Abstract #113: Iatrogenic Cushing & Secondary Adrenal Suppression Because of Drug Interaction in a Patient on H.A.A.R.T. for H.I.V

2017 ◽  
Vol 23 ◽  
pp. 8-9
Author(s):  
Adnan Haider ◽  
Yasir Ahmed ◽  
Mejia Tejada ◽  
Chaar Natalia ◽  
James Burks
2018 ◽  
Vol 11 (1) ◽  
pp. e226912 ◽  
Author(s):  
Navnit Makaram ◽  
Clark D Russell ◽  
Simon Benedict Roberts ◽  
Jarrad Stevens ◽  
Gavin Macpherson

We report a diagnosis of exogenous steroid-induced hypoadrenalism in a person living with HIV caused by a drug–drug interaction (DDI) between intrabursal triamcinolone and the pharmacokinetic booster cobicistat. A 53-year-old woman living with HIV, managed with dolutegravir and cobicistat-boosted darunavir, presented to the orthopaedic clinic with worsening hip pain. She was diagnosed with greater trochanteric pain syndrome (GTPS) of the hip and was treated with intrabursal injection of bupivacaine and triamcinolone. Seven days following this injection, she presented with Cushingoid features, an undetectable cortisol and was diagnosed with exogenous steroid-induced hypoadrenalism. Cobicistat is a cytochrome P450 3A inhibitor and in this case inhibited clearance of intrabursal triamcinolone, leading to exogenous glucocorticoid excess and adrenal suppression. This is the first report to describe this predictable DDI with cobicistat following intrabursal glucocorticoid injection. This case highlights the complexities in managing non-HIV-related chronic morbidities in people living with HIV.


2001 ◽  
Vol 120 (5) ◽  
pp. A581-A581
Author(s):  
T ANDERSSON ◽  
L ASTRAZENECA ◽  
K ROHSS ◽  
M HASSANALIN

1998 ◽  
Vol 5 (1) ◽  
pp. 195A-195A
Author(s):  
K MCNAMARA ◽  
R BAJAJ ◽  
C ANANTH ◽  
S HATANGADI ◽  
J SMULIAN ◽  
...  
Keyword(s):  

2019 ◽  
Vol 8 (2) ◽  
pp. 55-58
Author(s):  
Havizur Rahman ◽  
Teresia Anggi Octavia

Diabetes melitus merupakan penyakit degeneratif kronis yang apabila tidak ditangani dengan tepat, lama kelamaan bisa timbul berbagai komplikasi, ini cenderung menyebabkan pasien mendapatkan banyak obat dalam satu resep yang dapat menimbulkan interaksi antar obat. Tujuan dari penelitian ini adalah mengetahui persentase terjadinya interaksi obat metformin secara teori serta mengkaji efek yang mungkin timbul dan solusinya. Teknik pengambilan data dengan purpossive sampling, yaitu resep pasien rujuk balik yang menderita diabetes mellitus yang menggunakan metformin. Data yang diperoleh ditemukan bahwa obat yang berinteraksi dengan metformin dengan tingkat keparahan minor ialah sebesar 60%. Kemudian untuk tingkat keparahan moderat ialah sebesar 20%. Sedangkan untuk tingkat keparahan mayor tidak ditemukan. Dari tabel diatas juga dapat diketahui bahwa terdapat 4 obat yang saling berinteraksi dengan metformin, sedangkan untuk obat yang tidak saling berinteraksi dengan metformin terdapat 9 obat. Jumlah obat yang berinteraksi secara teori sebesar 6,85% dan yang tidak berinteraksi 93,15%. Terdapat interaksi obat metformin dengan beberapa obat yaitu furosemid, lisinopril, acarbose dan ramipril.   Kata kunci: interaksi obat, metformin, diabetes mellitus   STUDY OF METFORMIN INTERACTION IN MELLITUS DIABETES PATIENTS   ABSTRACT Mellitus is a chronic degenerative disease which if not handled properly, over time can arise various complications, this tends to cause patients to get many drugs in one recipe that can cause interactions between drugs. The purpose of this study is to determine percentage of metformin drug interactions in theory and examine the effects that may arise and solutions. Data collection techniques using purposive sampling, which is a recipe for reconciliation patients who suffer from diabetes mellitus using metformin. The data obtained it was found that drugs that interact with metformin with minor severity were 60%. Then for moderate severity is 20%. Whereas the major severity was not found. From the table above it can also be seen that there are 4 drugs that interact with metformin, while for drugs that do not interact with metformin there are 9 drugs. The number of drugs that interacted theoretically was 6.85% and 93.15% did not interact. An interaction of the drug metformin with several drugs namely furosemide, lisinopril, acarbose and ramipril.   Keywords: drug interaction, metformin, diabetes mellitus


2019 ◽  
Vol 4 (1) ◽  
pp. 64
Author(s):  
Nur Aisyah Zainordin ◽  
Fatimah Zaherah Mohamed Shah ◽  
Rohana Abdul Ghani

A 49-year old patient presented with symptoms of adrenal suppression following an attempt to withdraw Depo-Provera or Depot Medroxyprogesterone Acetate (DMPA) injection. She had been receiving DMPA injections for the past 16 years for contraception. She was initially prescribed DMPA by her gynaecologist but later on began obtaining the medication directly from a private pharmacy without prior consultation from her gynaecologist. Clinically, she had been experiencing significant weight gain and appeared cushingoid. Blood investigations confirmed partial adrenal suppression with presence of an adrenal incidentaloma. This case reports a known side effect of DMPA but occurring at a much lower dose than previously described. It also highlights the need to increase the awareness of the insidious side effect of DMPA and to avoid unsupervised use of the drug.


2013 ◽  
Vol 1 (Suppl. 1) ◽  
pp. A3.15
Author(s):  
Yaprak Dönmez Çakıl

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