Danazol Increases the Anticoagulant Effect of Warfarin

1992 ◽  
Vol 26 (5) ◽  
pp. 641-642 ◽  
Author(s):  
Mimi L. Meeks ◽  
Kenneth W. Mahaffey ◽  
Michael D. Katz
Keyword(s):  
English Language ◽  
Case Reports ◽  
Breast Disease ◽  
Anticoagulant Effect ◽  
Bleeding Complications ◽  
Protein C Deficiency ◽  
Data Synthesis ◽  
Study Selection ◽  
Underlying Mechanisms ◽  
Testosterone Derivative

OBJECTIVE: To report two cases demonstrating an interaction between danazol and warfarin, resulting in the potentiation of warfarin's effect and bleeding complications. DATA SOURCES: Case reports, review articles, and studies identified by MEDLINE. STUDY SELECTION: All published English-language reports involving danazol and warfarin interactions were reviewed. DATA SYNTHESIS: Danazol, a synthetic testosterone derivative, is used in the treatment of endometriosis, fibrocystic breast disease, menorrhagia protein C deficiency, and hemophilia. We describe two cases including an interaction between danazol and warfarin, resulting in bleeding complications. There are at least two other reported cases of this interaction. This interaction may be attributable to several mechanisms. Danazol may inhibit the metabolism of warfarin and/or it may have a direct effect on the coagulation and fibrinolytic systems. CONCLUSIONS: Based on this report and other published cases, clinicians must be aware that danazol may increase the anticoagulant effect of warfarin. Patients receiving warfarin who are prescribed danazol must be monitored closely to prevent excessive anticoagulation and subsequent bleeding. Studies are needed to determine the frequency of this interaction and its underlying mechanisms.

Isoniazid-Associated Psychosis: Case Report and Review of the Literature

1993 ◽  
Vol 27 (2) ◽  
pp. 167-170 ◽  
Author(s):  
Karen A. Pallone ◽  
Morton P. Goldman ◽  
Matthew A. Fuller
Keyword(s):  
Case Report ◽  
English Language ◽  
Case Reports ◽  
Data Extraction ◽  
Data Sources ◽  
Review Of The Literature ◽  
Data Synthesis ◽  
Medline Search ◽  
Study Selection ◽  
Language Literature

Objective To describe a case of isoniazid-associated psychosis and review the incidence of this adverse effect. Data Sources Information about the patient was obtained from the medical chart. A MEDLINE search of the English-language literature published from 1950 to 1992 was conducted and Index Medicus was manually searched for current information. Study Selection All case reports describing isoniazid-associated psychosis were reviewed. Data Extraction Studies were evaluated for the use of isoniazid, symptoms of psychosis, onset of symptoms, and dosage of isoniazid. Data Synthesis The case report is compared with others reported in the literature. The incidence of isoniazid-associated psychosis is rare. Conclusions The mechanism of isoniazid-associated psychosis is uncertain. It appears that isoniazid was associated with the psychosis evident in our patient and in the cases reviewed.

Examination of the Relationship Between Antimicrobials and Thrombocytosis

2012 ◽  
Vol 46 (10) ◽  
pp. 1425-1429 ◽  
Author(s):  
Christy C Forehand ◽  
Jennifer Cribb ◽  
J Russell May
Keyword(s):  
Antimicrobial Therapy ◽  
English Language ◽  
Case Reports ◽  
Data Extraction ◽  
Acute Phase Reactant ◽  
Drug Event ◽  
Probability Scale ◽  
Data Synthesis ◽  
Study Selection ◽  
The Relationship

Objective: To evaluate whether there is a relationship between antimicrobial therapy and the development of thrombocytosis. Data Sources: Literature was accessed through EMBASE (1977-June 2012) and MEDLINE (1977-June 2012) using the terms thrombocytosis and antimicrobial. In addition, reference citations from publications identified were reviewed. Study Selection and Data Extraction: All English-language publications identified were evaluated. For case reports, the Naranjo probability scale was used to calculate the likelihood of the drug causing the reaction. Data Synthesis: Thrombocytosis occurring during antimicrobial therapy is well documented, with several case reports and clinical trial observations. However, a direct causal relationship is not yet supported by the available literature. Platelets are welt known to be an acute phase reactant, with an elevated count occurring after acute conditions such as blood loss, inflammation, or infection. Thrombocytosis during antimicrobial therapy may be the result of an infectious process and not an adverse drug event. Conclusions: Based on the current available literature, a definitive link cannot be established between antimicrobial therapy and occurrence of thrombocytosis.

