Type 1 diabetes mellitus caused by treatment with low-dose interferon-α in a melanoma patient.

Melanoma Res. 2017 Jul 19;:

Authors: Sossau D, Kofler L, Eigentler T

Abstract
Interferon-α (INF-α) is used as an adjuvant treatment for high-risk cutaneous melanoma. It has a large variety of potentially severe and irreversible side effects and can contribute toward the development of autoimmune disease. We report a case of a 59-year-old woman who developed type 1 diabetes following the use of low-dose IFN-α for the adjuvant treatment of stage IIB melanoma. Fifteen months after initiating IFN-α, she presented with blood glucose of 1126 mg/dl, hyponatremia, and microalbuminuria. Antibodies to glutamic acid decarboxylase and islet antigen-2 were negative and C-peptide was markedly reduced. There was no personal or family history of any autoimmune conditions. Reinforced insulin treatment and volume substitution with saline and glucose as a counter-regulation was started. To the best of our knowledge, this is the first reported case of low-dose IFN-α-induced type 1 diabetes. Clinicians should closely evaluate the pros and cons of IFN-α treatment in an adjuvant setting and remain mindful of the possibility of drug-induced autoimmune disease.

PMID: 28727675 [PubMed - as supplied by publisher]

Epidural steroid injection-related events requiring hospitalisation or emergency room visits among 52,935 procedures performed at a single centre.

Eur Radiol. 2017 Jul 19;:

Authors: Lee JW, Lee E, Lee GY, Kang Y, Ahn JM, Kang HS

Abstract
OBJECTIVES: To analyse the incidence and type of epidural steroid injection (ESI)-related adverse events, including procedure-related complications and drug-related systemic effects requiring hospitalisation or emergency room (ER) visits.
METHODS: This study included 52,935 ESI procedures performed in 22,059 patients in our department from March 2004 to February 2016. Of these, we retrospectively reviewed the cases of 1570 patients (1713 procedures) who were hospitalised or visited the ER within 1 month after ESI. ESI-related events were classified as procedure-related complications, drug-related systemic effects, or of uncertain relationship. Descriptive data are provided; no statistical analysis was performed.
RESULTS: There were 244 ESI-related events in 235 patients (males:females = 102:133; mean age: 65.7 years; range: 20-93 years). The incidence of ESI-related events was 0.46% per procedure, including 14 procedure-related complications, 56 drug-related systemic effects, and 174 events of uncertain cause. Of the 52,935 patients, 6 (0.011%) experienced major complications (two spine haematomas and four infections), 1 patient died, and 1 experienced neurological sequelae.
CONCLUSIONS: Although major procedure-related complications and drug-related systemic effects of ESI requiring hospitalisation are very rare, infection and haematoma can occur, resulting in serious outcomes. Hence, ESI should be carefully considered in high-risk patients.
KEY POINTS: • The incidence of ESI-related events requiring hospitalisation was 0.46%. • The incidence of procedure-related complications was 0.026%. • The incidence of drug-related systemic effects was 0.11%. • The incidence of major complication of ESI was 0.011%. • The major complications were spine infection, haematoma, and sepsis.

PMID: 28726118 [PubMed - as supplied by publisher]

Medication Literacy in a Cohort of Chinese Patients Discharged with Acute Coronary Syndrome.

Int J Environ Res Public Health. 2016 Jul 15;13(7):

Authors: Zhong Z, Zheng F, Guo Y, Luo A

Abstract
This study aims at investigating medication literacy of discharged patients with acute coronary syndrome (ACS) in China, and the important determinants of medication literacy among them. For this purpose, we conducted a prospective cohort study. Patient's demographic and clinical data were retrieved from hospital charts and medication literacy was measured by instructed interview using the Chinese version of Medication Literacy Questionnaire on Discharged Patient between 7 and 30 days after the patient was discharged from the hospital. The results show that medication literacy for the surveyed patients was insufficient: >20% did not have adequate knowledge on the types of drugs and the frequency that they need to take the drugs, >30% did not know the name of and the dosage of the drugs they are taking, and >70% did not have adequate knowledge on the effects and side effects of the drugs they are taking. Our research indicated that medication literacy scores decreased with age but increased with education. The number of medicines the discharged patient took with them and days between discharge and interview were not associated with medication literacy levels.

