Amongst adverse drug reactions blood dyscrasias are not frequent, but they may have serious consequences. Compared with Sweden, data from The Netherlands are scarce. It is to be expected that regular reports about the incidence of drug-induced blood dyscrasias may play an important role in general prevention. Blood dyscrasias may be caused by a variety of drugs, from many pharmacotherapeutic groups with diverse chemical structures and with all application forms. Metabolism and distribution may influence the activity of drugs. Drug-induced anaemias, including aplastic anaemia, are briefly discussed. Toxic and immune mechanisms may occur. The same holds with regard to the leucopenias. Drug-induced thrombocytopenia is mainly immune-mediated (cytostatics being excluded as causative agents). In immune-mediated drug-induced blood dyscrasias often haptens must be formed. They can be formed in vivo in the liver or in the lymphocytes. In some cases they appear to be formed even in vitro. Tracing the causative agent of a dyscrasia, be it a drug or some other substance, requires a series of investigations, comprising usage of the drug, serology and cell culture. Provocation tests are seldom justified. Distinct preventive measures can be taken to minimize the risk of blood dyscrasias: avoidance of risky drugs, awareness of the patient about early clinical signs and haematological control.
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Therapeutic and pharmaceutical aspects of so-called non-regular medical treatment (anthroposophy, homoeopathy, phytotherapy etc.) were investigated by means of an inquiry directed to the suppliers of non-regular drugs. Data of 17 respondents are condensed into two tables and discussed in the light of the Medicines Supply Act. It is concluded that the pharmacist has to inform himself carefully about the non-regular preparations before he decides to supply them to the patient. It is concluded that the Drug Authorities should enforce five requirements regarding these preparations. SAMENVATTINGEen onderzoek werd ingesteld naar therapeutische en farmaceutische aspecten van niet-reguliere behandelingsmiddelen en hun leveranciers. De gegevens van zeventien leverancicrs werden samengevat in tabel II en nt en besproken, mede in het licht van de Wet op de Geneesmiddelenvoorziening. Geconcludeerd wordt dat de apotheker, wil hij genoemde middelen afleveren, zich zorgvuldig moet informeren bij de leverancier. In vijf punten worden eisen, die de Overheid aan dit soort middelen zou moeten stellen, samengevat.
Complexvorming. Zowel tussen hulpstoffen en geneeskrachtige stoffen, als tussen geneeskrachtige stoffen en voedsel kan complexvorming optreden.
Tel. (o70) 65 59 22 Postgirorekening 953 I Nederlandse Credietbank nr. 23.o7.o6.398 HOOFDBESTUUR Drs.J.L.M.Nieuwenhuis, voorzitter Dr.A.Bakker, ondervoorzitter Drs.M.F. van Lunen, secretaris-penningmeester Drs.J.Winters, waarnemend secretaris-penningmeester Drs.A.B.Cox, lid Mevr. Drs.J.A.L. van Lakwijk-Najoan, lid Drs.Th.Vos, lid D ~ ~ E C T O R I U M Mr. E. D. Harde rwij k, secretaris algemene zaken D rs. R. M. W. Eek ho f, secretaris maatschappelijke zaken Drs. H.A.Sloot, secretaris wetenschappelijke zaken ADMINISTRATEUR-BEHEERDER J.M.Kole BUREAU VOOR DE TARIEVEN
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