2 serious and life threatening cutaneous drug reactions

... skin and gastrointestinal, respiratory, and cardiovascular systems (Chap 311) Primary symptoms and signs include pruritus, urticaria, nausea, vomiting, cramps, bronchospasm, and laryngeal edema and, ... clones With many drugs, an original observation was that the drug could be presented to the TCR and activate a specific clone without prior processing by the antigen-presenting cell and through a ... mediated by neutrophils or eosinophils, and collaboration with B cells for production of specific antibodies for urticarial reactions IMMEDIATE REACTIONS Immediate reactions depend on the release of...

Ngày tải lên: 07/07/2014, 01:20

... of drug therapy, and half of adult Americans receive prescription drugs on a regular outpatient basis Many additional patients use over-the-counter medicines that may cause adverse cutaneous reactions ... cutaneous reactions INCIDENCE OF CUTANEOUS REACTIONS Several large cohort studies established that acute cutaneous reaction to drugs affected about 3% of hospital inpatients Reactions usually occur a ... sulfamethoxazole, and many anticonvulsants (Table 56-1) It may be even higher with anti-HIV agents Table 56-1 Cutaneous Reactions to Drugs Received by at Least 1000 Patients (BCDSP)a Drug Reactio...

Ngày tải lên: 07/07/2014, 01:20

... in reactions mediated by neutrophils or eosinophils and from the intensity of stimulation and response GENETIC FACTORS AND CUTANEOUS DRUG REACTIONS Specific genetically determined defects in ... applications of these findings are not yet possible CLINICAL PRESENTATION OF CUTANEOUS DRUG REACTIONS Nonimmune Cutaneous Reactions EXACERBATION DISEASES OR INDUCTION OF DERMATOLOGIC A variety of ... phototoxicity Phototoxic reactions resemble sunburn and can occur with first exposure to a drug Their severity depends on the tissue level of the drug, its efficiency as a photosensitizer, and the extent...

Ngày tải lên: 07/07/2014, 01:20

... thighs, and buttocks Lesions are sharply demarcated, erythematous, indurated, and purpuric and may resolve or progress to form large, irregular, hemorrhagic bullae with eventual necrosis and slow-healing ... Development of the syndrome is unrelated to drug dose, and the course is not altered by discontinuation of the drug after onset of the eruption Warfarin reactions are associated with protein C deficiency ... vessels Warfarin-induced cutaneous necrosis is treated with vitamin K and heparin Treatment with protein C concentrates may also be helpful DRUG- INDUCED HAIR DISORDERS Drug- Induced Hair Loss Medications...

Ngày tải lên: 07/07/2014, 01:20

... edematous dermal and subcutaneous tissues are known as angioedema Angioedema may involve mucous membranes Urticaria and angioedema may be part of a life- threatening anaphylactic reaction Drug- induced ... absence of symptoms in ears, nose, and throat and upper respiratory tract, and polymorphism of the skin lesions support a drug rather than a viral eruption Maculopapular reactions usually develop within ... dysfunction, and neurologic symptoms Certain drugs, such as NSAIDs, ACE inhibitors, angiotensin II antagonists, and radiographic dyes, may induce urticarial reactions, angioedema, and anaphylaxis...

Ngày tải lên: 07/07/2014, 01:20

... the drug is started and lasts longer than mild eruptions after drug cessation Symptoms may persist for several weeks, especially hepatitis The eruption recurs with rechallenge, and cross -reactions ... multiorgan drug- induced reaction—is also known as DRESS and drug- induced hypersensitivity syndrome (DIHS) It presents as a widespread erythematous eruption that may become purpuric or lichenoid and ... facial and periorbital edema, tender generalized lymphadenopathy, leukocytosis (often with atypical lymphocytes and eosinophils), hepatitis, and sometimes nephritis or pneumonitis The cutaneous...