PMID: 27428990 [PubMed - indexed for MEDLINE]

[Decision aids in complex polypharmacy : Medication data bases and counselling by clinical pharmacists].

Z Gerontol Geriatr. 2017 Jul 18;:

Authors: Weinrebe W, Preda R, Bischoff S, Nussbickel D, Humm M, Jeckelmann K, Goetz S

Abstract
The number of older people with polypharmacy (more than six drugs taken simultaneously) is increasing. The greatest proportion consists of guideline drugs, analgesics and psychopharmaceuticals because in many cases of geriatric multimorbidity several underlying main diseases are present which must be treated according to the guidelines. Polypharmacy is a complex and difficult situation for all treating physicians because substantial side effects and intoxication can be induced but it can also be very difficult to recognize which drug was at fault and how a reduction can be safely made. This article describes the exemplary case of a 77-year-old patient with drug-induced delirium and demonstrates the procedure followed. The question of rapid assistance by the utilization of medication data bases is described and the importance of clinical pharmacists is demonstrated. In the future working with medication data bases will possibly become increasingly more important for physicians and hopefully simpler. The case presented here also shows that the effective and justified reduction of drugs can show a very good effect and is possible.

PMID: 28721543 [PubMed - as supplied by publisher]

The efficacy and safety of sugammadex for reversing postoperative residual neuromuscular blockade in pediatric patients: A systematic review.

Sci Rep. 2017 Jul 18;7(1):5724

Authors: Liu G, Wang R, Yan Y, Fan L, Xue J, Wang T

Abstract
The aim of this study is to evaluate the efficacy and safety of sugammadex for reversing neuromuscular blockade in pediatric patients. MEDLINE and other three Databases were searched. Randomized clinical trials were included if they compared sugammadex with neostigmine or placebo in pediatric patients undergoing surgery involving the use of rocuronium or vecuronium. The primary outcome was the time interval from administration of reversal agents to train-of-four ratio (TOFr, T4/T1) > 0.9. Incidences of any drug-related adverse events were secondary outcomes. Trial inclusion, data extraction, and risk of bias assessment were performed independently. Mean difference and relative risk were used as summary statistics with random effects models. Statistical heterogeneity was assessed by the I(2) statistic. Funnel plot was used to detect publication bias. Ten studies with 580 participants were included. Although considerable heterogeneity (I(2) = 98.5%) was detected in primary outcome, the results suggested that, compared with placebo or neostigmine, sugammadex can reverse rocuronium-induced neuromuscular blockade more rapidly with lower incidence of bradycardia. No significant differences were found in the incidences of other adverse events. Compared with neostigmine or placebo, sugammadex may reverse rocuronium-induced neuromuscular blockade in pediatric patients rapidly and safely.

PMID: 28720838 [PubMed - in process]

Using constrained information entropy to detect rare adverse drug reactions from medical forums.

Conf Proc IEEE Eng Med Biol Soc. 2016 Aug;2016:2460-2463

Authors: Yi Zheng, Chaowang Lan, Hui Peng, Jinyan Li

Abstract
Adverse drug reactions (ADRs) detection is critical to avoid malpractices yet challenging due to its uncertainty in pre-marketing review and the underreporting in post-marketing surveillance. To conquer this predicament, social media based ADRs detection methods have been proposed recently. However, existing researches are mostly co-occurrence based methods and face several issues, in particularly, leaving out the rare ADRs and unable to distinguish irrelevant ADRs. In this work, we introduce a constrained information entropy (CIE) method to solve these problems. CIE first recognizes the drug-related adverse reactions using a predefined keyword dictionary and then captures high- and low-frequency (rare) ADRs by information entropy. Extensive experiments on medical forums dataset demonstrate that CIE outperforms the state-of-the-art co-occurrence based methods, especially in rare ADRs detection.

