Salmeterol rash

Hatton, MatthewQ.F.; Allen, MartinB.; Mellor, E; Cooke, N. J.

doi:10.1016/0140-6736(91)92845-s

Cited by 8 publications

(2 citation statements)

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“…The inhalation of salmeterol resulted in a hypersensitivity reaction characterised by a rash, found not to be caused by the propellant. [198] Exacerbation of asthma after nebulised beclomethasone in I child was put down to a reaction to the drug after discounting the excipient effect. [199] Preservatives contained in inhalation systems also give rise to unwanted hypersensitivity reactions.…”

Section: Inhalation Systemsmentioning

confidence: 99%

Adverse Drug Events Related to Dosage Forms and Delivery Systems

Uchegbu

Florence

1996

Drug Safety

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While some of the adverse events caused by the administration of medicines are specifically attributable to the drug molecule, a proportion arises because of the chemical, biological and physical nature of the formulation. The effects may be compounded by certain patient factors, an incomplete understanding of the behaviour of the formulation or the coadministration of other drugs. This review examines adverse drug reactions and other adverse events arising from the nature of the dosage form or formulation used. These adverse effects may be the result of local irritation/toxicity, hypersensitivity or allergic reactions, systemic effects from essentially local therapies, or idiosyncratic reactions in a small number of individuals. In certain cases where the exact nature of the formulation is unknown, adverse events cannot be attributed to any single ingredient. In addition, the total of all ingredients of a formulation, even where details of the formulation are clear, may give rise to abnormal behaviour of the formulation in vivo. Often the desired objective of a particular specialised formulation leads to an unforseen but related adverse effect, and in certain instances these events are completely unpredictable and at variance with the perceived objectives of the formulation.

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Section: Inhalation Systemsmentioning

confidence: 99%

Adverse Drug Events Related to Dosage Forms and Delivery Systems

Uchegbu

Florence

1996

Drug Safety

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“…The patient was also given inhalation aerosol with salmeterol for two weeks. Although salmeterol can cause an allergic rash, 5 it is unlikely that its use could be implicated in this adverse event. Systemic exposure to salmeterol is indeed negligible with the use of inhalation aerosol; this significantly lessens its potential to cause acute injury to the liver.…”

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confidence: 99%

Eosinophilic Hepatitis Associated with Cefonicid Therapy

et al. 2001

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tients had elevated liver enzymes. We describe a man who developed reversible eosinophilic hepatitis after two weeks of treatment of community-acquired pneumonia with cefonicid.Case Report. A 67-year-old white man was referred to the Internal Medicine Department for evaluation of hepatitis. Results of liver function tests performed two months earlier were normal, and his previous medical history was unremarkable. The patient did not drink alcohol and had no known exposure to hepatotoxins or parenterally transmitted viruses. There was no family history of liver disease. He was not using over-the-counter medications or herbal medicines and had no history of allergy to any medication.The patient had a 20-day history of a cough productive of yellowish sputum, with low-grade fever, asthma, and generalized malaise. A chest X-ray showed a small consolidation in the right lower lobe; treatment was begun with intramuscular cefonicid 1 g/d and inhalation aerosol with salmeterol xinafoate and fluticasone propionate. After one week of cefonicid therapy, the patient reported improved pulmonary symptoms, but not complete recovery. At that time, a transient, itchy, erythematous, papular rash was observed on his chest, forehead, and back. The rash promptly subsided after a single dose of diphenhydramine 25 mg. Treatment with cefonicid, salmeterol, and fluticasone was continued. Seven days later, the patient was seen in the emergency department reporting anorexia, nausea, vomiting, fatigue, and abdominal discomfort.On physical examination, the patient was afebrile, anicteric, fully alert, and had no cutaneous stigmata of chronic liver disease. The abdomen was diffusely tender, with no rebound tenderness and no evidence of organomegaly or ascites. Flapping tremor was absent. Laboratory results included a serum aspartate transaminase (AST) concentration of 160 U/L (normal range 10-36), an alanine transaminase (ALT) concentration of 312 U/L (6-40), a γ-glutamyl transferase (GGT) concentration of 453 U/L (7-49), and an alkaline phosphatase (AP) concentration of 563 U/L (91-258). Serum bilirubin was normal, and albumin concentration was 3.2 g/L. Laboratory evaluation did not reveal evidence of viral, metabolic, or autoimmune liver disease. Peripheral eosinophilia was observed (percentage of eosinophils was as high as 22% on repeated determination), with an absolute count of 700 cells/mm. 3 Abdominal ultrasonography showed an enlarged liver with a normal gallbladder and pancreas. Computed tomography of the abdomen was consistent with a fatty liver, and there was no evidence of biliary obstruction. A liver biopsy was not done.Cefonicid therapy was discontinued and the symptoms gradually improved, with complete resolution after four days. Serum enzyme concentrations and the absolute eosinophil count decreased rapidly, although they remained elevated throughout the eight days of hospitalization. At no time were signs or symptoms of hepatic failure observed. The patient did not consent to a rechallenge test.Because of the gradual decline i...

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Drug Reactions

Breathnach¹

2004

Rook's Textbook of Dermatology

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Salmeterol rash

Cited by 8 publications

References 0 publications

Adverse Drug Events Related to Dosage Forms and Delivery Systems

Adverse Drug Events Related to Dosage Forms and Delivery Systems

Eosinophilic Hepatitis Associated with Cefonicid Therapy

Drug Reactions

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