Amphotericin B is most widely used antifungal drug of choice. We report a case of a 56-year-old man developed pain and skin swelling over right forearm at the intravenous access site during amphotericin B administration treatment given for mucormycosis, the post-operative of sinuses. After 4 hours of affected period, amphotericin B was administration. A well revealed thrombophlebitis of the right forearm was noted. The systemic reaction was assessed based on the naranjo algorithm and was found to be probable. The safety profile of amphotericin B and its adverse effects must be monitored on long term treatment usage.
Estima-se que existam mais de 30 mil pessoas com diabetes mellitus tipo 1 (DM1) no Brasil. Entre as complicações, a retinopatia diabética (RD) é uma das mais prevalentes, acometendo até 50% dos portadores de DM1 em algumas populações. Este estudo objetiva estimar a prevalência de RD em DM1 ou Diabetes autoimune latente em adultos (LADA), além de avaliar fatores de risco envolvidos. Foi realizado um estudo de corte-transversal avaliando 81 pacientes com mais de 18 anos e diagnosticados com DM tipo 1 de longa evolução. Aspectos demográficos, clínicos e laboratoriais foram avaliados através de questionário estruturado. Dados do exame oftalmológico foram coletados de prontuários. Observamos uma prevalência de 33% de RD em pacientes portadores de DM1 no estado do Ceará. Tal complicação foi mais associada a doentes com maior idade (p=0,004), maior tempo de DM1 (p<0,001), controle metabólico inadequado e principalmente, níveis aumentados de creatinina (p=0,011). Foi observado que pacientes com episódios de hipoglicemia grave apresentavam maior prevalência de RD. Além disso, foi observado uma associação importante entre RD e nefropatia diabética, conforme o descrito na literatura. Este estudo demonstra a alta prevalência de RD nos pacientes portadores de DM1 e confirma a necessidade de rastreamento da doença principalmente em pacientes com maior tempo de doença e controle metabólico inadequado e outras complicações como a nefropatia.
Gastroesophageal Reflux Disease (GRD) is the most common form of esophagitis, where proton pump inhibitors are the most widely used drugs. This study aimed to perform a literature review about the clinical use and adverse reactions of proton pump inhibitors (PPIs). Treatment of GRD evolved in the 1970s, when the first PPI, timoprazole, was discovered and in 1979, omeprazole originated, with a high action on the proton bomb. The most potent drugs in gastric suppression are proton pump inhibitors where they act irreversibly in the proton pump H + , K + ,-ATPase, the suppression of acid secretion lasts for 24-48 hr. PPIs with prolonged use are associated with changes in the intestinal microbiota, which can be compared to changes seen with antimicrobials, in addition to altering the absorption of iron and Vitamin B 12 and the metabolism of calcium and magnesium. The population most susceptible to the appearance of the side effects of PPIs is the elderly, age is a factor that predisposes to the appearance of various pathologies and it is necessary to use many medications thus constituting a polypharmacy, in addition, may increase the risks of drug toxicity due to the hepatic metabolism of the elderly being compromised, this is a worrying condition, as it can cause, in addition to the side effects of PPIs, drug interactions, making pharmacotherapeutic follow-up essential, thus being able to make dose adjustments and assess possible drug-related problems and adverse drug reactions.
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