PMID: 28268822 [PubMed - indexed for MEDLINE]

Henoch-Schönlein purpura and drug and vaccine use in childhood: a case-control study.

Ital J Pediatr. 2016 Jun 18;42(1):60

Authors: Da Dalt L, Zerbinati C, Strafella MS, Renna S, Riceputi L, Di Pietro P, Barabino P, Scanferla S, Raucci U, Mores N, Compagnone A, Da Cas R, Menniti-Ippolito F, Italian Multicenter Study Group for Drug and Vaccine Safety in Children

Abstract
BACKGROUND: Henoch-Schönlein purpura (HSP) is the most common vasculitis in childhood; nevertheless, its etiology and pathogenesis remain unknown despite the fact that a variety of factors, mainly infectious agents, drugs and vaccines have been suggested as triggers for the disease. The aim of this study was to estimate the association of HSP with drug and vaccine administration in a pediatric population.
METHODS: An active surveillance on drug and vaccine safety in children is ongoing in 11 clinical centers in Italy. All children hospitalized through the local Paediatric Emergency Department for selected acute clinical conditions of interest were enrolled in the study. Data on drug and vaccine use in children before the onset of symptoms leading to hospitalization were collected by parents interview. A case-control design was applied for risk estimates: exposure in children with HSP, included as cases, was compared with similar exposure in children with gastroduodenal lesions, enrolled as controls. HSP cases were validated according to EULAR/PRINTO/PRES criteria. Validation was conducted retrieving data from individual patient clinical record.
RESULTS: During the study period (November 1999-April 2013), 288 cases and 617 controls were included. No increased risk of HSP was estimated for any drug. Among vaccines, measles-mumps-rubella (MMR) vaccine showed an increased risk of HSP (OR 3.4; 95 % CI 1.2-10.0).
CONCLUSIONS: This study provides further evidence on the possible role of MMR vaccine in HSP occurrence.

PMID: 27316345 [PubMed - indexed for MEDLINE]

Initial development of the Systems Approach to Home Medication Management (SAHMM) model.

Res Social Adm Pharm. 2017 Jan - Feb;13(1):39-47

Authors: Doucette WR, Vinel S, Pennathur P

Abstract
BACKGROUND: Adverse drug events and medication nonadherence are two problems associated with prescription medication use for chronic conditions. These issues often develop because patients have difficulty managing their medications at home. To guide patients and providers for achieving safe and effective medication use at home, the Systems Approach to Home Medication Management (SAHMM) model was derived from a systems engineering model for health care workplace safety.
OBJECTIVE: To explore how well concepts from the SAHMM model can represent home medication management by using patient descriptions of how they take prescription medications at home.
METHODS: Twelve patients were interviewed about home medication management using an interview guide based on the factors of the SAHMM model. Each interview was audio-taped and then transcribed verbatim. Interviews were coded to identify themes for home medication management using MAXQDA for Windows.
RESULTS: SAHMM concepts extracted from the coded interview transcripts included work system components of person, tasks, tools & technology, internal environment, external environment, and household. Concepts also addressed work processes and work outcomes for home medication management.
CONCLUSIONS: Using the SAHMM model for studying patients' home medication management is a promising approach to improving our understanding of the factors that influence patient adherence to medication and the development of adverse drug events.

PMID: 26853834 [PubMed - indexed for MEDLINE]

Diffuse edema suggestive of cytokine release syndrome in a metastatic lung carcinoma patient treated with pembrolizumab.

Immunotherapy. 2017 Mar;9(4):309-311

Authors: Rassy EE, Assi T, Rizkallah J, Kattan J

Abstract
Immune checkpoint inhibitors (ICIs) are actually being indicated more commonly in the management of chemoresistant cancer patients in view of their favorable toxicity profile in comparison to cytotoxic chemotherapy. In this paper, we report, to our knowledge, the first case suggestive of cytokine release syndrome secondary to pembrolizumab in a patient with metastatic lung squamous cell carcinoma. In view of the quick approvals of ICI and the absence of sufficient knowledge of the corresponding toxicity profile, the occurrence of any clinical or biological sign or symptom in patients receiving ICI requires further investigation.

