Ciprofloxacin interaction with sodium warfarin: A potentially dangerous side effect (2023)

Cited by (28)

  • Thermodynamics of the complexation of ciprofloxacin with calcium and magnesium perchlorate

    2011, Thermochimica Acta

    The thermodynamics of the reactions of ciprofloxacin (CIP) with calcium perchlorate (Ca(ClO4)2) and magnesium perchlorate (Mg(ClO4)2) have been investigated in water–methanol solvent using conductometric titration. The reactions of CIP with each ion produce two ionic complexes with the general formulas M(CIP)2+ and M(CIP)22+. The stability constants K1 and K2 at 25°C for the complexes formed from the reaction with Ca(ClO4)2 were 8.84×104 and 3.62×104, respectively. For the reaction with Mg(ClO4)2 K1 and K2 were 1.72×105 and 2.50×103, respectively. The enthalpy (ΔH1, ΔH2, ΔH12) and entropy (ΔS1, ΔS2, ΔS12) of complexation reactions were determined from the temperature dependence of the complexation constants. The reactions of CIP with both ions are accompanied by a decrease in entropy (ΔS12=−468.12 and −478.89J/K mol for complexation with Ca(ClO4)2 and Mg(ClO4)2, respectively) and enthalpy (ΔH12=−193.09 and −192.01kJ/mol for complexation with Ca(ClO4)2 and Mg(ClO4)2, respectively), which indicate that the reactions are driven by the enthalpy change.

  • The safety of levofloxacin in elderly patients on warfarin

    2005, American Journal of Medicine

  • Deadly drug interactions in emergency medicine

    2004, Emergency Medicine Clinics of North America

  • Drugs affecting blood coagulation and hemostasis

    1993, Side Effects of Drugs Annual

    This chapter discusses several drugs that affect blood coagulation and hemostasis. The most common adverse effect of coumarin congeners is bleeding. Case reports of intramedullary hematoma, massive hemothorax, intramural hematoma of the small intestine, and hemobilia have recently been published. The most feared complication is intracranial hemorrhage in which the use of prothrombin complex concentrate would be superior to fresh frozen plasma in reversing anticoagulation and possibly preventing further bleeding. The subcutaneous administration of low-molecular-weight heparins is now generally accepted to be as effective as intravenous heparin in the treatment of deep venous thrombosis. Hemorrhage is the most frequent adverse effect of heparin drugs. Heparin-induced thrombocytopenia (HIT) continues to receive a great deal of attention. Ticlopidine has recently been associated with thrombotic thrombocytopenic purpura. Cases of cholestatic hepatitis and one instance of marked hypercholesterolemia with the appearance of a large lipoprotein-X band have also been reported. New strategies developed include the use of cocktails of different types of thrombolytic agents and more powerful anti-thrombotic and anti-platelet agents to improve vascular patency.

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  • Structured override reasons for drug-drug interaction alerts in electronic health records

    2019, Journal of the American Medical Informatics Association

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    Post-bariatric surgery starvation ketoacidosis and lipase elevation in the absence of DKA or pancreatitis

    The American Journal of Emergency Medicine, Volume 36, Issue 3, 2018, pp. 525.e3-525.e5

    We report a case of post bariatric surgery by laparoscopic sleeve gastrectomy who presented with post-surgical poor oral tolerance and high anion gap metabolic ketoacidosis, who was initially misdiagnosed with diabetic ketoacidosis and treated with volume supplementation without improvement. The metabolic derangements were found to be caused by starvation ketoacidosis, which was then treated with glucose supplementation, and the anion gap quickly closed. Moreover, this patient also presented with non-pancreatitis lipase elevation. This case highlights the recognition and management of post-bariatric surgery starvation ketoacidosis; additionally, clinicians should be vigilant about the interpretation and management of elevated lipase without clinical pancreatitis.

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    The mycotoxin T-2 inhibits hepatic cytochrome P4503A activity in pigs

    Food and Chemical Toxicology, Volume 57, 2013, pp. 54-56

    Mycotoxins are toxic metabolites produced by fungi that readily colonize crops. After ingestion, these mycotoxins can compromise intestinal health, and once entering the blood stream, even affect the liver and its metabolizing enzymes. It was therefore the aim of the present study to investigate the effect of T-2 toxin, an emerging and potent Fusarium mycotoxin, on the enzymatic activity of cytochrome P4503A (CYP3A) metabolizing enzymes in the liver of pigs. In addition, a yeast-derived feed additive that claims to bind T-2 toxin was included in the study to evaluate its efficacy. Our results demonstrated that a 14-days intake of T-2 toxin contaminated feed at a dose of 903μg/kg feed, whether or not combined with the mycotoxin binder, results in a substantial inhibition of the CYP3A activity in the liver of pigs. This result may be of importance for animal health, the pharmacokinetics and the withdrawal time of drugs that are substrate of CYP3A enzymes, and consequently can be a threat for public health with respect to tissue residues of these drugs.

  • Research article

    Binding of the plant alkaloid aristololactam-β-d-glucoside and antitumor antibiotic daunomycin to single stranded polyribonucleotides

    Biochimica et Biophysica Acta (BBA) - General Subjects, Volume 1830, Issue 10, 2013, pp. 4708-4718

    Interaction of the plant alkaloid aristololactam-β-d-glucoside and the antitumor drug daunomycin with single stranded RNAs poly(G), poly(I), poly(C) and poly(U) has been investigated.