Ngày tải lên: 07/07/2014, 01:20

... subject of many investigations and a model for "drug allergy." Incidence of cutaneous reactions is about 1% About 85% of cutaneous reactions to penicillin are morbilliform, and about 10% are urticaria ... phenytoin, and carbamazepine among the older anticonvulsants, and lamotrigine among the newer, are associated with many types of severe reactions and a high incidence of less severe reactions, ... syndrome generally develops within h of drug administration Recurrences are frequent and can be complicated by nasal and sinus infection, polyposis, bloody discharge, and nasal eosinophilia In many individuals...

Ngày tải lên: 07/07/2014, 01:20

... followed by redness and a painful edematous eruption of the palms and soles; it is caused by cytarabine, doxorubicin, methotrexate, and 5-fluorouracil Urticaria, angioedema, and exfoliative dermatitis ... severe reactions including respiratory distress and hypotension are also observed in 10–20% of patients receiving paclitaxel regardless of premedication with glucocorticoids and histamine H(1) and ... anticancer effect Systemic antibiotics and topical anti-acne treatments are helpful Although not usually classified as adverse drug reactions, skin infections and skin cancer could become a major...

Ngày tải lên: 07/07/2014, 01:20

... general condition and severity of symptoms, size and location of the fistula and managing team Symptoms vary from mild coughing to more severe recurrent broncho-pneumonia and life- threatening mediastinitis ... was therefore freed from fibrosis and mobilised The fistula was exposed and transected The gastric and tracheal defects were closed with interrupted sutures and an intercostal muscle bundle was ... the gastric tube and esophageal stump proved well-vascularized and viable thus avoiding extensive heavy excisions and bypass replacement [2] We carried out selective dissection and transection...

Ngày tải lên: 10/08/2014, 10:20

... regulatory bodies and pharmaceutical companies, together with clinical experts and staff members of WHO and CIOMS, agreed on standard definitions of selected terms for adverse drug reactions and on minimum ... definitions and requirements, the easier it will be to monitor drug safety, and for drug regulators to carry out comparative assessment and verification of adverse reactions to new drugs Pharmaceutical ... medical terms used a b Professor and Director, Federal Institute for Drugs and Medical Devices, Berlin, Germany Director, Center for Drug Evaluation and Research, Food and Drug Administration, Rockville,...

Ngày tải lên: 07/03/2014, 10:20

... reports of drug abuse, overdoses, drug interactions and unusual lack of therapeutic efficacy” that may be an unintended response to a prescription drug 28 Food and Drugs Act: Food and Drug Regulations ... Health and Human Services Martin RM, Biswas PN, Freemantle SN, Pearce GL, Mann RD Age and sex distribution of suspected adverse drug reactions to newly marketed drugs in general practice in England: ... or “partner” in meeting the HPB mandate; and • a lack of new criteria for “safety”, new methods for post marketing evaluation of drugs and devices and social and ethical evaluation of new initiatives...

Ngày tải lên: 22/03/2014, 11:20

... Median MHS Drug toxicity 11 42 51 51 52 No drug toxicity 281 45 50 49 48 0.179 0.539 0.326 0.912 p-value Median PHS and median MHS pre-HAART and at week 16, 32 and 48 in patients with any drug toxicity ... 1.09; p = 0.081) Gender and the week 48 variables were not predictive of negative MHS at 48 weeks Drug toxicities and quality of life Eleven participants experienced drug- related toxicities during ... 6: Median physical health summary and median mental health summary scores and drug toxicity N Pre-HAART Week 16 Week 32 Week 48 Drug toxicity 11 39 51 52 50 No drug toxicity 281 44 52 53 53 0.854...

Ngày tải lên: 20/06/2014, 08:20

... appropriate levels of early screening and intervention that may prevent life threatening complications References Conclusion Combining the results of a recent publication and our own experience, we note ... hypercoagulability, and venous injury As first described by Trouseau in the nineteenth century, and supported by modern publications, some patients with malignancy are hypercoagulable and http://www.ro-journal.com/content/1/1/14 ... publication and our own unpublished experience yields (Table 3) cases of grade to cardiovascular (thrombosis/embolism) toxicity in a cohort of 128 patients The incidence of severe or life threatening...

