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Iatrogenic withdrawal

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https://www.readbyqxmd.com/read/28296768/difficult-clinical-management-of-antituberculosis-dress-syndrome-complicated-by-mrsa-infection-a-case-report
#1
Li Wang, Lin-Feng Li
RATIONALE: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe drug-induced hypersensitivity reaction characterized by skin rash, fever, blood abnormalities, and multiple organ involvement. The diagnosis of DRESS syndrome is often delayed because of its variable presentation. Prompt withdrawal of the culprit drug is the definitive treatment. DRESS syndrome induced by antituberculosis drugs has rarely been reported. PATIENT CONCERNS: A 50-year-old man admitted to our hospital with recurrent episodes of progressive rash, fever, eosinophilia, lymphadenopathy, hepatic, and pulmonary involvement were experienced after repeat trials of the same antituberculosis drugs...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28231495/drug-induced-panic-attacks-analysis-of-cases-registered-in-the-french-pharmacovigilance-database
#2
Delphine Abadie, Anaïs Essilini, Virginie Fulda, Aurore Gouraud, Mélissa Yéléhé-Okouma, Joëlle Micallef, François Montastruc, Jean Louis Montastruc
BACKGROUND: The potential role of drugs in the onset of panic attacks (PAs) is poorly understood. AIM: The objective of our study was to characterize drug-induced PAs. METHOD: We performed an analysis of PAs registered in the French pharmacovigilance database between 01/01/1985 and 05/11/2014. RESULTS: Among the 163 recorded cases, 136 (83.4%) were directly related to drugs, mainly antidepressants (11.3%, mainly serotonin reuptake inhibitors), mefloquine (7...
February 9, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28183374/experiences-of-codeine-use-misuse-and-dependence-application-of-liese-and-franz-s-cognitive-developmental-model-of-substance-abuse
#3
Marie Claire Van Hout, Ian Norman, Eileen Rich, Michael Bergin
BACKGROUND: Misuse of codeine-containing medicines is an emerging public health issue. AIMS: We present the application of Liese and Franz's (1996) cognitive developmental model of substance abuse to the trajectory from legitimate codeine use for pain, towards that of therapeutic and other forms of misuse, and physical and psychological dependence. It illustrates a cognitive behavioural analysis of the experiences of codeine misusers - which 'surfaces' the specific beliefs, thoughts, emotions and behaviours of this group of hidden codeine dependent individuals, who are distinct and unique from other opioid-dependent cohorts...
February 10, 2017: Behavioural and Cognitive Psychotherapy
https://www.readbyqxmd.com/read/28179883/new-microrna-biomarkers-for-drug-induced-steatosis-and-their-potential-to-predict-the-contribution-of-drugs-to-non-alcoholic-fatty-liver-disease
#4
Mireia López-Riera, Isabel Conde, Laia Tolosa, Ángela Zaragoza, José V Castell, María J Gómez-Lechón, Ramiro Jover
Background and Aims: Drug-induced steatosis is a major reason for drug failure in clinical trials and post-marketing withdrawal; and therefore, predictive biomarkers are essential. These could be particularly relevant in non-alcoholic fatty liver disease (NAFLD), where most patients show features of the metabolic syndrome and are prescribed with combined chronic therapies, which can contribute to fatty liver. However, specific biomarkers to assess the contribution of drugs to NAFLD are lacking. We aimed to find microRNAs (miRNAs) responsive to steatotic drugs and to investigate if they could become circulating biomarkers for drug-induced steatosis...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28157809/withdrawal-assessment-tool-1-monitoring-in-picu-a-multicenter-study-on-iatrogenic-withdrawal-syndrome
#5
Angela Amigoni, Maria Cristina Mondardini, Ilaria Vittadello, Federico Zaglia, Emanuele Rossetti, Francesca Vitale, Stefania Ferrario, Fabio Savron, Giancarlo Coffaro, Luca Brugnaro, Roberta Amato, Andrea Wolfler, Linda S Franck
OBJECTIVES: Withdrawal syndrome is an adverse reaction of analgesic and sedative therapy, with a reported occurrence rate between 17% and 57% in critically ill children. Although some factors related to the development of withdrawal syndrome have been identified, there is weak evidence for the effectiveness of preventive and therapeutic strategies. The main aim of this study was to evaluate the frequency of withdrawal syndrome in Italian PICUs, using a validated instrument. We also analyzed differences in patient characteristics, analgesic and sedative treatment, and patients' outcome between patients with and without withdrawal syndrome...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28155755/-objective-the-objective-of-this-study-was-to-determine-current-practices-in-the-lorraine-region-in-the-treatment-of-neuropathic-pain-and-to-assess-the-challenges-faced-by-general-practitioners-gps-methods-we-conducted-a-qualitative-study-by-the-focus-group
#6
https://www.readbyqxmd.com/read/28138449/budesonide-related-iatrogenic-cushing-s-syndrome-in-microscopic-colitis
#7
Kartikeya Tripathi, Thomas Dunzendorfer
Budesonide is the treatment of choice for microscopic colitis because of its excellent risk to benefit ratio. It is a potent, well-absorbed corticosteroid, but because of a high rate of first-pass metabolism in the liver, its systemic bioavailability is low. It has fewer corticosteroid-related adverse effects than prednisone, and adrenal suppression is considered to be rare. We present a middle-aged woman with lymphocytic colitis whose symptoms responded to budesonide but developed budesonide-related iatrogenic Cushing's syndrome...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28109052/the-use-of-methadone-to-facilitate-opioid-weaning-in-pediatric-critical-care-patients-a-systematic-review-of-the-literature-and-meta-analysis
#8
REVIEW
Leslie A Dervan, Beryl Yaghmai, Robert Scott Watson, Fredric M Wolf
BACKGROUND: Continuous opioid infusion therapy is commonly utilized in the pediatric intensive care setting to treat pain and facilitate tolerance of invasive therapies. Transitioning to methadone is one common strategy for weaning from continuous opioid infusions, but in practice this transition can be challenging, and many children still experience iatrogenic withdrawal. AIM: We reviewed the literature to evaluate the best available evidence to guide methadone therapy in this setting, and to summarize associated adverse events...