Acetazolamide in the Treatment of Seizures

1996 ◽  
Vol 30 (5) ◽  
pp. 514-519 ◽  
Author(s):  
William G Reiss ◽  
Karen S Oles
Keyword(s):  
English Language ◽  
Adverse Reactions ◽  
Case Reports ◽  
Data Synthesis ◽  
Medline Search ◽  
Study Selection ◽  
Clonic Seizures ◽  
Antiepileptic Medications ◽  
Patients With Epilepsy ◽  
Dosage Administration

OBJECTIVE: TO summarize the pharmacology, pharmacokinetics, efficacy, and safety of acetazolamide and to evaluate its therapeutic role in patients with epilepsy. DATA SOURCES: A computerized search of the MEDLINE (OVID) database (1966–1994) was used to identify publications regarding acetazolamide. The MEDLINE search was supplemented by information from textbooks. STUDY SELECTION: Included were English-language review articles, clinical trials, cohort studies, and case reports. Topics investigated included basic pharmacology, therapeutics, toxicology, adverse reactions, dosage, administration, and pharmacokinetics of acetazolamide. DATA SYNTHESIS: Acetazolamide, a carbonic anhydrase inhibitor, has been approved for the treatment of epilepsy since 1953. Acetazolamide is primarily used in combination therapy with other antiepileptic medications in both children and adults although it may be used as monotherapy. Drug concentration monitoring has not been found to be routinely beneficial. Adverse effects include kidney stones, metabolic acidosis, lethargy, appetite suppression, paresthesias, and rare blood dyscrasias. Partial tolerance may develop to the antiepileptic activity. CONCLUSIONS: Acetazolamide is a beneficial adjunctive agent in the pharmacotherapy of epilepsy and should be considered in refractory epilepsy. Although it may be useful in partial, myoclonic, absence, and primary generalized tonic—clonic seizures uncontrolled by other marketed agents, acetazolamide has been inadequately studied by current standards and its use has been limited.

Mitomycin-Induced Pulmonary Toxicity: Case Report and Review of the Literature

1992 ◽  
Vol 26 (4) ◽  
pp. 481-484 ◽  
Author(s):  
Donna C. Linette ◽  
Karen H. McGee ◽  
James A. McFarland
Keyword(s):  
Pulmonary Toxicity ◽  
English Language ◽  
Case Reports ◽  
Data Extraction ◽  
Vinca Alkaloid ◽  
Corticosteroid Treatment ◽  
Data Synthesis ◽  
Medline Search ◽  
Pulmonary Response ◽  
Study Selection

OBJECTIVE: This report describes a case of mitomycin-induced pulmonary toxicity and reviews the incidence of this adverse effect, reported patterns of toxicity and associated dosages of the drug, and the use of corticosteroids in the management of pulmonary toxicity. DATA SOURCES: Information about our patient was obtained in part from the medical chart; we had also treated him personally in the past. We conducted a MEDLINE search of the English language literature (restricted to human studies) from 1966 to 1991 and manually searched Index Medicus for current information. STUDY SELECTION: All case reports that described pulmonary toxicity possibly associated with mitomycin were reviewed. DATA EXTRACTION: Studies were evaluated for the dosages of mitomycin given to patients, the nature and onset of symptoms, management course, and corticosteroid use. DATA SYNTHESIS: Our case is similar to others described in the literature. The incidence of mitomycin-induced pulmonary toxicity has been reported to range from 2 to 38 percent. Concurrent vinca alkaloid administration may potentiate the risk of an acute pulmonary insult secondary to mitomycin use. The toxicity is usually of slow onset and the average total dosage of drug implicated is 78 mg. A formal evaluation of corticosteroid treatment has not been performed, but various authors have reported success with different regimens. CONCLUSIONS: The incidence of pulmonary toxicity associated with mitomycin is unpredictable, but more likely to occur at higher dosages. Treatment with corticosteroids is encouraged to improve pulmonary response.

Sugar Paste for Treatment of Decubital Ulcers

1996 ◽  
Vol 12 (6) ◽  
pp. 289-290 ◽  
Author(s):  
Laura Tuneu Valls ◽  
Magdalena Trullás Altisen ◽  
Ramón Plá Poblador ◽  
Angels Ciurán Alvarez ◽  
Rosa Garriga Biosca
Keyword(s):  
English Language ◽  
Case Reports ◽  
Low Cost ◽  
Data Extraction ◽  
Data Synthesis ◽  
Length Of Treatment ◽  
Study Selection ◽  
Wide Variability

