Overlap between maculopapular exanthema and drug reaction with eosinophilia and systemic symptoms among cutaneous adverse drug reactions in a dermatology ward

Pharmacogenomics (PGx) melds well with polypharmacy as another tool to identify medication related problems (MRPs) more specifically so they may be solved most effectively. PGx can pre-emptively assist in medication selection, medication dosing or identify better medications for patients already taking a medication. PGx can also confirm suspect medications of causing MRPs such as adverse drug reactions (ADRs) or drug interactions. In this case, PGx testing confirmed presence of a serious human leukocyte antigen (HLA) drug reaction with eosinophilia and systemic symptoms (DRESS) after a suspect medication had been stopped.

Download Full-text

The Role of Viral Reactivation in Drug Reaction with Eosinophilia and Systemic Symptoms and Other Cutaneous Adverse Drug Reactions (cADRs)

Current Dermatology Reports ◽

10.1007/s13671-016-0124-y ◽

2016 ◽

Vol 5 (1) ◽

pp. 5-11 ◽

Cited By ~ 1

Author(s):

Che-Wen Yang ◽

Yi-Chun Chen ◽

Yung-Tsu Cho ◽

Chia-Yu Chu

Keyword(s):

Drug Reaction ◽

Adverse Drug Reactions ◽

Viral Reactivation ◽

Drug Reactions ◽

Systemic Symptoms

Download Full-text

The class imbalance problem detecting adverse drug reactions in electronic health records

Health Informatics Journal ◽

10.1177/1460458218799470 ◽

2018 ◽

Vol 25 (4) ◽

pp. 1768-1778 ◽

Cited By ~ 3

Author(s):

Sara Santiso ◽

Arantza Casillas ◽

Alicia Pérez

Keyword(s):

Adverse Drug Reaction ◽

Drug Reaction ◽

Electronic Health Records ◽

Adverse Drug Reactions ◽

Class Imbalance ◽

Drug Reactions ◽

Class Imbalance Problem ◽

Health Records ◽

Imbalance Problem ◽

Electronic Health

This work focuses on adverse drug reaction extraction tackling the class imbalance problem. Adverse drug reactions are infrequent events in electronic health records, nevertheless, it is compulsory to get them documented. Text mining techniques can help to retrieve this kind of valuable information from text. The class imbalance was tackled using different sampling methods, cost-sensitive learning, ensemble learning and one-class classification and the Random Forest classifier was used. The adverse drug reaction extraction model was inferred from a dataset that comprises real electronic health records with an imbalance ratio of 1:222, this means that for each drug–disease pair that is an adverse drug reaction, there are approximately 222 that are not adverse drug reactions. The application of a sampling technique before using cost-sensitive learning offered the best result. On the test set, the f-measure was 0.121 for the minority class and 0.996 for the majority class.

Download Full-text

Cutaneous Adverse Drug Reactions

10.2310/tywc.1009 ◽

2018 ◽

Author(s):

Neil H. Shear ◽

Sandra Knowles ◽

Lori Shapiro

Keyword(s):

Adverse Drug Reaction ◽

Drug Reaction ◽

Toxic Epidermal Necrolysis ◽

Adverse Drug Reactions ◽

Skin Necrosis ◽

Drug Eruption ◽

Hypersensitivity Syndrome ◽

Stevens Johnson Syndrome ◽

Drug Reactions ◽

Cutaneous Eruption

An adverse drug reaction is defined as any noxious, unintended, and undesired effect of a drug that occurs at doses used in humans for prophylaxis, diagnosis, or therapy. A cutaneous eruption is one of the most common manifestations of an adverse drug reaction. This chapter reviews the epidemiology, etiology, diagnosis, clinical manifestations, and differential diagnosis of adverse drug reactions, as well as laboratory tests for them. Also discussed are the types of cutaneous eruption: exanthematous eruption, urticarial eruption, blistering eruption, pustular eruption, and others. The simple and complex forms of each type of eruption are reviewed. The chapter includes 4 tables and 12 figures. Tables present the warning signs of a serious drug eruption, clinical features of hypersensitivity syndrome reaction and serum sickness-like reaction, characteristics of Stevens-Johnson Syndrome and toxic epidermal necrolysis, and clinical pearls to identify anticoagulant-induced skin necrosis. Figures illustrate hypersensitivity syndrome reaction, a fixed drug eruption from tetracycline, pseudoporphyria from naproxen, linear immunoglobulin A disease induced by vancomycin, pemphigus foliaceus from taking enalapril, pemphigus vulgaris from taking penicillamine, toxic epidermal necrolysis after starting phenytoin therapy, acneiform drug eruption due to gefitinib, acute generalized exanthematous pustulosis from cloxacillin, coumarin-induced skin necrosis, a lichenoid drug eruption associated with ramipril, and leukocytoclastic vasculitis from hydrochlorothiazide. This chapter contains 106 references.

