Acupuncture Treatment for Bortezomib-Induced Peripheral Neuropathy: A Case Report

Peripheral neuropathy is a common and severe dose-limiting side effect of the chemotherapy agent, bortezomib, in multiple myeloma patients. Treatment with narcotics, antidepressants, and anticonvulsants has limited response and potential significant side effects. Acupuncture has been reported to be effective in treating diabetic neuropathy and chemo-induced peripheral neuropathy. There has not been report on the effect of acupuncture in treating bortezomib-induced peripheral neuropathy specifically. Here, we report a successful case of using acupuncture to relieve bortezomib-induced peripheral neuropathy symptoms.

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PENGARUH AKUPUNKTUR JIN’S 3 NEEDLE TERHADAP PENURUNAN INTENSITAS NYERI DIABETIC NEUROPATHY PERIFER

Journal of Islamic Medicine ◽

10.18860/jim.v4i1.9051 ◽

2020 ◽

Vol 4 (1) ◽

pp. 46-51

Author(s):

Leny Candra Kurniawan ◽

Ikhwan Abdullah

Keyword(s):

Peripheral Neuropathy ◽

Side Effects ◽

Diabetic Neuropathy ◽

Diabetic Peripheral Neuropathy ◽

Nerve Fibers ◽

Significance Level ◽

Peripheral Diabetic Neuropathy ◽

Study Population ◽

Sugar Levels ◽

Needle Acupuncture

Diabetic Peripheral Neuropathy is a type of nerve damagethat occurs due to diabetes. High blood sugar levels in thelong term can cause damage to nerve fibers throughout thebody, such as legs, feet, blood circulation, heart, digestivesystem, and urinary tract. Diabetic Peripheral Neuropathy isa serious complication of diabetes that often causes pain inthe limbs. Pain management Diabetic Peripheral Neuropathyis usually by administering pain medication for a long periodof time. These medicines will have side effects. The use ofacupuncture as an alternative to help reduce the intensity ofpain in peripheral diabetic neuropathy has proven to beeffective and relatively without side effects. The advantage ofacupuncture therapy is that it has relatively no side effects.The general aim of this study is to reduce the intensity of painin peripheral neuropathy. The research design usesquantitative methods. The study population was all patientswith peripheral neuropathy who visited the Harmoni HealthyClinic in March-May 2019. The sampling method used wasaccidental sampling. The benefits of this study provide analternative for DM sufferers to reduce the intensity ofneuropathic pain naturally with acupuncture without fear.side effects. From the results of this study it is known thatthere is an influence of Jin’s Three Needle acupuncture inreducing the intensity of pain in Peripheral Neuropathy.Calculations using statistical SPSS 21 with paired sample ttest obtained significant results (0.00) from the value of α(0.05), then H1 is accepted. So with a significance level of5%, it can be concluded that Jin's Three Needle acupuncturecan reduce the intensity of pain in diabetic peripheralneuropathy

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Cisplatin induced neurotoxicity is mediated by Sarm1 and calpain activation

Scientific Reports ◽

10.1038/s41598-020-78896-w ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Aysel Cetinkaya-Fisgin ◽

Xinghua Luan ◽

Nicole Reed ◽

Ye Eun Jeong ◽

Byoung Chol Oh ◽

...

Keyword(s):

Peripheral Neuropathy ◽

Side Effects ◽

Cancer Cells ◽

Wallerian Degeneration ◽

Axonal Degeneration ◽

Adduct Formation ◽

Calpain Activation ◽

Chemotherapy Agent ◽

Distal Axonal Degeneration ◽

Calpain Inhibitors

AbstractCisplatin is a commonly used chemotherapy agent with significant dose-limiting neurotoxicity resulting in peripheral neuropathy. Although it is postulated that formation of DNA-platinum adducts is responsible for both its cytotoxicity in cancer cells and side effects in neurons, downstream mechanisms that lead to distal axonal degeneration are unknown. Here we show that activation of calpains is required for both neurotoxicity and formation of DNA-platinum adduct formation in neurons but not in cancer cells. Furthermore, we show that neurotoxicity of cisplatin requires activation of Sarm1, a key regulator of Wallerian degeneration, as mice lacking the Sarm1 gene do not develop peripheral neuropathy as evaluated by both behavioral or pathological measures. These findings indicate that Sarm1 and/or specific calpain inhibitors could be developed to prevent cisplatin induced peripheral neuropathy.