PMID: 28303768 [PubMed - indexed for MEDLINE]

Case report of nivolumab-related pneumonitis.

Immunotherapy. 2017 Mar;9(4):313-318

Authors: Tada K, Kurihara Y, Myojo T, Kojima F, Ishikawa Y, Yoshiyasu N, Morimoto M, Ito R, Koyamada R, Yamashita T, Bando T, Mori S, Heike Y

Abstract
We report a case with suggestive antiprogrammed death-1 inhibitor-related pneumonitis in an endometrial cancer patient. This case presented with fever and cough after three dosages of nivolumab. Computed tomography initially showed centrilobular nodularities in a unilateral lung, which was compatible with aspiration pneumonia. However, diffuse ground-glass opacities (GGO) rapidly developed in the unilateral lung over 4 days despite the use of broad-spectrum antibiotics. Development of GGO was considered to be related to a nivolumab-mediated immune reaction. Corticosteroid was administered and the GGO subsequently disappeared. The present report focuses on the computed tomography diagnostic features of nivolumab-related pneumonitis. The accumulation of knowledge regarding various types of antiprogrammed death-1-related pneumonitis will lead to appropriate treatment for this newly emerging adverse event.

PMID: 28303763 [PubMed - indexed for MEDLINE]

Show drugs work before selling them.

Nature. 2017 03 08;543(7644):174-175

Authors: Sipp D, McCabe C, Rasko JE

PMID: 28277530 [PubMed - indexed for MEDLINE]

Nurses' Perceived Skills and Attitudes About Updated Safety Concepts: Impact on Medication Administration Errors and Practices.

J Nurs Care Qual. 2017 Jul/Sep;32(3):226-233

Authors: Armstrong GE, Dietrich M, Norman L, Barnsteiner J, Mion L

Abstract
Approximately a quarter of medication errors in the hospital occur at the administration phase, which is solely under the purview of the bedside nurse. The purpose of this study was to assess bedside nurses' perceived skills and attitudes about updated safety concepts and examine their impact on medication administration errors and adherence to safe medication administration practices. Findings support the premise that medication administration errors result from an interplay among system-, unit-, and nurse-level factors.

PMID: 27607849 [PubMed - indexed for MEDLINE]

Anticholinergic properties of medications.

Geriatr Nurs. 2016 Jul-Aug;37(4):302-3

Authors: Simonson W

PMID: 27393158 [PubMed - indexed for MEDLINE]

15 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

("drug-induced" OR "drug-related") AND ("adverse events" OR "side effects" OR "side-effects")

These pubmed results were generated on 2017/07/18

PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

Medical treatment of erectile dysfunction: too many medical prescriptions?

Urologia. 2017 Jul 05;:0

Authors: Capogrosso P, Ventimiglia E, Oreggia D, Salonia A, Montorsi F

Abstract
Erectile dysfunction (ED) is a worldwide commonly reported condition; epidemiological data showed a prevalence ranging from 2.3 to 53.4% within different population subsets. In this context, the advent of phosphodiesterase type 5 inhibitors (PDE5is) in the second mid of 1990s has deeply changed the treatment scenario of this bothersome condition. Being user-friendly compounds with an excellent overall safety profile, PDE5is emerged as the first-line treatment for ED, thus overcoming topical alprostadil and intracavernous injections (ICIs). However, available data on treatment-utilization patterns and medical prescriptions of PDE5is showed a range of as wide as 22-78% of patients reporting to purchase PDE5is even without a proper medical prescription. Moreover, an increase in the recreational use of PDE5is among young men has been observed in the last decades, with a worrisome diffusion of potential health-risky behaviours associated with this habit. Indeed, treatment of ED should carefully follow internationally based clinical guidelines to avoid inappropriate drug prescriptions, which may eventually expose treated patients to drug-related side effects. Thereof, a careful assessment of the so-called modifiable and reversible ED risk factors along with a patient-tailored screening for potential contraindications to the treatment itself should be performed in every case. Lastly, although conclusive data still lack, the potential association between life-risky PDE5is side effects (i.e. cardiovascular adverse events, melanoma skin cancer and worsening of prostate cancer outcomes) should be carefully taken into account when counselling patients for ED treatment.

