scholarly journals Ayurvedic medicine- Not always a safe bet

2019 ◽  
Vol 4 ◽  
pp. 23
Author(s):  
Buddhi Paudyal ◽  
Astha Thapa ◽  
Keshav Raj Sigdel ◽  
Sudeep Adhikari ◽  
Buddha Basnyat
Keyword(s):  
Rheumatoid Arthritis ◽  
Nephrotic Syndrome ◽  
Side Effects ◽  
Liver Injury ◽  
Adverse Effects ◽  
Indian Subcontinent ◽  
Ayurvedic Medicine ◽  
Gold Salt ◽  
Traditional System ◽  
Wide Range

Ayurvedic medicine, a traditional system of medicine practiced in the Indian subcontinent is considered to be devoid of adverse effects. We report three cases which highlight the possibility of adverse events with the use of ayurvedic products. A 35 years old woman with hepatitis took ayurvedic powders and had her liver injury worsen, possibly due to alkaloids, and developed nephrotic syndrome, possibly due to gold salt. A 57 years old hypertensive man was taking ayurvedic medicine containing reserpine which had long been withdrawn from the allopathic system of medicine due to wide range of side effects. A 47 years old woman with rheumatoid arthritis was taking an unknown tablet containing a steroid as an adulterant for 2 years and developed side effects typical of steroid excess. We like to highlight the fact that ayurvedic medicines do have propensity to cause adverse effects due to adulterations or inherent constituents like alkaloids, and hence are not completely safe.

scholarly journals Adverse events with ayurvedic medicines- possible adulteration and some inherent toxicities

2019 ◽  
Vol 4 ◽  
pp. 23 ◽  
Author(s):  
Buddhi Paudyal ◽  
Astha Thapa ◽  
Keshav Raj Sigdel ◽  
Sudeep Adhikari ◽  
Buddha Basnyat
Keyword(s):  
Rheumatoid Arthritis ◽  
Nephrotic Syndrome ◽  
Side Effects ◽  
Liver Injury ◽  
Adverse Events ◽  
Indian Subcontinent ◽  
Ayurvedic Medicine ◽  
Gold Salt ◽  
Traditional System ◽  
Wide Range

Ayurvedic medicine, a traditional system of medicine practiced in the Indian subcontinent is considered to be devoid of adverse events. We report three cases which highlight the possibility of adverse events related with the use of ayurvedic products. A 35 year old woman with hepatitis took ayurvedic powder medicine and swarnabhasma (gold salt) and had her liver injury worsened, possibly due to alkaloids, and developed nephrotic syndrome, possibly due to gold salt. A 57 year old hypertensive man was taking ayurvedic medicine containing reserpine which had long been withdrawn from the allopathic system of medicine due to wide range of side effects. A 47 year old woman with rheumatoid arthritis was taking an unknown tablet containing steroid as an adulterant for 2 years and developed side effects typical of steroid excess. We would like to highlight the fact that ayurvedic medicines do have propensity to cause adverse events due to adulteration or inherent constituents like alkaloids, and hence may not always be completely safe.

scholarly journals Adverse events with ayurvedic medicines- possible adulteration and some inherent toxicities

2019 ◽  
Vol 4 ◽  
pp. 23
Author(s):  
Buddhi Paudyal ◽  
Astha Thapa ◽  
Keshav Raj Sigdel ◽  
Sudeep Adhikari ◽  
Buddha Basnyat
Keyword(s):  
Rheumatoid Arthritis ◽  
Nephrotic Syndrome ◽  
Side Effects ◽  
Adverse Effects ◽  
Adverse Events ◽  
Indian Subcontinent ◽  
Ayurvedic Medicine ◽  
Gold Salt ◽  
Traditional System ◽  
Wide Range

Ayurvedic medicine, a traditional system of medicine practiced in the Indian subcontinent is considered to be devoid of adverse effects. We report three cases which highlight the possibility of adverse events related with the use ofwith the use of ayurvedic products. A 35 years old woman with hepatitis took ayurvedic powder medicine and with swarnabhasma (gold salt)s and had her liver injury worsened, possibly due to alkaloids, and developed nephrotic syndrome, possibly due to and gold salt. A 57 years old hypertensive man was taking ayurvedic medicine containing reserpine which had long been withdrawn from the allopathic system of medicine due to wide range of side effects. A 47 years old woman with rheumatoid arthritis was taking an unknown tablet containing a steroid as an adulterant for 2 years and developed side effects typical of steroid excess. We like to highlight the fact that ayurvedic medicines do have propensity to may cause adverse effects due to adulterations or inherent constituents like alkaloids, and hence are may not always be completely safe.

