Aims To assess the frequency and cost of drug reactions causing or prolonging hospitalization. Methods All patients admitted to an internal medicine ward over 6 months were evaluated to identify serious adverse reactions. The number of drug classes on admission or at the time of the adverse drug reaction (ADR) was counted. Excess ADR-related hospital stay was computed using a) raw excess duration of hospital stay, b) correction of duration of hospital stay by age, sex, and number of drug classes, and c) estimation by investigator of excess hospital stay. Results Three hundred and twenty-nine patients were evaluated: 212 male, 117 female, mean age 57.2 (males: 52.2, females: 66.2 ( P<0.05)), range 17-95 years.
Objective. To date, statins have more often been considered a safe medication. However, with the wider use of statins, severe side effects have also been reported to occur in statin-treated patients, especially myositis and rhabdomyolysis. Currently, however, statin-associated tendon impairment has only been described anecdotally. The aim of this retrospective study was to evaluate tendon manifestations occurring in statin-treated patients. Methods. All reports in which a statin was listed spontaneously as a causative suspect medication of tendon complications in the network of the 31 French Pharmacovigilance Centers from 1990 -2005 were included in this study. Data collection included patient characteristics and tendon adverse effects (time to onset of adverse effects, pattern, site of injury, and outcome). The percentage of the reports was further calculated for each statin. Results. Data were collected from 96 patients with a median age of 56 years; patients exhibited tendinitis (n ؍ 63) and tendon rupture (n ؍ 33). Tendinopathy more often occurred within the first year after statin initiation (59%). Tendon manifestations were related to atorvastatin (n ؍ 35), simvastatin (n ؍ 30), pravastatin (n ؍ 21), fluvastatin (n ؍ 5), and rosuvastatin (n ؍ 5). Statin was reinitiated in 7 patients, resulting in recurrence of tendinopathy in all cases. Conclusion. Our series suggests that statin-attributed tendinous complications are rare, considering the huge number of statin prescriptions. We suggest that prescribers should be aware of tendinous complications related to statins, particularly in risky situations, including physical exertion and association with medications known to increase the toxicity of statins.
Aims To test the existence of an association between reports of hypoglycaemia and angiotensin converting enzyme inhibitors, in a spontaneous reports database. Methods The French Pharmacovigilance database was examined for an association between adverse drug reaction reports mentioning hypoglycaemia, and angiotensin converting enzyme inhibitors (ACEI) using the case/non-case methodology, with reports of hypoglycaemia as cases and all other reports as comparators. The association between ACEI or other chosen drugs and hypoglycaemia was also tested in the subgroups of patients taking or not antidiabetic agents (ADA). Results 428 of 93338 reports mentioned hypoglycaemia (202/2227 with ADA (OR 40, 95% CI 33-48)). 46/5717 reports mentioned ACEI (OR 1.8 (1.25-2.54)). Other study drugs associated with hypoglycaemia were cibenzoline (OR 80 (57-112)), disopyramide (OR 32 (22-46)), nifedipine (OR 2.16 (1.32-3.51)), diltiazem (OR 1.76 (1.01-3.06)) nitrates (nitroglycerin, molsidomine) (OR 1.91 (1.16-3.16)) and frusemide (OR 1.89 (1.31-1.76)), but not nicardipine, amlodipine, felodipine or nitrendipine, diazepam, atenolol or combination thiazide diuretics. However, ACEI and other drugs were associated with ADA, so that in the subgroups of patients taking or not ADA, the association of ACEI with hypoglycaemia disappeared (OR 0.9 (0.5-1.4) and 1.2 (0.7-2.2), respectively). The same was found for other drugs except cibenzoline. Conclusion The association between reporting of hypoglycaemia and ACE inhibitors was related to concomitant use of antidiabetic agents. This was true also for other drugs used in arterial disease or renal failure, such as calcium channel blockers, nitrates, and frusemide.
Although buprenorphine hepatitis is uncommon and has spontaneously good evolution, we suggest better monitoring of hepatic profiles in patients whose mitochondrial function is already impaired by viral infections or other toxic factors.
A 60-year-old woman was diagnosed with PV in 1969 and successfully maintained in remission by repeated courses of busulfan alternating with phlebotomy. In 1990, hydroxyurea was given instead of busulfan. The patient had never smoked nor drunk any alcohol and had never been exposed to other toxic drugs or poisons.In May 1992, the patient became anemic, hydroxyurea was stopped. In September 1992, the hemoglobin (Hb) level was 11.1 g%, the leukocyte count was 48,600/mm3, and the platelet count was 518,000/mm3. Bone marrow biopsy showed myelofibrosis and a normal 46XX karyotype. Hydroxyurea was again started and further remission obtained. In April 1993, fatigue, dysphagia, dyspnea on exertion, and rapid weight loss occurred. Upon admission to Geneva University Hospital, the patient looked pale and was bedridden. No lymph nodes were palpable, but one 2-cm subcutaneous nodule in the scalp and another in the upper part of the thorax, also measuring 2 cm, were identified. The spleen was grossly enlarged to 21 cm. Laboratory investigations were as follows. Hemoglobin was 9.9 g% and leukocytes 15,000/mm3 with 90% neutrophils, 3% basophils, 4% monocytes, 2% lymphocytes, and 1% myelocytes; platelets were 398,000/ mm3. Asymptomatic hypercalcemia at 1.54 mmol/L (normal range = 1.06-1.26) was discovered, which returned to normal after infusion of 1,800 mg of clodronate.Fiberoptic esophagoscopy revealed an ulcerative lesion of the middle portion of the esophagus measuring 4 cm in length with a stenosis leaving an open passage inferior to 1 cm. Biopsies were taken, and the histology showed a well-differentiated squamous cell carcinoma. Cytology of the skin nodes gave a similar result. Thoracic and abdominal CT showed mediastinal and retroperitoneal metastatic lymph nodes as well as direct contiguous infiltration of both lungs and of the thoracic spine. Bronchoscopy was macroscopically normal, but tumor cells were found in the bronchial aspirate. Despite palliative external radiation therapy, the patient's condition rapidly declined, and she died with bilateral infectious pneumonia and overt progressive malignant disease 1 month later. Autopsy was not permitted.Patients with PV are at greater risk than the normal population of the development of a second malignancy. In a review of 431 PV patients treated with phlebotomy with or without CLB and 3zP over 11 years, a total of 51 nonhematological malignancies were reported, of which 20 were of gastrointestinal origin [l]. Patients treated with CLB had a 3-3.5 relative risk (RR) of developing a secondary malignancy compared to the population with PV that did not receive that drug. For patients treated with "P, the RR was 2.3-2.5, and the RR was not increased for patients treated with phlebotomy alone.Our patient was treated with another alkylating agent, busulfan, at a total cumulative dose of 950 mg, which has the same, if not greater, carcinogenic potential than CLB [2]. The patient also received several courses of hydroxyurea, which has never proved any carcinogenicity. In the abse...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.