Ondansetron Usage in HIV Positive Patients: A Pilot Study on the Control of Nausea and Vomiting in Patients on High Dose Co-Trimoxazole for Pneumocystis Carinii Pneumonia

1993 ◽  
Vol 4 (5) ◽  
pp. 293-296 ◽  
Author(s):  
M Gompels ◽  
S McWilliams ◽  
M O'Hare ◽  
J R W Harris ◽  
A J Pinching ◽  
...  
Keyword(s):  
Pneumocystis Carinii Pneumonia ◽  
Pneumocystis Carinii ◽  
Good Control ◽  
Nausea And Vomiting ◽  
Stevens Johnson Syndrome ◽  
First Episode ◽  
High Dose ◽  
Serious Adverse Event ◽  
Johnson Syndrome ◽  
Single Centre Study

This was an open, single centre study, to evaluate the safety and efficacy of ondansetron in the treatment of co-trimoxazole associated nausea and vomiting in AIDS patients. Sixteen patients presenting with their first episode of HIV-associated Pneumocystis carinii pneumonia (PCP) on high dose co-trimoxazole were given ondansetron 8 mg orally, every 8h. Measurements were made from data recorded by each patient on diary cards. In this study 11 out of 16 (69%) patients on ondansetron experienced good control of emesis (2 or less emetic episodes) on their ‘worst day’ of therapy and 8 out of 16 (50%) of patients demonstrated good control of emesis throughout their treatment with co-trimoxazole. Good control of nausea (mild or none) was achieved in 7 out of 16 (47%) patients. A total of 7 patients were able to complete the full course of co-trimoxazole whilst on ondansetron. One serious adverse event (Stevens-Johnson syndrome) was reported and felt to be unrelated to ondansetron. If conventional anti-emetics fail to achieve control of symptoms or have unacceptable side effects, ondansetron may represent a possible alternative.

scholarly journals The Role of Aerosol Pentamidine Prophylaxis

1993 ◽  
Vol 4 (2) ◽  
pp. 67-69
Author(s):  
E L C Ong
Keyword(s):  
Cell Count ◽  
Pneumocystis Carinii Pneumonia ◽  
Lymphocyte Count ◽  
Pneumocystis Carinii ◽  
Total Lymphocyte Count ◽  
First Episode ◽  
Cd4 Cell Count ◽  
Drug Of Choice ◽  
Cd4 Cell

Pneumocystis carinii pneumonia (PCP) is the most frequent opportunistic infection in patients with AIDS, occurring in 80% and recurring in 50% of patients within 12 months of the first episode. Prophylaxis for PCP is recommended if the CD4+ cell count is <200×106/l or 20% of the total lymphocyte count, or after an episode of PCP. The most effective prophylactic agent currently is trimethoprim-sulphamethoxazole and should be the drug of choice but alternatives such as aerosol pentamidine are being increasingly used for patients who cannot tolerate this combination or other oral preparations. If aerosol pentamidine is used and administered via a Respigard II Marquest nebulizer, the dosage should be higher than the currently recommended monthly dosage of 300 mg.

scholarly journals ORAL SECONDARY INFECTION IN STEVENS-JOHNSON SYNDROME PATIENT WITH ORAL INVOLVEMENT: A CASE REPORT

2021 ◽  
Vol 6 (1) ◽  
pp. 79
Author(s):  
Etis Duhita Rahayuningtyas ◽  
Indah Suasani Wahyuni ◽  
Irna Sufiawati
Keyword(s):  
Case Report ◽  
Secondary Infection ◽  
Severity Of Illness ◽  
The Body ◽  
Stevens Johnson Syndrome ◽  
High Dose ◽  
Oral Manifestation ◽  
Secondary Infections ◽  
Johnson Syndrome ◽  
Oral Involvement