The Use of Methotrexate in Rheumatoid Arthritis

1985 ◽  
Vol 19 (5) ◽  
pp. 349-358 ◽  
Author(s):  
Peter W. Letendre ◽  
Douglas J. DeJong ◽  
Donald R. Miller
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trials ◽  
Folic Acid ◽  
Side Effects ◽  
Adverse Effects ◽  
Systemic Administration ◽  
Refractory Disease ◽  
Controlled Clinical Trials ◽  
Folic Acid Antagonist ◽  
Acid Antagonist

The use of methotrexate in rheumatoid arthritis is reviewed. Methotrexate, a folic acid antagonist, is sometimes employed in an attempt to symptomatically control patients whose disease does not respond adequately to conventional therapies. Systemic administration of 7.5–15 mg/wk in a “pulse” fashion appears to be effective without precipitating severe adverse effects. However, concern over potentially serious side effects and a lack of well-controlled clinical trials have limited its use to severe, refractory disease. Further studies are needed before its role in rheumatoid arthritis can justifiably be expanded.

INCIDENCE OF CATARACT IN DERMATOLOGICAL PATIENTS USING STEROID CREAMS

2021 ◽  
pp. 65-66
Author(s):  
(Lt Col) Rajnish Kumar ◽  
(Lt Col) Vaka Raja Sekhar Reddy ◽  
(Lt Col) Sumit Kumar Singh ◽  
Debarshi jana
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Tertiary Care ◽  
Population Based ◽  
Topical Steroids ◽  
Study Group ◽  
Care Hospital ◽  
Ocular Side ◽  
Wide Range ◽  
The Face

Background/ Context: Corticosteroids, despite being a very effective line of treatment for various disorders is known to have a wide range of adverse effects. The use of systemic and topical steroids has been associated with cataract formation, however the ophthalmic side effects of application of steroid on skin away from the face has not been studied in depth. With increasing use of corticosteroids as rst line of therapy in treatment of various dermatological conditions, the ocular side effects, if any, of these preparations, cannot be overlooked. Aim: To study the incidence of cataract in patients using skin preparations of corticosteroids away from the face and also to correlate the dose and duration of steroid therapy to incidence of cataract. Materials & Methods: 50 patients with dermatological disorders who were being treated with dermatological steroids, on sites other than the face and periorbital region, for a period of more than six months consisted of the study group. The study group consisted of patients in the age group of 20 – 60 years. The study was conducted over a period of two years at a tertiary care hospital. Visual acuity, Slit lamp biomicroscopy, applanation tonometryand detailed fundus examination using 90D lens were carried out. Results: The incidence of cataract was signicantly higher in patients using dermatological steroids away from the face. Prolonged duration of use of these steroids also indicated a signicantly higher incidence of cataract. However, a larger population based study needs to be carried out to study the relationship between potency of steroid and incidence of cataract, although preliminary studies indicate a denite correlation between the two. Conclusions: Despite, steroids being used away from the face, there was a denite increase in the incidence of cataract. Before coming to any rm conclusions it would be advisable to reproduce the study in a larger population. However from the present pilot study it is prudent to advocate judicious use of innocuous looking steroid creams as they can cause signicant adverse effects

scholarly journals Comparative endocrine disrupting effects of abamectin and indoxacarb insecticides

2016 ◽  
Vol 4 (1) ◽  
pp. 89
Author(s):  
Atef Nassar
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Mode Of Action ◽  
Management Program ◽  
Plant Pests ◽  
Wide Range ◽  
Endocrine Disrupting ◽  
Chemical Groups ◽  
Pronounced Reduction ◽  
Follicular Stimulating Hormone