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Determining the impact of chemotherapy-induced peripheral neuropathy: A survey of cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e24080 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e24080-e24080

Author(s):

Eva Battaglini ◽

David Goldstein ◽

Susanna Park

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Peripheral Neuropathy ◽

Side Effects ◽

Cancer Survivors ◽

Side Effect ◽

Functional Disability ◽

Health Conditions ◽

The Impact

e24080 Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a major yet poorly understood side effect of cancer treatment, leading to symptoms including numbness, tingling and pain. It can lead to cessation of effective treatment, long-term functional disability and reduced quality of life. Despite this, there is currently little understanding of its impact. Methods: The aim of the study was to investigate the impact of neurotoxic chemotherapy side effects on the lives of cancer survivors. Data was collected via an online survey covering demographics, cancer diagnosis and treatment, CIPN and other side effects of chemotherapy, using standardised measures to assess comorbidities, quality of life, physical activity, pain and CIPN symptoms. Results: Data was analysed from 986 respondents who were treated with neurotoxic therapies (83% female, 16% male), with mean age 59 years ( SD 10.7 years). A majority of respondents were treated for breast cancer (59%), 14% for colorectal cancer and 11% for multiple myeloma. Chemotherapy types received included paclitaxel (32%), docetaxel (32%) and oxaliplatin (13%), and respondents completed treatment a mean of 3.6 years ago. The majority of respondents (80%) reported experiencing neuropathic symptoms after finishing chemotherapy, with 77% reporting current CIPN. Those with CIPN reported functional impacts, with 23% reporting moderate to severe problems with hand function and 28% reporting moderate to severe walking difficulties. CIPN was second most commonly rated as the treatment side effect having the greatest impact, following fatigue. Respondents with high levels of current CIPN symptoms had poorer quality of life, more comorbid health conditions, higher BMI and more often received multiple neurotoxic chemotherapies than those with low levels of CIPN symptoms. In addition, respondents who reported meeting government physical activity guidelines had lower CIPN and higher quality of life scores than those who did not meet the guidelines. Regression analyses investigating the association between quality of life and clinical and sociodemographic characteristics resulted in a model with comorbid health conditions, CIPN symptoms, years since treatment, age and physical activity as significant predictors of quality of life. Conclusions: These findings suggest that CIPN has a lasting impact on cancer survivors, leading to decreases in quality of life, often occurring alongside poorer general health. This impact supports the need for further research to improve assessment, prevention and treatment.

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Tropicamide eye drops reduce clozapine-induced hypersalivation: A case report

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.2009 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S543-S544 ◽

Cited By ~ 1

Author(s):

O. Kilic ◽

H.M. Ozturk ◽

E. Ata

Keyword(s):

Case Report ◽

Side Effects ◽

Side Effect ◽

Negative Symptoms ◽

Rating Scale ◽

Short Form ◽

Eye Drops ◽

Oral Application ◽

Competing Interest ◽

Pressure Changes

IntroductionClozapine-induced sialorrhea (CIS) is a common, treatment-limiting and stigmatizing side effect. All systemic agents that are used for hypersalivation may increase clozapine side effects such as blood pressure changes, constipation, or arrythmias. Oral application of topical anti-muscarinic agents may be a low side effect option for treatment of CIS.ObjectiveThe aim of this case report was to propose an off-label treatment of tropicamide drops to CIS and to stimulate further investigation.Case reportA 33-year-old male inpatient with schizophrenia has been on clozapine 800 mg and amisulpride 600 mg/day. His drooling was occasional and severe as drool drips off his chin during the day and night. Wet area over the pillow, visual analog scale (VAS), the short form of health survey (SF-36), UKU side effect rating scale, scale for the assessment of negative symptoms (SANS), scale for the assessment of positive symptoms (SAPS) were applied at baseline and in one-week intervals. Oral application of one drop of tropicamide % 0.5 (5 mg/mL) to left and one drop to right side before going to bed in the first week and two drops to each side were administered subsequently. Informed consent was given by the patient.ResultsNo psychological, neurological, autonomic and other side effects were observed associated with tropicamide. On VAS, the patient rated hypersalivation 5/7 at baseline, 4/7 after one drop each, 3/7 after two drops each.ConclusionsThe reduction of CIS by oral use of tropicamide eye drops is promising and should be explored with randomized controlled trials.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Bortezomib Induced Paralytic Ileus: Are we Aware?