Ngày tải lên: 09/08/2014, 10:20

... advertised drugs in those with a chronic condition, and that advertising made prescription drugs appear harmless [21] US Food and Drug Administration research is quoted as showing that patients and ... – data – can be conveyed, and possibly manipulated, for clarity or impact), and pertinent facts (accurate data with clear, decisive relevance to the matter in hand, and which may be used as the ... gastrointestinal bleeding NSAIDs and coxibs have become some of the most studied drugs ever, with at least 145,000 patients enrolled in randomised trials [3], and with up to 3.5 million patients...

Ngày tải lên: 09/08/2014, 10:23

... participated in study design and in data collection and interpretation, performed the statistical analysis, and drafted the manuscript JFG, XM, HK, and JM participated in study design and data collection ... face of life- threatening hypotension [1] We paid particular attention to patients with prior left ventricular dysfunction and particularly when a high MAP value was achieved Materials and methods ... international guidelines recommend to administer a vasopressor early to sustain life and maintain perfusion in the face of life- threatening hypotension, even when hypovolemia has not yet been resolved...

Ngày tải lên: 13/08/2014, 21:21

Ngày tải lên: 13/04/2015, 15:23

... between organic compounds and deuterium sources is very important for a wide range of applications such as protein dynamics, labeled drugs and mechanistic studies of organic reactions Recently, there ... lowered to 16.4 and 17.0 kcal/mol, for S-82b and R-82b, respectively Transition states S-H2O-TS and R-H2O-TS support the model of bifunctional activation by guanidine catalyst 25,8 and more importantly, ... In the direct process, two transition states, S-TS and R-TS, were located for S-1b and R-1b, with an overall activation free energy of 19.9 and 21.2 kcal/mol, respectively When a water molecule...

Ngày tải lên: 10/09/2015, 15:51

... cinchonidine and cinchonine were used and the products were obtained in opposite hands Following the above results, Deng et al reported the first highly diastereoselective and enantioselective and DA reactions ... approach.3 Rickborn and Koerner were the first to observe that anthrones can behave as dienes and able to take part in DA reactions with several dienophiles.4 However, it was Kagan and Riant who reported ... chemistry.1 The methods whereby DA reactions are traditionally and conventionally carried out included reflux and the use of Lewis acids as catalysts.2 On the other hand, the use of BrØnsted bases...

Ngày tải lên: 14/09/2015, 08:47

... 14 Chapter 2.2 2-Pyrones and derivatives The majority of 2-pyrone reactions lies in its use as a diene in DA reactions was mentioned in the earlier part (Section 2.1) and that a small amount of ... reactions of such 2-pyrones On the other hand, the products they produce are significantly useful in the course of synthetic organic chemistry It is thus worthwhile to study these reactions and ... oxazoline-containing compounds as catalysts for the reactions (Figure 2.3) These bis-oxazolines (BOX) are commonly used for metal-catalyzed reactions and had their roles as ligands binding to the metal centre.16...

Ngày tải lên: 14/09/2015, 08:47

... reaction of 1and 2a With the additional examples by Okamura and Deng, they demonstrated that a molecule containing a hydrogen-bond donor and an acceptor would be a suitable catalyst for the DA reactions ... N-benzyl maleimide 2c gave the DA product in 87% and 89% enantiomeric excess Different N-aryl maleimides were synthesized and applied in the DA reactions and the products could also be obtained in ... because of its robustness to most acidic and alkaline conditions in the reactions Attempts to put other types of protecting groups on the nitrogen, such as Cbz and Boc, in a bid to vary the chemical...

Ngày tải lên: 14/09/2015, 08:47