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Adverse drug reactions

Stefanie Thevelin, Anne Spinewine, Jean-Baptiste Beuscart, Benoit Boland, Sophie Marien, Fanny Vaillant, Ingeborg Wilting, Ariel Vondeling, Carmen Floriani, Claudio Schneider, Jacques Donzé, Nicolas Rodondi, Shane Cullinan, Denis O'Mahony, Olivia Dalleur
AIM: We aimed to develop a standardized chart review method to identify drug-related hospital admissions (DRA) in older people caused by non-preventable adverse drug reactions and preventable medication errors including overuse, underuse and misuse of medications: the DRA adjudication guide. METHODS: The DRA adjudication guide was developed based on design and test iterations with international and multidisciplinary input in 4 subsequent steps: literature review, evaluation of content validity using a Delphi consensus technique, a pilot test and a reliability study...
July 14, 2018: British Journal of Clinical Pharmacology
Clara Crespillo-Andújar, Emmanuele Venanzi-Rullo, Rogelio López-Vélez, Begoña Monge-Maillo, Francesca Norman, Ana López-Polín, José A Pérez-Molina
INTRODUCTION: Benznidazole is the preferred drug for treatment of Chagas disease. However, it is toxic and of limited value in chronic infection. OBJECTIVE: We aimed to estimate the rates of and factors related to adverse reactions (ARs) to benznidazole and treatment discontinuations (TDs). METHODS: A meta-analysis was performed using an electronic search of the published literature with no language restrictions until June 2017. Prospective studies were included of chronically infected patients in which at least one treatment arm included benznidazole...
July 13, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Bianca J Levkovich, Gordon Bingham, Daryl Jones, Carl M Kirkpatrick, D J Jamie Cooper, Michael J Dooley
BACKGROUND: In hospitals, rapid response systems (RRSs) identify patients who deteriorate and provide critical care at their bedsides to stabilise and escalate care. Medications, including oral and parenteral pharmaceutical preparations, are the most common intervention for hospitalised patients and the most common cause of harm. This connection between clinical deterioration and medication safety is poorly understood. OBJECTIVES: To inform improvements in prevention and management of clinical deterioration, this review aimed to examine how medications contributed to clinical deterioration and how medications were used in RRSs...
July 10, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Margo H Lederhandler, Anthony Ho, Nooshin Brinster, Roger S Ho, Tracey N Liebman, Kristen Lo Sicco
Treatment of malignancy with anti-programmed cell death 1 (PD-1) immune checkpoint inhibitors can cause mucocutaneous side effects resulting from T cell activation. Due to their recent development, the full side effect profile remains to be fully elucidated, however dermatologic adverse events are most common. The main oral toxicities of these immune checkpoint inhibitors include: xerostomia, dysgeusia, and lichenoid reactions. Oral mucositis occurs more rarely in the setting of PD-1 inhibition, and few other reports of a Grade 3 or higher, severe, stomatitis have been reported in the literature...
July 1, 2018: Journal of Drugs in Dermatology: JDD
Chang-Hyun Lee, Hae-Won Koo, Seong Rok Han, Chan-Young Choi, Moon-Jun Sohn, Chae-Heuck Lee
OBJECTIVE De novo seizure following craniotomy (DSC) for nontraumatic pathology may adversely affect medical and neurological outcomes in patients with no history of seizures who have undergone craniotomies. Antiepileptic drugs (AEDs) are commonly used prophylactically in patients undergoing craniotomy; however, evidence supporting this practice is limited and mixed. The authors aimed to collate the available evidence on the efficacy and tolerability of levetiracetam monotherapy and compare it with that of the classic AED, phenytoin, for DSC...
July 13, 2018: Journal of Neurosurgery
Shaoshuang Fan, Yuhuan Zou, Yifeng Wang, Fang Fang, Wenguang Song
PURPOSE: To investigate the efficacy and safety of apatinib mesylate (AM) in treating advanced non-small cell lung cancer (aNSCLC) with wild or unknown epidermal growth factor receptor (w/nEGFR). METHODS: A total of 34 w/nEGFR -aNSCLC patients who failed chemotherapy from August 2015 to April 2017 were administered orally AM (425 mg/d) as primary treatment and observed their progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR), as well as related adverse events...
May 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Gary L O'Brien, Denis O'Mahony, Paddy Gillespie, Mark Mulcahy, Valerie Walshe, Marie N O'Connor, David O'Sullivan, James Gallagher, Stephen Byrne
BACKGROUND: A recent randomised controlled trial conducted in an Irish University teaching hospital that evaluated a physician-implemented medication screening tool, demonstrated positive outcomes in terms of a reduction in incident adverse drug reactions. OBJECTIVE: The present study objective was to evaluate the cost effectiveness of physicians applying this screening tool to older hospitalised patients compared with usual hospital care in the context of the earlier randomised controlled trial...
