Purpose of review
Although vitamin C is essentially a nontoxic vitamin; however, it is important to be aware regarding the safety of high doses before the wide clinical use.
Recent findings
Minor side effects of vitamin C have been reported, many being reported in earlier studies. High doses of vitamin C (up to 1.5 g/kg three times a week as intravenously) were safe in cancer patients with normal renal function and perfect glucose-6-phosphate dehydrogenase activity. As the dose and duration of administration of vitamin C in sepsis are lower and shorter than those used in cancer patients, it seems that it is relatively safe for this population. In ongoing trials, safety of high doses of vitamin C is considered.
Summary
Data regarding the safety of high doses of vitamin C are scant. Until more data become available, caution should be applied in the use of high doses of vitamin C in patients with hemochromatosis, glucose-6-phosphate dehydrogenase deficiency, renal dysfunction, kidney stone, oxaluria, and pediatrics.
Pyoderma gangrenosum is a rare ulcerative dermatosis. It may be caused by some drugs, including small molecule tyrosine kinase inhibitors (TKIs). The aim of this study was to evaluate the reported evidence of pyoderma gangrenosum associated with the use of these drugs. A systematic electronic literature search of PubMed and Embase was conducted. In these databases, search terms describing pyoderma gangrenosum were combined with TKIs. Fifteen case reports (eight cases associated with sunitinib, two with imatinib, two with ibrutinib, one with gefitinib, one with pazopanib, and one with dabrafenib and trametinib) were identified over the 14 years. The average Naranjo score of these cases is 6.6, which indicates a probable adverse drug reaction. Pyoderma gangrenosum is a probable and reversible drug reaction associated with some TKIs. Detailed medical history can help to prompt diagnosis of drug-induced pyoderma gangrenosum.Clinicians should be aware of TKI-associated pyoderma gangrenosum when caring for the skin of oncologic patients undergoing therapy with kinase inhibitors. Anti-Cancer Drugs 33: e1-e8
Background:
In recent years, few cases of post-artemisinin delayed hemolysis have been reported.
Objective:
All cases of post-artemisinin delayed hemolysis were reported from non-middle east areas.
No case of post-artemisinin delayed hemolysis has yet been reported from this region. In this paper, we
describe a case of post-artemisinin delayed hemolysis in an Iranian female. Moreover, previous reports
have been reviewed.
Methods:
Patient’s data including demographic characteristics, past medical, drug and travelling
history, present illness, vital signs, laboratory data, clinical course of current illness and follow-up
findings were considered.
Results:
A 27-year-old female with a recent travel history to Ghana admitted with severe falciparum
malaria. She was successfully treated with parenteral artesunate. However after 12 days of post
artesunate treatment, she returned with dark urine, malaise and fatigue.
Conclusion:
Considering the clinical course and base on a reliable causality assessment scale, post
artesunate delay hemolytic anemia was possible.
Background: Pharmacotherapy with biologics and small molecules, as the more effective therapies for moderate to severe ulcerative colitis (UC) and Crohn’s disease (CD), is complex. Choosing the best methods for their utilization in order to induce and maintain remission are critical for practicing gastroenterologists. We aimed to develop an Iranian consensus on the management of inflammatory bowel disease (IBD) patients with biologics and small molecules. Methods: A Delphi consensus was undertaken by experts who performed a literature summary and voting process. Quality of evidence was assessed using the Grading and Recommendations Assessment, Development, and Evaluation; and an additional risk of bias-protocol. Results: Following an extensive search of the literature, 219 studies were used to determine the quality of the evidence. After three rounds of voting, consensus (defined as≥80% agreement) was reached for 87 statements. Conclusion: We considered different aspects of pharmacotherapy in this consensus. This guideline, along with clinical judgment, can be used to optimize management of IBD patients.
Datura spp. is a potentially poisonous plant that is widely spread and is simply accessible, which can yield poisoning with a central and peripheral anticholinergic effect. We reported cases of family poisoning caused by the herbal tea with refreshing effects that were identified as Datura spp.
Background and Aim
The COVID‐19 pandemic forced healthcare systems to apply new technology‐based solutions. The main objective of our study was to describe the conceptual model for rapid implementation of telepharmacy service and the main steps that should be considered.
Method
In response to a limited number of on‐site clinical pharmacy specialists and a lack of technology infrastructure, a cross‐sectional telepharmacy program was established to support major teaching hospitals. A store and forward model of teleconsultation was employed using WhatsApp messenger to cover various aspects of multidisciplinary collaboration in COVID‐19 management. All identifiable personal information was removed from all exchanged messages of collaborative consultations. The thematic analysis of consultations was performed to extract the main themes and subthemes that should be considered for designing future telepharmacy systems.
Results
Through telepharmacy service, 600 intensive care unit teleconsultations for COVID‐19 cases were conducted in the residence center and nonresidence centers. In total, 1200 messages were exchanged between specialists in 3 months. The average time taken to respond to a message was 1.30 h. Thematic analysis revealed four main concepts and 15 subconcepts that should be considered in telepharmacy consultations for COVID‐19 management. Based on the extracted themes, a conceptual model for developing a telepharmacy program was devised.
Conclusion
The results showed that by utilizing telehealth, clinical pharmacists could cover critically ill patients who need pharmacotherapy counseling through interdisciplinary collaboration. Moreover, the main features of our service that are represented through this survey can be employed by other researchers for developing telepharmacy services.
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.