January 20, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27984286/knowing-risk-factors-for-iatrogenic-withdrawal-syndrome-in-children-may-still-leave-us-empty-handed
#9
Erwin Ista, Monique van Dijk
No abstract text is available yet for this article.
January 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27850485/847-iatrogenic-withdrawal-in-enteral-vs-parenteral-conversions-of-sedative-infusions-in-a-pediatric-icu
#10
Suzanne Barry, Meg Frizzola
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27803375/pre-trilostane-and-three-hour-post-trilostane-cortisol-to-monitor-trilostane-therapy-in-dogs
#11
L Macfarlane, T Parkin, I Ramsey
It is recommended that trilostane therapy of canine hyperadrenocorticism is monitored using an ACTH stimulation test, however this has never been validated. Three cortisol concentrations (pre-trilostane, 3-hour posttrilostane and 1-hour post-ACTH stimulation) were compared to a clinical score obtained from an owner questionnaire. There were 110 sets of 3 cortisol measurements and questionnaires obtained from 67 trilostane treated dogs. Questionnaire results were used to classify each dog as well or unwell. Well dogs were then categorised as having excellent, moderate or poor hyperadrenocorticism control, using thresholds produced by 14 independent veterinarians...
December 10, 2016: Veterinary Record
https://www.readbyqxmd.com/read/27779775/clonidine-for-sedation-and-analgesia-and-withdrawal-in-critically-ill-infants-and-children
#12
REVIEW
Amanda C Capino, Jamie L Miller, Peter N Johnson
The need for sedation and analgesia and treatment of iatrogenic drug withdrawal is common in critically ill children. First-line therapy typically includes opioid agonists. However, clonidine, a central α2 agonist, has been suggested as a treatment option for sedation and analgesia and iatrogenic drug withdrawal. Therefore, we conducted a literature search to identify articles evaluating the use of enteral (PO) and transdermal clonidine in critically ill infants and children for sedation and analgesia and treatment of iatrogenic drug withdrawal...
December 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27750020/variable-cold-induced-brown-adipose-tissue-response-to-thyroid-hormone-status
#13
Alina Gavrila, Per-Olof Hasselgren, Allison Glasgow, Ashley N Doyle, Alice J Lee, Peter Fox, Shiva Gautam, James V Hennessey, Gerald M Kolodny, Aaron M Cypess
BACKGROUND: In addition to its role in adaptive thermogenesis, brown adipose tissue (BAT) may protect from weight gain, insulin resistance/diabetes, and metabolic syndrome. Prior studies have shown contradictory results regarding the influence of thyroid hormone (TH) levels on BAT volume and activity. The aim of this pilot study was to gain further insights regarding the effect of TH treatment on BAT function in adult humans by evaluating the BAT mass and activity prospectively in six patients, first in the hypothyroid and then in the thyrotoxic phase...
January 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/27729254/opioid-dependence-and-pregnancy-minimizing-stress-on-the-fetal-brain
#14
REVIEW
John J McCarthy, Martin H Leamon, Loretta P Finnegan, Catherine Fassbender
Increase in the number of opioid-dependent pregnant women delivering babies at risk for neonatal abstinence syndrome prompted a US Government Accountability Office report documenting deficits in research and provider knowledge about care of the maternal/fetal unit and the neonate. There are 3 general sources of dependence: untreated opioid use disorder, pain management, and medication-assisted treatment with methadone or buprenorphine. A survey of methadone patients' experiences when telling a physician of their pregnancy and opioid dependence demonstrated physician confusion about proper care, frequent negative interactions with the mother, and failures to provide appropriate referral...