Download Full-text

Cutaneous reactions to drugs

Oxford Textbook of Medicine ◽

10.1093/med/9780198746690.003.0565 ◽

2020 ◽

pp. 5752-5760

Author(s):

Sarah Walsh ◽

Daniel Creamer ◽

Haur Yueh Lee

Keyword(s):

Adverse Drug Reactions ◽

Adverse Reactions ◽

Normal Function ◽

Stevens Johnson Syndrome ◽

Drug Reactions ◽

Drug Induced ◽

Drug Eruptions ◽

Fixed Drug ◽

Iatrogenic Illness ◽

Systemic Symptoms

Adverse reactions to medications are common and important cause of iatrogenic illness. Severe cutaneous adverse drug reactions include toxic epidermal necrolysis, Stevens–Johnson syndrome, drug reaction with eosinophilia and systemic symptoms, and acute generalized exanthematous pustulosis, which together constitute 2% of all adverse drug reactions and may be life-threatening. Less severe drug-induced skin reactions such as exanthems, urticaria, lichenoid drug rashes, and fixed drug eruptions are more common, sometimes termed benign cutaneous adverse reactions, and generally resolve without sequelae. Drugs may also cause adverse events due to alteration of the normal function of the skin or its appendages. This may take the form of photosensitivity, abnormal pigmentation, or disrupted growth of hair or nails.

Download Full-text

Promoting adverse drug reaction reporting: comparison of different approaches

Revista de Saúde Pública ◽

10.1590/s1518-8787.2016050006122 ◽

2016 ◽

Vol 50 (0) ◽

Cited By ~ 8

Author(s):

Inês Ribeiro-Vaz ◽

Cristina Costa Santos ◽

Ricardo Cruz-Correia

Keyword(s):

Adverse Drug Reaction ◽

Drug Reaction ◽

Cost Effectiveness ◽

Adverse Drug Reactions ◽

Health Care Professionals ◽

Adverse Drug Reaction Reporting ◽

Pharmacovigilance Centre ◽

Drug Reactions ◽

Educational Approach ◽

Reaction Reporting

ABSTRACT OBJECTIVE To describe different approaches to promote adverse drug reaction reporting among health care professionals, determining their cost-effectiveness. METHODS We analyzed and compared several approaches taken by the Northern Pharmacovigilance Centre (Portugal) to promote adverse drug reaction reporting. Approaches were compared regarding the number and relevance of adverse drug reaction reports obtained and costs involved. Costs by report were estimated by adding the initial costs and the running costs of each intervention. These costs were divided by the number of reports obtained with each intervention, to assess its cost-effectiveness. RESULTS All the approaches seem to have increased the number of adverse drug reaction reports. We noted the biggest increase with protocols (321 reports, costing 1.96 € each), followed by first educational approach (265 reports, 20.31 €/report) and by the hyperlink approach (136 reports, 15.59 €/report). Regarding the severity of adverse drug reactions, protocols were the most efficient approach, costing 2.29 €/report, followed by hyperlinks (30.28 €/report, having no running costs). Concerning unexpected adverse drug reactions, the best result was obtained with protocols (5.12 €/report), followed by first educational approach (38.79 €/report). CONCLUSIONS We recommend implementing protocols in other pharmacovigilance centers. They seem to be the most efficient intervention, allowing receiving adverse drug reactions reports at lower costs. The increase applied not only to the total number of reports, but also to the severity, unexpectedness and high degree of causality attributed to the adverse drug reactions. Still, hyperlinks have the advantage of not involving running costs, showing the second best performance in cost per adverse drug reactions report.

Download Full-text

Factors Affecting Adverse Drug Reaction Reporting of Healthcare Professionals and Their Knowledge, Attitude, and Practice towards ADR Reporting in Nekemte Town, West Ethiopia

BioMed Research International ◽

10.1155/2016/5728462 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 12

Author(s):

Lense Temesgen Gurmesa ◽

Mohammed Gebre Dedefo

Keyword(s):

Health Care ◽

Adverse Drug Reaction ◽

Drug Reaction ◽

Adverse Drug Reactions ◽

Health Care Professionals ◽

Adverse Drug Reaction Reporting ◽

Drug Reactions ◽

Reaction Reporting ◽

Attitude And Practice ◽

Knowledge Attitude And Practice

Background. Adverse drug reactions are global problems of major concern. Adverse drug reaction reporting helps the drug monitoring system to detect the unwanted effects of those drugs which are already in the market. Aims. To assess the knowledge, attitude, and practice of health care professionals working in Nekemte town towards adverse drug reaction reporting. Methods and Materials. A cross-sectional study design was conducted on a total of 133 health care professionals by interview to assess their knowledge, attitude, and practice using structured questionnaire. Results. Of the total respondents, only 64 (48.2%), 56 (42.1%), and 13 (9.8%) health care professionals have correctly answered the knowledge, attitude, and practice assessment questions, respectively. Lack of awareness and knowledge on what, when, and to whom to report adverse drug reactions and lack of commitments of health care professionals were identified as the major discouraging factors against adverse drug reaction reporting. Conclusion. This study has revealed that the knowledge, attitude, and practice of the health care professionals working in Nekemte town towards spontaneous adverse drug reaction reporting were low that we would like to recommend the concerned bodies to strive on the improvement of the knowledge, attitude, and practice status of health care professionals.

Download Full-text