scholarly journals Adverse drug reactions due to cycloserine on the central nervous system in the multidrug-resistant tuberculosis cases: a case series

2019 ◽  
Vol 1 ◽  
Author(s):  
Sankalp Yadav ◽  
Gautam Rawal
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Adverse Drug Reactions ◽  
Case Series ◽  
Multidrug Resistant ◽  
Drug Reactions ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
The Central Nervous System

scholarly journals CYP2D6 in the Brain: Potential Impact on Adverse Drug Reactions in the Central Nervous System—Results From the ADRED Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Katja S. Just ◽  
Harald Dormann ◽  
Mathias Freitag ◽  
Marlen Schurig ◽  
Miriam Böhme ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Drug Metabolism ◽  
Adverse Drug Reactions ◽  
Drug Exposure ◽  
Drug Reactions ◽  
Cyp2d6 Activity ◽  
Secondary Analyses ◽  
The Central Nervous System ◽  
The Brain

Cytochrome P450 (CYP) 2D6 is a polymorphic enzyme expressed in the central nervous system (CNS), important in drug metabolism and with a potentially constitutive role in CNS function such as vigilance. This study aimed to analyze variability in CYP2D6 activity linked to vigilance-related adverse drug reactions (ADRs) in the CNS. A dataset of N = 2939 ADR cases of the prospective multicenter observational trial in emergency departments (EDs) (ADRED; trial registration: DRKS-ID: DRKS00008979) was analyzed. Dizziness as the most frequent reported CNS ADR symptom (12.7% of patients, n = 372) related to vigilance was chosen as the outcome. The association of dizziness with CYP2D6 activity markers was analyzed. The number of CYP2D6 substrates taken, a CYP2D6 saturation score (no, moderate, and strong saturation), a CYP2D6 saturation/inhibition score (no, weak, moderate, and strong), and composed CYP2D6 activity using a genotyped subsample (n = 740) calculating additive effects of genotype and CYP2D6 saturation by drug exposure were used as CYP2D6 activity markers. Effects were compared to other frequent nonvigilance-related CNS ADR symptoms (syncope and headache). Secondary analyses were conducted to control for other ADR symptoms frequently associated with dizziness (syncope, nausea, and falls). The majority of all patients (64.5%, n = 1895) took at least one drug metabolized by CYP2D6. Around a third took a CNS drug (32.5%, n = 955). The chance to present with drug-related dizziness to the ED increased with each CYP2D6 substrate taken by OR 1.11 [1.01–1.23]. Presenting with drug-related dizziness was more likely with CYP2D6 saturation and saturation/inhibition (both OR 1.27 [1.00–1.60]). The composed CYP2D6 activity was positively associated with dizziness (p = 0.028), while poorer activity affected patients more often with dizziness as an ADR. In contrast, nonvigilance-related ADR symptoms such as syncope and nausea were not consistently significantly associated with CYP2D6 activity markers. This study shows an association between the number of CYP2D6 substrates, the predicted CYP2D6 activity, and the occurrence of dizziness as a CNS ADR symptom. As dizziness is a vigilance-related CNS symptom, patients with low CYP2D6 activity might be more vulnerable to drug-related dizziness. This study underlines the need for understanding individual drug metabolism activity and individual risks for ADRs.

Occurrence, Management, and Risk Factors for Adverse Drug Reactions in Multidrug Resistant Tuberculosis Patients

2018 ◽  
Vol 25 (5) ◽  
pp. e533-e540 ◽  
Author(s):  
Nafees Ahmad ◽  
Arshad Javaid ◽  
Syed Azhar Syed Sulaiman ◽  
Afsar Khan Afridi ◽  
Zainab ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adverse Drug Reactions ◽  
Multidrug Resistant ◽  
Drug Reactions ◽  
Tuberculosis Patients ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis

scholarly journals Adverse drug reactions in primary care: a scoping review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
H. Khalil ◽  
C. Huang
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Patient Safety ◽  
Adverse Events ◽  
Adverse Drug Reactions ◽  
Scoping Review ◽  
Primary Healthcare ◽  
Adverse Reactions ◽  
Drug Reactions ◽  
The Central Nervous System

