NR 508 Week 4 Open Forum Discussion

Sample Answer

Concomitant Diseases are defined as “occurring or existing at the same time as something else. In medicine, it may refer to a condition a person has or a medication a person is taking that is not being studied in the clinical trial he or she is taking part in” (National Cancer Institute, n.d.). This means that when a patient has heart disease, but also diabetes, and is in a study for diabetes treatment, the heart disease would be a concomitant disease. SSRIs are known to have interactions with a few different herbal and homeopathetic treatments. The most important interaction is between SSRIs and St. Johns Wort.

St. Johns Wort is a plant that is thought to help mild depression. However, “as a result of its ability to induce CYP3A4, 2E1, 2C9 and P-glycoproteins,” it is dangerous in conjunction with SSRIs (Bleakly, 2016). This can cause “transplant rejections, reducing the effectiveness of oral contraceptives causing unintended pregnancies, and studies demonstrate reduced levels and effectiveness of warfarin, digoxin, methadone and some benzodiazepines” (Bleakly, 2016).

It has been found that for pregnant patients with heart failure that diuretics are the best drug of choice. There is no evidence that diuretics harm the baby whatsoever and “the use of diuretics in circumstances where the mother becomes symptomatic on the basis of increased preload complicating left ventricular dysfunction justifies the use of diuretic therapy as first-line treatment” (Anthony & Silwa, 2016). Beta Blockers should only be taken if the life of the mother or child are at risk and ACE Inhibitors, Spironolactone, or Nitroglycerine should not be taken at all (Anthony & Silwa, 2016).

Good luck on the midterm, everyone!

References

• Anthony, J., & Sliwa, K. (2016). Decompensated Heart Failure in Pregnancy. Cardiac Failure Review, 2(1), 20–26. http //doi.org/10.15420/cfr.2015 24 2
• Bleakly, S. (2016). Antidepressant drug interactions Evidence and clinical significance. Progress in Neurology and Psychiatry. Retrieved from https //onlinelibrary.wiley.com/doi/pdf/10.1002/pnp.429
• National Cancer Institute. (n.d.). Definition of concomitant. National Institutes of Health. Retrieved from https //www.cancer.gov/publications/dictionaries/cancer-terms/def/concomitant