Makindo Medical Notes"One small step for man, one large step for Makindo" |
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MEDICAL DISCLAIMER: The contents are under continuing development and improvements and despite all efforts may contain errors of omission or fact. This is not to be used for the assessment, diagnosis, or management of patients. It should not be regarded as medical advice by healthcare workers or laypeople. It is for educational purposes only. Please adhere to your local protocols. Use the BNF for drug information. If you are unwell please seek urgent healthcare advice. If you do not accept this then please do not use the website. Makindo Ltd. |
⚠️ Be very cautious when prescribing or combining the following drugs, especially in frail, elderly, or comorbid patients. Always cross-check the 💊 BNF for interactions and dosing.
💊 Drugs | ⚠️ Details / Risks |
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Opiates / Codeine | ↑ Sedation, respiratory depression, constipation.
💡 Use lowest effective dose, avoid combining with other CNS depressants. |
Benzodiazepines | ↑ Sedation, falls, confusion.
💡 Avoid co-prescription with opioids unless palliative setting. |
Diuretics | Risk of dehydration, electrolyte imbalance (low Na⁺, K⁺), and AKI.
💡 Monitor U&Es regularly. |
Anticoagulants | ↑ Risk of major bleeding.
💡 Especially dangerous with NSAIDs, steroids, or antiplatelets. |
Antiplatelets | ↑ Risk of GI bleeding, particularly in dual therapy or with anticoagulants.
💡 Consider PPI co-prescription. |
NSAIDs | Risk of GI bleed, AKI, and fluid retention.
💡 Avoid in heart failure, renal impairment, or when combined with ACEi + diuretic (triple whammy). |
Steroids | ↑ Risk of infection, hyperglycaemia, osteoporosis, and fluid retention.
💡 Warn patients and use lowest dose possible. |
Paracetamol | Generally safe, but overdose risk (esp. in frail/liver disease).
💡 Ensure max daily dose = 4 g (8 x 500 mg tablets). |