July 13, 2018: Drugs & Aging
Yi-Wen Li, Chung-Hsing Wang, Chao-Jung Chen, Charles C N Wang, Cheng-Li Lin, Wai-Kok Cheng, Hsin-Yi Shen, Yun-Ping Lim
To characterize the association between epilepsy, use of antiepileptic drugs (AEDs), and the risk of hyperlipidemia, we conducted a nationwide population-based cohort study with data obtained from the National Health Insurance Research Database of Taiwan. The effects of AEDs on lipogenic gene expression were also examined in vitro. We identified 3617 cases involving patients, whose epilepsy was newly diagnosed between 2000 and 2011, and selected a comparison cohort comprising 14,468 patients without epilepsy...
July 13, 2018: Archives of Toxicology
E Di Leo, P Delle Donne, G F Calogiuri, L Macchia, E Nettis
Adverse reactions (ARs) to drugs administered during general anesthesia may be very severe and life-threatening, with a mortality rate ranging from 3 to 9%. The adverse reactions to drugs may be IgE and non-IgE-mediated. Neuromuscular blocking agents (NMBA) represent the first cause of perioperative reactions during general anesthesia followed by latex, antibiotics, hypnotic agents, opioids, colloids, dyes and antiseptics (chlorhexidine). All these substances (i.e. NMBA, anesthetics, antibiotics, latex devices) may cause severe systemic non-IgE-mediated reactions or fatal anaphylactic events even in the absence of any evident risk factor in the patient's anamnesis...
2018: Clinical and Molecular Allergy: CMA
Hakan Ogutlu, Ali Karayagmurlu, Ibrahim Selcuk Esin, Onur Burak Dursun
Myasthenia gravis (MG) is an autoimmune disease, which can be triggered by anticholinergic agents. The 6-year-old female patient was admitted to the outpatient clinic. She was had been previously diagnosed with comorbid attention deficit hyperactivity disorder and conduct disorder and was receiving short-acting methylphenidate and risperidone, as recommended by a child psychiatrist. However, after using the drugs, she stated that she was overly tired during the day and that her eyelids drooped. Hence, the current treatment was stopped...
June 2018: Eurasian Journal of Medicine
Blas Y Betancourt, Ann Biehl, James D Katz, Ananta Subedi
Providing safe and effective pharmacotherapy to geriatric patients with rheumatologic disorders is challenging. Multidisciplinary care involving rheumatologists, primary care physicians, and other specialties can optimize benefit and reduce adverse outcomes. Oral disease-modifying antirheumatic drugs, including methotrexate, hydroxychloroquine, sulfasalazine, and leflunomide, and the small molecule inhibitors tofacitinib and apremilast have distinctive monitoring requirements and specific adverse reaction profiles...
August 2018: Rheumatic Diseases Clinics of North America
Marius Goldkuhle, Maria Dimaki, Gerald Gartlehner, Ina Monsef, Philipp Dahm, Jan-Peter Glossmann, Andreas Engert, Bastian von Tresckow, Nicole Skoetz
BACKGROUND: Hodgkin's lymphoma (HL) is a cancer of the lymphatic system, and involves the lymph nodes, spleen and other organs such as the liver, lung, bone or bone marrow, depending on the tumour stage. With cure rates of up to 90%, HL is one of the most curable cancers worldwide. Approximately 10% of people with HL will be refractory to initial treatment or will relapse; this is more common in people with advanced stage or bulky disease. Standard of care for these people is high-dose chemotherapy and autologous stem cell transplantation (ASCT), but only 55% of participants treated with high-dose chemotherapy and ASCT are free from treatment failure at three years, with an overall survival (OS) of about 80% at three years...
July 12, 2018: Cochrane Database of Systematic Reviews
Nathalie López, Anamaría Correa, Romina Ammann, Adriana Diettes, Rodrigo Riveros, Francisco Torres
INTRODUCTION: Propofol Infusion Syndrome (PRIS) is a rare but potentially lethal adverse reaction secondary to the continuous intravenous infusion of this drug. The diagnosis is based on the com bination of metabolic acidosis, rhabdomyolysis, hyperkalemia, hepatomegaly, renal failure, hyperli pidemia, arrhythmias, and rapidly progressive heart failure. OBJECTIVE: To report a case of PRIS and literature review. CLINICAL CASE: A 6-year-old female patient with history of epilepsy secondary to large malformation of cortical development of the right hemisphere...
