Evaluation of the adverse reactions of antiretroviral drug regimens in a tertiary care hospital

Rather, Zahoor Ahmad; Chowta, Mukta N; Raju, Gagan; Mubeen, Faheem

doi:10.4103/0253-7613.108294

Cited by 13 publications

(3 citation statements)

References 12 publications

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“…Peripheral neuropathy, anaemia, hepatitis and gastritis were the most prevalent DIDs with use of highly active anti-retroviral therapy (HAART) treatment in the study of Anwikar et al 28 . Rather et al 29 reported anaemia, hepatic toxicity, itching, skin rash, elevated triglycerides and peripheral neuropathy to be the most common DIDs in their study due to ART. Common cardiovascular adverse drug events reported were drug-induced arrhythmias, blood pressure abnormalities and heart failure 22 .…”

Section: Discussionmentioning

confidence: 91%

Drug-induced diseases (DIDs): An experience of a tertiary care teaching hospital from India

Tandon¹,

Khajuria²,

Mahajan³

et al. 2015

Indian J Med Res

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Background & objectives:Drug-induced diseases (DIDs) are well known but least studied. Data on DIDs from India are not available. Hence, this retrospective cross-sectional study was undertaken using suspected adverse drug reaction (ADR) data collected form Pharmacovigilance Programme of India (PvPI) to evaluate profile of DIDs over two years, in a tertiary care teaching hospital from north India.Methods:The suspected ADRs in the form of DID were evaluated for drug and disease related variables and were classified in terms of causality.Results:DID rate was 38.80 per cent. Mean duration of developing DIDs was 26.05 ± 9.6 days; 25.16 per cent had more than one co-morbid condition. Geriatric population (53.99%) accounted for maximum DIDs followed by adult (37.79%) and paediatric (8.21%). Maximum events were probable (93.98%) followed by possible (6.04%). All DIDs required intervention. Gastritis (7.43%), diarrhoea (5.92%), anaemia (4.79%), hypotension (2.77%), hepatic dysfunction (2.69%), hypertension (1.51%), myalgia (1.05%), and renal dysfunction (1.01%) were some of the DIDs. Anti tubercular treatment (ATT), anti retroviral treatment (ART), ceftriaxone injection, steroids, non-steroidal anti-inflammatory drugs, antimicrobials and anticancer drugs were found as commonly offending drugs.Interpretation & conclusions:Our findings show that DIDs are a significant health problem in our country, which need more attention.

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Section: Discussionmentioning

confidence: 91%

Drug-induced diseases (DIDs): An experience of a tertiary care teaching hospital from India

Tandon¹,

Khajuria²,

Mahajan³

et al. 2015

Indian J Med Res

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“…This also substantiates our findings that anti-tubercular and antiretroviral drugs are known to cause skin reactions and liver damage. [181920] Probably, this supports cohort monitoring and integration of Revised National Tuberculosis Control Programme and ART programme with nationwide PvPI. In addition, it has been reported by Agaard et al .…”

Section: Discussionmentioning

confidence: 67%

An analysis of serious adverse drug reactions at a tertiary care teaching hospital

et al. 2016

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Objective:The objective of this study was to analyze the various aspects of serious adverse drug reactions (serious ADRs) such as clinical presentation, causality, severity, and preventability occurring in a hospital setting.Materials and Methods:All serious ADRs reported from January 2010 to May 2015 at ADR Monitoring Centre, Department of Pharmacology, B. J. Medical College and Civil Hospital, Ahmedabad, were selected as per the World health Organization –Uppsala Monitoring Center (WHO-UMC) criteria. A retrospective analysis was carried out for clinical presentation, causality (as per the WHO-UMC scale and Naranjo's algorithm), severity (Hartwig and Siegel scale), and preventability (Schumock and Thornton criteria).Results:Out of 2977 ADRs reported, 375 were serious in nature. The most common clinical presentation involved was skin and appendageal disorders (71, 18.9%). The common causal drug group was antitubercular (129, 34.4%) followed by antiretroviral (76, 20.3%) agents. The criteria for the majority of serious ADRs were intervention to prevent permanent impairment or damage (164, 43.7%) followed by hospitalization (158, 42.1%). Majority of the serious ADRs were continuing (191, 50.9%) at the time of reporting, few recovered (101, 26.9%), and two were fatal. The majority of serious ADRs were categorized as possible (182, 48.8%) followed by probable (173, 46.1%) in nature.Conclusion:Antitubercular, antiretroviral, and antimicrobial drugs were the most common causal drug groups for serious ADRs. This calls for robust ADR monitoring system and education of patients and prescribers for identification and effective management.

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“…Treated with antiretroviral therapy, HIV-infected individuals are living longer but prone to the potentially neurotoxic effects of antiretroviral therapy ( Gabbai et al ., 2013 ). Antiretroviral toxicity is an increasingly important issue in the management of HIV-infected patients ( Rather et al ., 2013 ). The neuropathic pain caused by DSP is very difficult to manage with few options available.…”

Section: Discussionmentioning

confidence: 99%

The Protective Effects of IGF-1 on Different Subpopulations of DRG Neurons with Neurotoxicity Induced by gp120 and Dideoxycytidine In Vitro

Lin

Dong

Liu

et al. 2014

Biomolecules & Therapeutics

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Peripheral neuropathy induced by human immunodeficiency virus (HIV) infection and antiretroviral therapy is not only difficult to distinguish in clinical practice, but also difficult to relieve the pain symptoms by analgesics because of the severity of the disease at the later stage. Hence, to explore the mechanisms of HIV-related neuropathy and find new therapeutic options are particularly important for relieving neuropathic pain symptoms of the patients. In the present study, primary cultured embryonic rat dorsal root ganglion (DRG) neurons were used to determine the neurotoxic effects of HIV-gp120 protein and/or antiretroviral drug dideoxycytidine (ddC) and the therapeutic actions of insulin-like growth factor-1 (IGF-1) on gp120- or ddC-induced neurotoxicity. DRG neurons were exposed to gp120 (500 pmol/L), ddC (50 μmol/L), gp120 (500 pmol/L) plus ddC (50 μmol/L), gp120 (500 pmol/L) plus IGF-1 (20 nmol/L), ddC (50 μmol/L) plus IGF-1 (20 nmol/L), gp120 (500 pmol/L) plus ddC (50 μmol/L) plus IGF-1 (20 nmol/L), respectively, for 72 hours. The results showed that gp120 and/or ddC caused neurotoxicity of primary cultured DRG neurons. Interestingly, the severity of neurotoxicity induced by gp120 and ddC was different in different subpopulation of DRG neurons. gp120 mainly affected large diameter DRG neurons (>25 μm), whereas ddC mainly affected small diameter DRG neurons (≤25 μm). IGF-1 could reverse the neurotoxicity induced by gp120 and/or ddC on small, but not large, DRG neurons. These data provide new insights in elucidating the pathogenesis of HIV infection- or antiretroviral therapy-related peripheral neuropathy and facilitating the development of novel treatment strategies.

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Evaluation of the adverse reactions of antiretroviral drug regimens in a tertiary care hospital

Cited by 13 publications

References 12 publications

Drug-induced diseases (DIDs): An experience of a tertiary care teaching hospital from India

Drug-induced diseases (DIDs): An experience of a tertiary care teaching hospital from India

An analysis of serious adverse drug reactions at a tertiary care teaching hospital

The Protective Effects of IGF-1 on Different Subpopulations of DRG Neurons with Neurotoxicity Induced by gp120 and Dideoxycytidine In Vitro

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