ABSTRACTBackground: Stevens-Johnson syndrome (SSJ) is a hypersensitivity reaction that is often triggered by drugs but this case is rare. These reactions result in uncontrolled keratinocyte damage to the skin and mucosa throughout the body, including the oral mucosa, and are often life-threatening. The use of high doses of corticosteroids is a treatment that is often given but it can trigger secondary infections of fungal and viral in the oral cavity. Purpose: This case report discusses the management of oral manifestations and secondary infections in SSJ patients, and becomes guidance for health professionals. Case: A-42-years-old male patient was consulted from the Department of Dermatology and Venereology (DV) due to oral pain and eating difficulties. The severity-of-illness-score for toxic-epidermal-necrolysis (SCORTEN) was 1. Erosive serosanguinous crusts, tend to bleed were found on the lips. Intraoral clinically presented wide erosive lesions and multiple ulcers, accompanied by a pseudomembranous plaque, and teeth decay. Hematologic examination showed an increase in leukocytes, neutrophil segments, monocytes, SGOT, urea, and creatinine as well as decreased hemoglobin, hematocrit, erythrocytes, MCHC, protein, and albumin. Anti-HSV1 IgG increased almost 6 times than normal values. The patient was diagnosed with SJS with oral involvement, secondary infections of pseudomembranous candidiasis, and herpetic stomatitis. Case Management: Systemic therapy given were intravenous dexamethasone, ranitidine, calcium, and cetirizine, from the DV Department, while hydrocortisone lip ointment, Chlorhexidine digluconate 0.12%, and Nystatin oral suspension for oral problems. The lesions progressed in 24 days. Conclusion: Oral secondary infections may occur in SJS patients due to high-dose corticosteroid therapy.Keywords: Herpetic Stomatitis, Oral Manifestation, Oral Secondary Infection, Pseudomembranous Candidiasis, Stevens-Johnson Syndrome.

Ethosuximide-induced Stevens-Johnson syndrome: Beneficial effect of early intervention with high-dose corticosteroid therapy

2018 ◽  
Vol 45 (5) ◽  
pp. 592-595 ◽  
Author(s):  
Kota Tachibana ◽  
Toshihisa Hamada ◽  
Hiroki Tsuchiya ◽  
Takashi Shibata ◽  
Kazuyasu Fujii ◽  
...  
Keyword(s):  
Early Intervention ◽  
Beneficial Effect ◽  
Corticosteroid Therapy ◽  
Stevens Johnson Syndrome ◽  
High Dose ◽  
High Dose Corticosteroid ◽  
Johnson Syndrome ◽  
Dose Corticosteroid

Non-drug-induced Stevens-Johnson syndrome successfully treated with high-dose i.v. immunoglobulin

2015 ◽  
Vol 42 (4) ◽  
pp. 439-440 ◽  
Author(s):  
Yuu Nozaki ◽  
Hiroyuki Fujita ◽  
Rika Okada ◽  
Kenzen Kou ◽  
Michiko Aihara
Keyword(s):  
Stevens Johnson Syndrome ◽  
High Dose ◽  
Drug Induced ◽  
Johnson Syndrome

scholarly journals Recent Dermatological Treatments for Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Japan

2021 ◽  
Vol 8 ◽  
Author(s):  
Ming-Hsiu Hsieh ◽  
Tomoya Watanabe ◽  
Michiko Aihara
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Ivig Therapy ◽  
Japanese Patients ◽  
Mortality Rates ◽  
Pulse Therapy ◽  
Stevens Johnson Syndrome ◽  
High Dose ◽  
Methylprednisolone Pulse ◽  
Johnson Syndrome ◽  
Additional Therapy

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious conditions characterized by necrosis of the skin and mucus membranes, and are mainly caused by medication and infections. Although the exact pathomechanism of SJS/TEN remains unclear, keratinocyte death is thought to be triggered by immune reactions to these antigens. While there is no established therapy for SJS/TEN, corticosteroids and intravenous immunoglobulin (IVIG) have been utilized as immunomodulator. We previously conducted a study to evaluate the efficacy of IVIG therapy in Japanese patients with SJS/TEN. IVIG was administered at a dosage of 400 mg/kg/day for 5 consecutive days as an additional therapy with systemic steroids. Prompt amelioration was observed in seven of the eight patients. All patients survived without sequelae. Recently, we retrospectively analyzed 132 cases of SJS/TEN treated in our two hospitals. The mortality rates in the patients treated with methylprednisolone pulse were 0% (0/31) for SJS and 7.0% (3/43) for TEN, and 0% (0/10) in the TEN patients treated with methylprednisolone pulse in combination with IVIG. These results suggest that early treatment with high-dose steroids, including methylprednisolone pulse therapy, and IVIG together with corticosteroids are possible therapeutic options to improve the prognosis of SJS/TEN.

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