Objective: To review the use of sugar paste in the treatment of decubital ulcers. Data Sources: A MEDLINE, IDIS, and current journal search of English-language articles published between 1978 and 1993 on sugar paste in the treatment of ulcers. Study Selection: Case reports, cohort, epidemiologic, in vivo, and in vitro studies were evaluated. Data Extraction: Reports using granulated sugar or derivatives in the treatment of refractory cutaneous ulcers were evaluated. Data Synthesis: All the studies show that sugar paste treatment has satisfactorily resolved decubital ulcers, although a wide variability in treatment length has been seen. Considering the likely mechanisms of action for sugar paste, this wide variability may be a result of dressing frequency. In other words, for sugar paste to be most effective it has to be applied in such a way that a continuous optimal sugar concentration in the ulcer is maintained. To achieve this, dressing frequency should not be standardized, but individualized according to ulcer type, depth, and exudate, as well as patient healing capacity. Healing could probably have been achieved earlier if dressing had been individualized. Besides effectiveness and low cost, sugar paste is also safe, with few adverse events associated with its use. Conclusions: In spite of difficulties in evaluating the use of sugar paste in treatment of decubital ulcers, it has been shown to be an effective therapy for this disorder. However, we recommend that length of treatment be individualized for each patient.

Ranitidine and Thrombocytopenia

1995 ◽  
Vol 11 (6) ◽  
pp. 263-266 ◽  
Author(s):  
Josephine M Yim ◽  
Jerry L Frazier
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
English Language ◽  
Case Reports ◽  
Healthcare Providers ◽  
Data Sources ◽  
Equal Weight ◽  
Data Synthesis ◽  
Human Data ◽  
Study Selection

Objective: To provide an overview of thrombocytopenia, focusing on ranitidine-induced thrombocytopenia. Data Sources: References were selected from published bibliographies of books, case reports, and topical searches in the MEDLINE database (English language, through 1994) on thrombocytopenia, ranitidine-induced thrombocytopenia, and cimetidine-induced thrombocytopenia. Study Selection: All reports of ranitidine-induced thrombocytopenia have been published as case reports. All reports were given equal weight because none involved a rechallenge. Only human data were included. There was only one case of a patient receiving ranitidine after experiencing cimetidine-induced thrombocytopenia. Data Synthesis: Literature systematically examining the incidence and cause of ranitidine-induced thrombocytopenia is lacking. No cases of rechallenge have been reported, thus raising the concern of effect versus association. Conclusions: Ranitidine has been reported to induce thrombocytopenia by several different mechanisms. Although the incidence of ranitidine-induced thrombocytopenia is relatively rare, healthcare providers need to be aware of this possible adverse drug reaction.

Pegfilgrastim-Induced Bone Pain: A Review on Incidence, Risk Factors, and Evidence-Based Management

2017 ◽  
Vol 51 (9) ◽  
pp. 797-803 ◽  
Author(s):  
Donald C. Moore ◽  
Annie E. Pellegrino
Keyword(s):  
Risk Factors ◽  
Bone Pain ◽  
English Language ◽  
Data Extraction ◽  
Treatment Modalities ◽  
Management Options ◽  
Data Synthesis ◽  
Pharmacological Management ◽  
Study Selection ◽  
Incidence Risk

Objective: To review the incidence, risk factors, and management of pegfilgrastim-induced bone pain (PIBP). Data Sources: PubMed was searched from 1980 to March 31, 2017, using the terms pegfilgrastim and bone pain. Study Selection and Data Extraction: English-language, human studies and reviews assessing the incidence, risk factors, and management of PIBP were incorporated. Data Synthesis: A total of 3 randomized, prospective studies and 2 retrospective studies evaluated pharmacological management of PIBP. Naproxen compared with placebo demonstrated a reduction in the degree, incidence, and duration of bone pain secondary to pegfilgrastim. Loratadine was not effective in reducing the incidence of bone pain prophylactically, but a retrospective study evaluating dual antihistamine blockade with loratadine and famotidine demonstrated a decreased incidence in bone pain when administered before pegfilgrastim. Conclusion: Naproxen is effective at managing PIBP. Although commonly used, antihistamines have a paucity of data supporting their use. Dose reductions of pegfilgrastim and opioids may also be potential management options; however, data supporting these treatment modalities are scarce.