    Biophysical techniques of absorption, fluorescence, competition dialysis, circular dichroism, and microcalorimetry have been used.

    Absorption and fluorescence studies have revealed noncooperative binding of ADG and DAN to the single stranded RNAs. The binding affinity of ADG varied as poly(G) > poly(I) > > poly(C) > poly(U). The affinity of DAN was one order higher than that of ADG and varied as poly(G) > poly(I) > poly(U) > poly(C). This binding preference was further confirmed by competition dialysis assay. The thermodynamics of the binding was characterised to be favourable entropy and enthalpic terms but their contributions were different for different systems. The major non-polyelectrolytic contribution to the binding revealed from salt dependent data appears to be arising mostly from stacking of DAN and ADG molecules with the bases leading to partial intercalation to single stranded RNA structures. Small negative heat capacity values have been observed in all the four cases.

    This study presents the comparative structural and thermodynamic profiles of the binding of aristololactam-β-d-glucoside and daunomycin to single stranded polyribonucleotides.

    These results suggest strong, specific but differential binding of these drug molecules to the single stranded RNAs and highlight the role of their structural differences in the interaction profile.

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  • Research article

    Male Patient with Throat Swelling and Painful Swallowing

    The Journal of Emergency Medicine, Volume 44, Issue 6, 2013, pp. 1142-1143

  • Research article

    The Ankle Brachial Index Exhibits Better Association of Cardiovascular Prognosis Than Non–High-Density Lipoprotein Cholesterol in Type 2 Diabetes

    The American Journal of the Medical Sciences, Volume 351, Issue 5, 2016, pp. 492-498

    The association between ankle brachial index (ABI) and outcomes in diabetic subjects is controversial. The purpose of this study was to evaluate whether the ABI is more strongly associated with cardiovascular outcomes comparing with non–high-density lipoprotein cholesterol (non–HDL-c).

    A total of 452 type 2 diabetic subjects followed up for a mean of 5.8 years were grouped by ABI (<0.9 versus ≥0.9) and non–HDL-c (<100mg/dL versus ≥100mg/dL). Primary outcomes were composite events including all-cause mortality, hospitalization for coronary artery disease, stroke, revascularization, amputation and diabetic foot, and the secondary end point was all-cause mortality.

    Intergroup differences in percentage of men, duration of diabetes, hemoglobin A1c, total cholesterol, low-density lipoprotein cholesterol, triglycerides and estimated glomerular filtration rate were significant. A total of 64 composite events and 17 deaths were recorded. A higher number of composite events occurred in the group with abnormal ABI but optimal non–HDL-c than in those with suboptimal non–HDL-c but normal ABI (29% versus 11%, P < 0.05). A similar trend was observed in all-cause mortality (11% versus 1%, P < 0.05). The ABI was the dominant risk factor for both end points after adjusting other factors (for composite events, hazard ratio = 0.02, 95% CI: 0.00-0.10, P < 0.001 and for all-cause mortality, hazard ratio = 0.01, 95% CI: 0.00-0.28, P = 0.006).

    The ABI was more strongly associated with outcomes in diabetes than non–HDL-c. The ABI should be routinely screened in diabetes even without symptom.

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  • Research article

    Are children undergoing cardiac surgery receiving antibiotics at subtherapeutic levels?

    The Journal of Thoracic and Cardiovascular Surgery, Volume 148, Issue 4, 2014, pp. 1591-1596

    Perioperative antibiotics have decreased—but not eradicated—postoperative infections. In patients undergoing cardiac surgery with cardiopulmonary bypass, the dilutional effect of the priming and any additional volume given during the procedure may lead to subtherapeutic antibiotic levels. Our aim was to determine if children undergoing cardiac surgery with cardiopulmonary bypass receive perioperative antibiotics at subtherapeutic levels.

    Using published pharmacokinetic data on cefuroxime, we developed a computer simulation model to generate a nomogram predicting patients at risk for subtherapeutic cefuroxime levels based on time from initial dosing and additional volume given.

    A computer-generated 1-compartment pharmacokinetic model was created to predict cefuroxime plasma levels over time for patients of all weights and additional volumes given for both a 25- and 50-mg/kg intravenous dose. For example, following a 25-mg/kg dose, a patient receiving an additional volume of 275 mL/kg is predicted to be subtherapeutic (<16 mg/L=4×minimum inhibitory concentration) at 4 hours. Our nomogram predicts all patients will be subtherapeutic at 8 hours, consistent with general pediatrics dosing schemes. Following a 50-mg/kg dose, levels are predicted to be subtherapeutic after an additional volume of 315 mL/kg at 5.5 hours.

    Our model predicts which patients undergoing cardiac surgery with cardiopulmonary will have subtherapeutic cefuroxime levels. This nomogram enables providers to determine when to administer additional antibiotics in patients receiving large additional volumes during cardiac surgeries. This rational approach to perioperative antibiotic dosing may result in a reduction in postoperative infection in this vulnerable patient population.

Copyright © 1991 Published by Elsevier Inc.

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