PMID: 28708203 [PubMed - as supplied by publisher]

The British National Formulary.

Nurs Stand. 2016 Nov 02;31(10):64-65

Authors: Tallo D

Abstract
What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice? The CPD article introduced the revised format of the British National Formulary (BNF) and explained how the information it contains may be accessed. It discussed the importance of developing healthcare professionals' knowledge and understanding of the BNF to enable safe and effective prescribing, dispensing, administration and monitoring of medicines.

PMID: 27861054 [PubMed - indexed for MEDLINE]

Life threatening torsades de pointes due to abiraterone-induced hypokaelemia in a patient with metastatic prostate cancer.

N Z Med J. 2016 Nov 18;129(1445):124-127

Authors: Khan A, Kneale B

Abstract
We present a case of a 77 year-old gentleman with previous coronary artery bypass grafting, admitted to hospital with recurrent torsades de pointes (TdP) due to abiraterone-induced hypokalaemia and prolonged QTc. The patient was on abiraterone and prednisone for metastatic prostate cancer. He required multiple defibrillations for recurrent TdP. Abiraterone is a relatively novel drug used in metastatic prostate cancer and we discuss this potential adverse effect and its management in this unusual presentation.

PMID: 27857247 [PubMed - indexed for MEDLINE]

Adverse drug reactions: classification, susceptibility and reporting.

Nurs Stand. 2016 Aug 10;30(50):53-63

Authors: Kaufman G

Abstract
Adverse drug reactions (ADRs) are increasingly common and are a significant cause of morbidity and mortality. Historically, ADRs have been classified as type A or type B. Type A reactions are predictable from the known pharmacology of a drug and are associated with high morbidity and low mortality. Type B reactions are idiosyncratic, bizarre or novel responses that cannot be predicted from the known pharmacology of a drug and are associated with low morbidity and high mortality. Not all ADRs fit into type A and type B categories; therefore, additional categories have been developed. These include type C (continuing), type D (delayed use), and type E (end of use) reactions. Susceptibility to ADRs is influenced by age, gender, disease states, pregnancy, ethnicity and polypharmacy. Drug safety is reliant on nurses and other healthcare professionals being alert to the possibility of ADRs, working with patients to optimise medicine use and exercising vigilance in the reporting of ADRs through the Yellow Card Scheme.

PMID: 27507394 [PubMed - indexed for MEDLINE]

Safety of Drugs during Pregnancy and Breastfeeding in Cystic Fibrosis Patients.

Respiration. 2016;91(4):333-48

Authors: Panchaud A, Di Paolo ER, Koutsokera A, Winterfeld U, Weisskopf E, Baud D, Sauty A, Csajka C

Abstract
Health management of cystic fibrosis (CF) patients should be maximized during pregnancy and breastfeeding because of its significant impact on the maternal and newborn outcomes. Thus, numerous drugs will have to be continued during pregnancy and lactation. Most of the drugs representing CF treatment lines cross the placenta or are excreted into human milk. Research addressing the risks and benefits of drugs used in CF patients during pregnancy and lactation is often incomplete or challenged by limited methodology, which often leads to conflicting or inconclusive results. Yet, potential treatment benefits for CF pregnant patients most often outbalance potential risks for the unborn child.

PMID: 26942733 [PubMed - indexed for MEDLINE]

20 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

("drug-induced" OR "drug-related") AND ("adverse events" OR "side effects" OR "side-effects")

These pubmed results were generated on 2017/07/14

PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.