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/45267.13944 ◽

2020 ◽

Author(s):

Shailendra Prasad Verma ◽

Avaneesh Shukla ◽

Punita Pavecha ◽

Durga Prasad Verma ◽

Rashmi Kushwaha

Keyword(s):

Multiple Myeloma ◽

Peripheral Neuropathy ◽

Side Effects ◽

Paralytic Ileus ◽

Gastrointestinal Symptoms ◽

Abdominal Distension ◽

Stool Frequency ◽

Weekly Dose ◽

X Ray ◽

Rare Side Effect

Bortezomib is one of the most commonly used drugs in the treatment of multiple myeloma. It has many well-known side effects like peripheral neuropathy, thrombocytopenia and diarrhoea. Paralytic ileus has been rarely reported in patients of multiple myeloma receiving bortezomib and one should be aware about this entity. Stool frequency should be carefully monitored and the drug should be stopped timely to prevent complications of paralytic ileus. The patient was admitted for management of multiple myeloma and supportive care. He was started on the VTD (Bortezomib/thalidomide/dexamethasone) protocol. He developed abdominal distension and absolute constipation soon after the 2nd weekly dose of bortezomib. Abdominal X-ray revealed grossly dilated large bowel loops. Although he was given lactulose, glycerine suppository enema, the problem of abdominal distension and constipation persisted. His gastrointestinal symptoms improved and he was able to pass stools after bortezomib was removed from the protocol. One should be aware of this rare side effect of bortezomib. Bortezomib dose should be modified or it should be stopped timely to prevent complications.

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Statin-Induced Neuropathic Pain: A Case Report

Journal of Pharmaceutical Care ◽

10.18502/jpc.v7i4.2382 ◽

2020 ◽

Author(s):

Nima Vaziri ◽

Habib Mofakham ◽

Fanak Fahimi

Keyword(s):

Adverse Effect ◽

Neuropathic Pain ◽

Case Report ◽

Peripheral Neuropathy ◽

Statin Therapy ◽

Side Effect ◽

Severe Form ◽

Rare Side Effect

The most reported form of statin induced pain is myalgia, conversely peripheral neuropathy is a rare side effect. We report a patient who received rosuvastatin for hypercholesterolemia and experienced episodes of pain in both hands during the night. Rosuvastatin was stopped and atorvastatin was replaced. Re-introduction with another statin resulted in a more severe form of the similar adverse effect after 4 months. This is a rare adverse effect of a extensively prescribed class of drug. Physicians should be aware of the possibility of peripheral neuropathy symptoms in patients on statin therapy. J Pharm Care 2019; 7(4): 120-122.

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Metronidazole Induced Cerebellar Toxicity: A Case Report

Journal of Nepal Medical Association ◽

10.31729/jnma.6644 ◽

2021 ◽

Vol 59 (241) ◽

pp. 922-924

Author(s):

Shova Sapkota ◽

Aliska Niroula ◽

Rina Prajapati ◽

Subhani Sharma ◽

Krishna Dhungana

Keyword(s):

Magnetic Resonance Imaging ◽

Case Report ◽

Peripheral Neuropathy ◽

Side Effects ◽

Magnetic Resonance ◽

Liver Abscess ◽

Imaging Findings ◽

Resonance Imaging ◽

Cerebellar Sign ◽

Protozoan Infections

Metronidazole is a widely used antibiotic against bacterial and protozoan infections. Even though the therapeutic use of the drug is high, it is associated with some severe side effects like neurotoxicity such as optic neuropathy, peripheral neuropathy, encephalopathy and cerebellar toxicity. We present a case of a 55-years male presented with dysarthria, who had positive cerebellar sign and magnetic resonance imaging findings suggestive of metronidazole induced cerebellar toxicity following metronidazole therapy for two months in a case of liver abscess. And, the symptoms resolved after cessation of metronidazole.

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Primary Treatment with Pulsed Melphalan, Dexamethasone, Thalidomide (MDT) for Symptomatic Patients with Multiple Myeloma ≥ 75 Years of Age.

Blood ◽

10.1182/blood.v104.11.1482.1482 ◽

2004 ◽

Vol 104 (11) ◽

pp. 1482-1482 ◽

Cited By ~ 4

Author(s):

Meletios A. Dimopoulos ◽

Panagiotis Repoussis ◽

Evangelos Terpos ◽

Maria Christina Kyrtsonis ◽

Athanasios Zomas ◽

...

