Friday, October 16, 2015

Drug causing Pericarditis

Which Drug causes Pericarditis among 3 ?

a. Hydralazine
b. NSAID's
c. Amiodarone


Some medications, including penicillin and cromolyn sodium, induce pericarditis through a hypersensitivity reaction. The anthracycline antineoplastic agents, such as doxorubicin and cyclophosphamide, have direct cardiac toxicity and can cause acute pericarditis and myocarditis.
Pericarditis can also develop from a drug-induced lupus syndrome caused by medications including procainamide, hydralazine, methyldopa, isoniazid, mesalazine, and reserpine. Methysergide causes constrictive pericarditis through mediastinal fibrosis. Dantrolene, phenytoin, and minoxidil produce pericarditis through an unknown mechanism.
Smallpox vaccination infrequently leads to myocarditis. In a review of a large vaccination program in the US military, approximately 12 per 100,000 vaccinated troops developed myopericarditis within 14 days of vaccination. Whether this was due to a direct viral cytopathic effect or an immune-mediated phenomenon is unclear.

Very common (>10% frequency) side effects include:
Hydralazine (Apresoline) is a direct-actingsmooth muscle relaxant used to treathypertension by acting as a vasodilatorprimarily in arteries and arterioles. By relaxingvascular smooth muscle, vasodilators act to decrease peripheral resistance, thereby lowering blood pressure and decreasing afterload.

However, this only has a short term effect on blood pressure, as the system will reset to the previous, high blood pressure needed to maintain pressure in the kidney necessary fornatriuresis. The long-term effect of antihypertensive drugs comes from their effects on the pressure natriuresis curve. It belongs to the hydrazinophthalazine class of drugs.

It is on the World Health Organization's List of Essential Medicines, the most important medications needed in a basic health system


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