives
      - Baroreceptor function impaired
        
        Vulnerable to postural hypotension
      - Density/Number of Receptors :arrow_down:
        
        :arrow_down: Beta-Adrenoceptors
        
        :arrow_down:response to Beta agonist drugs
        
        Salbutamol (Asthma)
      - Increase total peripheral resistance
        
        Less responsive to arterial vasodilators
- - - - Enamel Dysplasia
      - Inhibit Bone Growth
      - Discolor Teeth
    - - Reye's syndrome (toxic encephalopathy)
  - - - Increase half-life & concentration of drugs > ADRs
        
        Grey Baby Syndrome :!:
        
        Chloramphenicol (Antibiotic) :!:
- - - - Teratogenic Risk
    - - Fetal Death
    - - Neonatal Goitre & Thyroid Dysfunction