Micromedex

You can switch to detailed version in the contraindication chapter of each medicine.

Best Regards.

Hsiang, I tried your method and it didn't work. Micromedex just lists the contraindications without explaining the background/rationale behind the contraindication.

Mostafa, You can copy the key words to find in adverse effect or check more from the references. It will help.

Mostafa: Within the contraindications there are different types . Depending on what you look for you can find information in one way or another: Contraindications for side effects: that refer to an unintended consequence that is part of the pharmacological action of a medication; for example, dry mouth in the course of a treatment with anticholinergics. Think of, a patient with s. Sjogren, who sees his symptoms worsened by taking anticholinergics. It could also be a non-selective beta-blocker and an asthmatic patient. The physiological mechanism of bronchial relaxation is through beta2 agonism, if you block it you can trigger asthma attacks. You can usually find the cause by looking at the physiology of the mechanism of action and physiology of the side effect.Also books of clinical pharmacolgy usually explain this.

Secondary effect, on the other hand, is an unintended manifestation that arises as a consequence of the fundamental action of a medicine, but that is not an inherent part of it. By way of example, hypokalemia may occur that occurs in the course of treatment with thiazide diuretics. You can also evaluate it depending on the mechanism of action of the drug. Adverse reaction or undesirable effect, finally, refer to the unwanted effects that, in addition, are harmful. In these the cause of the adverse reaction is not usually known . You know the frequency of appearance, the characteristics of the population that it affects ... in these cases the information can be found in pivotal trials, or in safety drug monitoring agencies, and drug technical data sheets. Physiologically justify why they appear is difficult, if a patient taking ibuprofen suffers a syndrome of Steve Johnson, you may say that it is a very rare adverse reaction, but not why this patient, its idiosyncrasic.

The idea that there's only one possible medicine is a bit restrictive or academic. Is there a medicine without the contraindication, even if less effective clinically?

Is the contraindication something manageable - don't take with alcohol, lose weight, whatever - that would reduce the risk?

The known side effects of the "best" medicine will have some indication of frequency. If the side effect is low frequency or low severity, and the patient is advised of the adverse effects (to watch for them and stop taking the medicine) treatment may be permitted.

This seems very theoretical - is this an ethics case study?

From a pharmacy point of view, a drug contra-indication is regarded as a drug-disease interaction, as part of drug-therapy problems. There are usually four types of drug interactions: drug-drug, drug-disease, drug-food/CAM and drug-lab. The contra-indications of a drug listed in the formularies, pharmacopoeia or leaflets are not always clinically significant or have various degrees of seriousness/severity. Additionally, many factors, e.g. a patient's condition, preparations or PK/PD, are involved in the interactions. We still need more evidence to support the claims. That is why in practice it is quite a challenge for pharmacists to give any advice to healthcare professionals or patients on the contra-indication issues without concrete evidence. For example, a selective or non-selective beta-blocker is used in asthmatic patients or thiazide diuretics in diabetic or gout patients.

Most of medical textbooks or guidelines mention the contraindications with explanation why it's contraindicated , and if not mentioned you can find the answer by searching online

It depends on your information about the contraindication of drugs they used