October 8, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27631576/behavioral-toxicity-revisited-iatrogenic-comorbidity-in-psychiatric-evaluation-and-treatment
#15
Giovanni A Fava, Fiammetta Cosci, Emanuela Offidani, Jenny Guidi
In 1968, DiMascio and Shader provided a conceptual framework for behavioral toxicity of psychotropic drugs (ie, the pharmacological actions of a drug that, within the dose range in which it has been found to possess clinical utility, may produce alterations in mood, perceptual, cognitive, and psychomotor functions that limit the capacity of the individual or constitute a hazard to one's well-being). A drug effect such as sedation or motor stimulation may be considered adverse for one patient and yet therapeutic and desired for another patient; within the same patient, it may be of value at one stage of one's illness and adverse at a later stage...
December 2016: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/27606309/sedation-in-critically-ill-children-with-respiratory-failure
#16
REVIEW
Nienke J Vet, Niina Kleiber, Erwin Ista, Matthijs de Hoog, Saskia N de Wildt
This article discusses the rationale of sedation in respiratory failure, sedation goals, how to assess the need for sedation as well as effectiveness of interventions in critically ill children, with validated observational sedation scales. The drugs and non-pharmacological approaches used for optimal sedation in ventilated children are reviewed, and specifically the rationale for drug selection, including short- and long-term efficacy and safety aspects of the selected drugs. The specific pharmacokinetic and pharmacodynamic aspects of sedative drugs in the critically ill child and consequences for dosing are presented...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27513532/patient-process-and-system-predictors-of-iatrogenic-withdrawal-syndrome-in-critically-ill-children
#17
Kaitlin M Best, David Wypij, Lisa A Asaro, Martha A Q Curley
OBJECTIVE: To generate a multidimensional predictive model of risk factors for iatrogenic withdrawal syndrome in critically ill children. DESIGN: Secondary analysis of prospective data from the Randomized Evaluation of Sedation Titration for Respiratory Failure clinical trial. SETTING: PICU. PATIENTS: Children who received greater than or equal to 5 days of sedation during mechanical ventilation for acute respiratory failure...
January 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27507082/hypothyroidism-and-hyponatremia-data-from-a-series-of-patients-with-iatrogenic-acute-hypothyroidism-undergoing-radioactive-iodine-therapy-after-total-thyroidectomy-for-thyroid-cancer
#18
L Vannucci, G Parenti, G Simontacchi, G Rastrelli, C Giuliani, A Ognibene, A Peri
PURPOSE: The aim of the present study was to evaluate the role of hypothyroidism as a cause of hyponatremia in a clinical model of iatrogenic acute hypothyroidism due to thyroid hormone withdrawal prior to ablative radioactive iodine (RAI) therapy after total thyroidectomy. METHODS: The study group consisted of 101 differentiated thyroid cancer (DTC) patients (77 women and 24 men). Plasma concentration of thyroid-stimulating hormone ([TSH]) and sodium ([Na(+)]) was evaluated before total thyroidectomy (pre[TSH] and pre[Na(+)]) and on the day of RAI therapy (post[TSH] and post[Na(+)])...
January 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/27215354/tolerance-and-withdrawal-issues-with-sedatives-in-the-intensive-care-unit
#19
REVIEW
Gina Riggi, Antonia Zapantis, Simon Leung
Prolonged use of sedative medications continues to be a concern for critical care practitioners, with potential adverse effects including tolerance and withdrawal. The amount of sedatives required in critically ill patients can be lessened and tolerance delayed with the use of pain and/or sedation scales to reach the desired effect. The current recommendation for prolonged sedation is to wean patients from the medications over several days to reduce the risk of drug withdrawal. It is important to identify patients at risk for iatrogenic withdrawal and create a treatment strategy...
June 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/27084344/clinical-recommendations-for-pain-sedation-withdrawal-and-delirium-assessment-in-critically-ill-infants-and-children-an-espnic-position-statement-for-healthcare-professionals
#20
REVIEW
Julia Harris, Anne-Sylvie Ramelet, Monique van Dijk, Pavla Pokorna, Joke Wielenga, Lyvonne Tume, Dick Tibboel, Erwin Ista
BACKGROUND: This position statement provides clinical recommendations for the assessment of pain, level of sedation, iatrogenic withdrawal syndrome and delirium in critically ill infants and children. Admission to a neonatal or paediatric intensive care unit (NICU, PICU) exposes a child to a series of painful and stressful events. Accurate assessment of the presence of pain and non-pain-related distress (adequacy of sedation, iatrogenic withdrawal syndrome and delirium) is essential to good clinical management and to monitoring the effectiveness of interventions to relieve or prevent pain and distress in the individual patient...
June 2016: Intensive Care Medicine
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