Abstract Background Medication-related adverse events, or adverse drug reactions (ADRs) are harmful events caused by medication. ADRs could have profound effects on the patients’ quality of life, as well as creating an increased burden on the healthcare system. ADRs are one of the rising causes of morbidity and mortality internationally, and will continue to be a significant public health issue with the increased complexity in medication, to treat various diseases in an aging society. This scoping review aims to provide a detailed map of the most common adverse drug reactions experienced in primary healthcare setting, the drug classes that are most commonly associated with different levels/types of adverse drug reactions, causes of ADRs, their prevalence and consequences of experiencing ADRs. Methods We systematically reviewed electronic databases Ovid MEDLINE, Embase, CINAHL Plus, Cochrane Central Register of Controlled Trials, PsycINFO and Scopus. In addition, the National Patient Safety Foundation Bibliography and the Agency for Health Care Research and Quality and Patient Safety Net Bibliography were searched. Studies published from 1990 onwards until December 7, 2018 were included as the incidence of reporting drug reactions were not prevalent before 1990. We only include studies published in English. Results The final search yielded a total of 19 citations for inclusion published over a 15-year period that primarily focused on investigating the different types of adverse drug reactions in primary healthcare. The most causes of adverse events were related to drug related and allergies. Idiosyncratic adverse reactions were not very commonly reported. The most common adverse drug reactions reported in the studies included in this review were those that are associated with the central nervous system, gastrointestinal system and cardiovascular system. Several classes of medications were reported to be associated with adverse events. Conclusion This scoping review identified that the most causes of ADRs were drug related and due to allergies. Idiosyncratic adverse reactions were not very commonly reported in the literature. This is mainly because it is hard to predict and these reactions are not associated with drug doses or routes of administration. The most common ADRs reported in the studies included in this review were those that are associated with the central nervous system, gastrointestinal system and cardiovascular system. Several classes of medications were reported to be associated with ADRs.

scholarly journals Frequency and type of adverse drug reactions related to multidrug-resistant tuberculosis therapy

2021 ◽  
Author(s):  
Afaq Ahmed ◽  
Ashok Kumar Gudagunti ◽  
Shylendra . ◽  
Veena Hagalur Nayak ◽  
H. Mallikarjun Swamy
Keyword(s):  
Adverse Drug Reactions ◽  
Prospective Observational Study ◽  
Multidrug Resistant ◽  
Drug Reactions ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Initiation Of Therapy ◽  
Tuberculosis Therapy

Background: Adverse drug reactions (ADRs) are inevitable consequences of multidrug-resistant tuberculosis drug therapy. Reporting of ADR in India is poor and inadequate. ADRs monitoring forms an integral part of pharmacovigilance. ADRs with second line anti-tuberculous therapy (ATT) have been mentioned as obstacles in the management of multidrug-resistant tuberculosis (MDR-TB). Objectives of the study was to study the frequency and type of adverse drug reaction related to MDR-TB therapy.Methods: 72 patients diagnosed as MDR-TB and enrolled for DOTS-PLUS (CAT.IV) regimen at NTEP centre, KIMS HUBLI were included. This was a prospective observational study. All patients were followed up for a period of 9 months from the day of commencement of treatment. Adverse drug reactions were determined by monthly clinical and biochemical monitoring of patients to identify ADRs.Results: Among 72 Patients, 42 (58.3%) were males. 44 out of 72 patients experienced at least one type of ADRs (61.1%). Mean age was 35.86±12.62 and mean weight was 42.00±9.05. Four most common ADRs reported were Gastro-intestinal symptoms (29.2%), anorexia (15.3%), giddiness (12.5%), and pain at injection site (11.1%). Highest percentage of ADRs were seen in patients of age group>60 years (66.7%). ADRs were most commonly reported in first 3 months of initiation of therapy. 9 out of 72 patients (12.5%) or 20.5% of 44 patients who showed ADRs required change of treatment. There was a significant impact of ADRs on treatment among those with ADRs (p=0.01).Conclusion: ADRs of varying severity are common in patients of MDR-TB on DOTS-PLUS regimen, occurring in more than half of the cases, with around one fifth requiring change of MDR-TB treatment.

Sign in / Sign up

Export Citation Format

Share Document