Drug-Induced Restless Legs Syndrome

2018 ◽  
Vol 52 (7) ◽  
pp. 662-672 ◽  
Author(s):  
Edna Patatanian ◽  
Melanie K. Claborn
Keyword(s):  
Restless Legs Syndrome ◽  
English Language ◽  
Case Reports ◽  
Data Extraction ◽  
Case Series ◽  
Predisposing Factors ◽  
Drug Induced ◽  
Restless Legs ◽  
Drug Classes ◽  
Study Selection

Objective: To review the literature on drug-induced restless legs syndrome (DI-RLS). Data Sources: The review included a search for English-language literature from 1966 to December 2017 in the MEDLINE, PubMed, and Ovid databases using the following search terms: restless legs syndrome (RLS), periodic limb movement, adverse effects, and drug-induced. In addition, background articles on the pathophysiology, etiology, and epidemiology of RLS were retrieved. Bibliographies of relevant articles were reviewed for additional citations. Study Selection and Data Extraction: All case reports, case series, and review articles of DI-RLS were identified and analyzed. There were only a small number of controlled clinical trials, and most data were from case reports and case series. Results: Several drugs and drug classes have been implicated in DI-RLS, with antidepressants, antipsychotics, and antiepileptics having the most evidence. In addition, RLS may be linked with a number of disorders or underlying predisposing factors as well. Conclusions: The prevalence of RLS is variable and ranges from 3% to 19% in the general population. There are many predisposing factors to RLS, but an emerging body of evidence suggests that there is an association between numerous drugs and RLS.

A Review of Cyclic Antidepressant-Induced Blood Dyscrasias

1992 ◽  
Vol 26 (3) ◽  
pp. 378-383 ◽  
Author(s):  
Edward A. Hartshorn ◽  
Gary M. Levin ◽  
C. Lindsay DeVane
Keyword(s):  
English Language ◽  
Human Subjects ◽  
Onset Time ◽  
Data Sources ◽  
Letters To The Editor ◽  
Data Synthesis ◽  
Chemical Structures ◽  
Study Selection ◽  
Pertinent Data

OBJECTIVE: To review the literature for cases of blood dyscrasias associated with cyclic antidepressants. Several types of blood dyscrasias are discussed. DATA SOURCES: All references were selected through the use of MEDLINE. Indexing terms were blood, abnormalities, dyscrasias, antidepressants, agranulocytosis, and eosinophilia. The only constraints were English language and human subjects. STUDY SELECTION: All cases were included except for letters to the editor of various journals when pertinent data such as doses and additional medications were omitted. DATA SYNTHESIS: The review provides a table listing the different blood dyscrasias and the drug the patient was receiving. The table also includes time of onset, time to recovery, and several symptoms for each patient. CONCLUSIONS: Common symptoms of various blood dyscrasias are discussed. The chemical structures of the antidepressants are related to phenothiazines, which are also implicated in causing blood dyscrasias. Recommendations for treatment of both the dyscrasia and depression are discussed.

Intranasal Glucagon: A New Way to Treat Hypoglycemic Emergencies

2020 ◽  
Vol 54 (8) ◽  
pp. 780-787
Author(s):  
Rachel N. Lowe ◽  
Jennifer M. Trujillo
Keyword(s):  
Adverse Events ◽  
English Language ◽  
Data Extraction ◽  
Severe Hypoglycemia ◽  
Data Synthesis ◽  
Language Studies ◽  
Study Selection ◽  
Free Treatment ◽  
Patients With Diabetes ◽  
Data Source

Objective: To review the safety, efficacy, and administration of intranasal (IN) glucagon for the management of hypoglycemia. Data Source: A literature search of PubMed/MEDLINE (1995 to November 2019) using the terms intranasal glucagon, nasal glucagon, glucagon, hypoglycemia treatment, and hypoglycemia management was completed. Study Selection and Data Extraction: English-language studies evaluating IN glucagon were evaluated. Data Synthesis: IN glucagon is a newly approved product for the treatment of hypoglycemia in patients with diabetes, 4 years and older. Administered as a 3-mg dose, it was shown to be noninferior to intramuscular (IM) glucagon. In comparison trials, more than 98% of hypoglycemic events were treated successfully with IN glucagon in both pediatric and adult patients. In simulated and real-world studies, IN glucagon was administered in less than a minute for the majority of scenarios. IM glucagon took longer to administer, ranging from 1 to 4 minutes, and often, patients did not receive the intended full dose. Nausea and vomiting, known adverse events for glucagon, as well as local adverse events were most commonly reported with IN glucagon. Relevance to Patient Care and Clinical Practice: IN glucagon is safe, effective, easy to use, and does not require reconstitution prior to use, which can lead to faster delivery in a severe hypoglycemic event. It does not require age- or weight-based dosing. This delivery method offers an option for someone who fears needles or is uncomfortable with injections. Conclusion: IN glucagon is a safe, effective, easy to use, needle-free treatment option for severe hypoglycemia.

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