June 2018: Revista Chilena de Pediatría
A Zambernardi, M Label
It is estimated that 10% to 15% of medicated patients develop adverse drug reactions (ADR). Despite the high prevalence of ADR, the identification of the trigger drugs remains a medical challenge, mainly in polymedicated patients. Our goal is to update the diagnostic tools to identify enhancer drugs of type B-ADR that compromise the skin and /or mucous membranes, in order to optimize patients' follow-up and improve their quality of life. We develop the review in two stages: I- we review the pathophysiological mechanisms of the ADR; II- we developed the clinical approach for the identification of the triggering drug...
July 8, 2018: Actas Dermo-sifiliográficas
Ajay K Nooka, Charise Gleason, Marva Ollivierre Sargeant, Michelle Walker, Melanie Watson, Elyse Hall Panjic, Sagar Lonial
Monoclonal antibodies (elotuzumab and daratumumab) are the newest class of drugs that have proven to be efficacious antimyeloma agents. Although daratumumab, a CD38 monoclonal antibody, has established its efficacy as a single agent and in combination with immunomodulatory agents and proteasome inhibitors, elotuzumab (signaling lymphocytic activation molecule F7 monoclonal antibody) has proven activity in combination with lenalidomide and dexamethasone. Infusion-related reactions (respiratory and nonrespiratory) seem to be a common theme of adverse events with monoclonal antibodies, although the relative incidence differs across these two agents...
July 2018: Journal of Oncology Practice
Masahiro Ohgami, Takayuki Kaburagi, Atsuhiko Kurosawa, Kosuke Doki, Toshihiro Shiozawa, Nobuyuki Hizawa, Masato Homma
BACKGROUND: Erlotinib is used for treating non-small cell lung cancer (NSCLC). Intestinal absorption of erlotinib is impaired under gastric pH elevation, therefore, co-administration of gastric acid suppressants may provide lower blood concentration of erlotinib. We investigated the effects of erlotinib co-administration with proton pump inhibitors (PPI) and histamine H2 receptor blockers (H2RB) on the plasma concentration of erlotinib and erlotinib-induced adverse reaction in NSCLC patients...
July 9, 2018: Therapeutic Drug Monitoring
Simon de Lusignan, Gaël Dos Santos, Rachel Byford, Anne Schuind, Silvia Damaso, Vishvesh Shende, Chris McGee, Ivelina Yonova, Filipa Ferreira
INTRODUCTION: The European Medicines Agency (EMA) requires vaccine manufacturers to conduct enhanced safety surveillance (ESS) of seasonal influenza vaccines including a near real-time evaluation of collected data. The objective was to identify whether the use of passive surveillance or active surveillance provides different results of reported adverse events of interest (AEIs) by specified age strata and AEI type. We report the weekly incidence rates of AEIs within 7 days following seasonal influenza vaccination using passive and active surveillance...
July 11, 2018: Advances in Therapy
Yun Wu, Peiru Wang, Linglin Zhang, Bo Wang, Xiuli Wang
BACKGROUND: Bowen's disease (BD) is treated effectively with 5-aminolevulinic acid (ALA)-photodynamic therapy (ALA-PDT). Plum-blossom needling (PBN) may enhance topical drug delivery. OBJECTIVE: To compare the effects of and adverse reactions to PBN and ALA-PDT of BD with those associated with ALA-PDT alone. MATERIALS AND METHODS: Forty-three lesions from 24 patients were randomly assigned to 2 groups. The PBN-ALA-PDT group underwent vertical skin tapping with PBN before applying 10% ALA cream and narrow-band light-emitting diode irradiation (λ = 633 ± 10 nm; 100-200 J/cm)...
July 9, 2018: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Lotta Schepel, Lasse Lehtonen, Marja Airaksinen, Outi Lapatto-Reiniluoto
OBJECTIVES: High-alert medications may cause significant patient harm when used in error. Hospital-specific safety data should be used to customize high-alert medication lists to fit the local context. The aim of this study was to identify organizational high-alert medications by evaluating university hospital's data on adverse drug reaction (ADR) and medication error (ME). METHODS: The Anatomical Therapeutic Chemical (ATC) codes and top active substances in ADR (n = 401) and ME (n = 11,668) reports of Helsinki University Hospital from 2015-2016 were analyzed and compared with hospitals' drug consumption and the Institute for Safe Medication Practices' (ISMP) list of high-alert medications...
July 7, 2018: Journal of Patient Safety
Jun-Sang Yu, Dongnyung Lee, Daesung Hyun, Sei-Jin Chang
OBJECTIVES: Cold hypersensitivity in the hands and feet (CHHF) and Raynaud's phenomenon (RP) are prevalent among Asian populations, especially among women, who exhibit a higher rate of cold hypersensitivity that may be associated with gynecological problems. In several countries, herbal medicine has effectively treated cold hypersensitivity symptoms. This systematic review and meta-analysis of the literature was undertaken to evaluate the efficacy of herbal medicine for the treatment of CHHF in adults...
July 11, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
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