Keyword(s):

Multiple Myeloma ◽

Peripheral Neuropathy ◽

Side Effects ◽

Elderly Patients ◽

Objective Response ◽

Elevated Serum ◽

Primary Treatment ◽

Moderate Degree ◽

The Impact

Abstract Introduction: Thalidomide is usually administered orally continuously once daily and has shown remarkable activity in about 30% of patients with heavily pretreated multiple myeloma (MM). Moreover, there is considerable interest in the administration of thalidomide-containing combinations as primary treatment of MM. With such regimens at least 60% of patient achieve an objective response. Thalidomide can cause a variety of side effects whose incidence and severity may be related to the maximum dose and duration of thalidomide treatment. Furthermore, this drug may be poorly tolerated by older patients. We designed a phase II study for the primary treatment of elderly patients (≥ 75 years of age) with MM which was based on intermittent oral administration of melphalan, thalidomide and dexamethasone. Patients and Methods: This ongoing multicenter study was initiated in February 2003 and includes patients with symptomatic myeloma ≥75 years of age regardless of performance status, renal function, and comorbidities. Treatment consists of melphalan (M) 8mg/m2 days 1–4, dexamethasone (D) 12mg/m2 p.o. after breakfast on days 1–4 and 14–18 and thalidomide (T) 300 mg p.o. at bedtime on days 1–4 and 14–18. This regimen is repeated every 5 weeks for 3 courses. Patients without evidence of progressive disease are scheduled to receive 9 additional courses of MDT (but without DT on days 14–18) every 5 weeks. Results: As of July 2004, 43 patients have been enrolled. Their median age is 78 years (range: 75 to 85 years). Features of advanced myeloma are frequent and include International Staging System (ISS) 3 in 58%, hemoglobin <8.5g/dl in 13%, calcium >11.5 in 15%, creatinine > 2 mg/dl in 28% and elevated serum LDH in 11%. On an intent-to-treat basis, 72% of patients achieved at least a partial response (EBMT criteria) including 10% of patients who achieved a complete response with negative immunofixation. Median time to 50% reduction of monoclonal protein was 2 months (range 0.5 to 5.5). Grade 3 or 4 granylocytopenia and thrombocytopenia occurred in 15% and 10% of patients respectively. Twelve episodes of infections were noted one of which was fatal. Several patients developed thalidomide-related side effects, usually of mild or moderate degree, such as constipation (30%), somnolence (35%), tremor (25%), xerostomia (15%), headache (10%). Deep venous thromosis (DVT) and peripheral neuropathy occurred in 10% of patients each. With a mean follow-up of 15 months, 88% of patients remain alive. Conclusions: This is one of few prospective studies designed for myeloma patients with advanced age (≥75 years) ie patients who are frequently excluded from trials. The pulsed MDT regimen appears to be a well tolerated and active primary treatment for elderly patients with multiple myeloma. The incidence of DVT and of peripheral neuropathy appears lower than that seen when thalidomide is administered continuously. Patient accrual and follow-up is ongoing in order to assess the impact of this regimen on response duration and survival.

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RIFAXIMIN INDUCED HYPONATREMIA: A CASE REPORT

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2016.v9s3.14452 ◽

2016 ◽

Vol 9 (9) ◽

pp. 1 ◽

Cited By ~ 1

Author(s):

Shalini Upadhyay ◽

Prabhat Agrawal ◽

Manish Bansal ◽

Anjalika Gupta

Keyword(s):

Irritable Bowel Syndrome ◽

Case Report ◽

Clinical Practice ◽

Side Effects ◽

Side Effect ◽

Aged Woman ◽

Rare Side Effect ◽

Middle Aged Woman ◽

The Common ◽

Irritable Bowel

ABSTRACTRifaximin is one of the common drugs used in clinical practice in the management of traveler’s diarrhea, irritable bowel syndrome (IBS), and hepaticencephalopathy. Hyponatremia is one of the rare side effects of this drug. We hereby present the case of a middle-aged woman who was a known caseof IBS: Diarrhea predominant who developed symptoms of hyponatremia after a short duration of rifaximin treatment, no other cause of hyponatremiawas found on evaluation, so we suspect this as a rare side effect of rifaximin therapy.Keywords: Rifaximin, Hyponatremia, Irritable bowel syndrome.

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