Abamectin and indoxacarb are relatively new insecticides with different mode of action and are applied to control a wide range of plant pests. However, their side effects to mammals are not fully studied. Accordingly, current study aimed to compare the adverse effects of both insecticides against the endocrine biomarkers: triiodothyronine (T3), tetraiodothyronine (T4), follicular-stimulating hormone (FSH), progesterone, and testosterone. These parameters were measured after orally-injecting rats with 1/20 LD50 doses of each of abamectin and indoxacarb for 60 days. Results showed that indoxacarb had pronounced reduction in the contents of T3 and FSH hormones compared to control and abamectin. Also, indoxacarb increased testosterone level compared to abamectin. T4 level was reduced by abamectin treatment compared to indoxacarb. Progesterone content was significantly increased after the abamectin treatment, while it was decreased after the indoxacarb treatment. However, the tested insecticides belong to avermectins and oxadiazine chemical groups that have different mode of action. They showed some similarity in their effect on T3, T4, and FSH, except for the progesterone hormone that showed a contradicting response. These two insecticides were marked as safe but current study highlight the need for caution during their application in the integrated pest management program.

scholarly journals Adverse Events Profile of Low-dose Methotrexate in Nepalese Patients with Rheumatoid Arthritis: an Observational Study

2020 ◽  
Vol 18 (3) ◽  
pp. 360-365
Author(s):  
Shweta Nakarmi ◽  
Kalpana Pudasaini ◽  
Bhojraj Adhikari ◽  
Binit Vaidya
Keyword(s):  
Rheumatoid Arthritis ◽  
Adverse Effect ◽  
Side Effects ◽  
Liver Function ◽  
Adverse Effects ◽  
Adverse Events ◽  
Observational Study ◽  
P Value ◽  
Function Tests ◽  
Patient Reported

Background: Methotrexate is considered as the anchor drug for the treatment of rheumatoid arthritis. However, various adverse effects limit its use leading to frequent discontinuation of treatment. This study aimed to evaluate the common adverse effects of methotrexate in patients with rheumatoid arthritis. Methods: A prospective observational study was conducted at National Center for Rheumatic Diseases from June 2018 to May 2019 among patients with rheumatoid arthritis using methotrexate monotherapy. Laboratory tests like liver function tests, renal function tests, complete blood count, C-reactive protein, erythrocyte sedimentation rate were done at baseline and every 3 months. Data on patients’ comorbidities, disease activity and side effects of drug were collected on every follow- up. Statistical analysis was carried out with the help of SPSS 23.0. Results: Out of 232 patients experiencing at least one adverse effect while on methotrexate monotherapy, 87.5% were female and mean age was 46.9±10.8 years. The mean dose of methotrexate was 16.6 ± 3.9 mg/week with the most frequently used dose of 20mg/week. Among the variety of adverse reaction observed, the most common was transaminitis (75.0%) with approximately 50.0% as isolated liver function abnormality, followed by nausea (19.4%), anorexia (12.9%), leukopenia (12.5%), oral ulcer (8.2%) and psychological intolerance (4.7%). Multiple regression analysis showed significant predictive value of body mass index for transaminitis (p-value 0.007). Conclusions: Asymptomatic liver function test derangement was the most frequent adverse-effect of methotrexate observed, whereas nausea and anorexia were the most common patient reported events. The frequent dose associated with side-effects in Nepalese patients was around 20mg/week. Keywords: Adverse events; methotrexate; Nepal; rheumatoid arthritis

scholarly journals Safety of infliximab in real clinical practice

2019 ◽  
Vol 1 (18) ◽  
pp. 39-43
Author(s):  
E. S. Aronova ◽  
G. V. Lukina
Keyword(s):  
Rheumatoid Arthritis ◽  
Adverse Reaction ◽  
Case Report ◽  
Clinical Practice ◽  
Side Effects ◽  
Genetically Engineered ◽  
Clinical Rheumatology ◽  
Actual Clinical Practice ◽  
Wide Range ◽  
Real Clinical Practice

A wide range of highly effective genetically engineered biological preparations introduced into clinical rheumatology in recent years causes a special interest in their safety.Purpose of the study. Evaluation of the safety of infliximab therapy in patients with rheumatoid arthritis.Materials and methods. The authors' own data, which analyzed the undesirable effects of infliximab in 135 patients with rheumatoid arthritis in actual clinical practice, are presented. A case report of the adverse reaction of combination therapy with leflunomide and infliximab is presented.Results and its discussion. The overall tolerability of infliximab was satisfactory. Adverse events were observed in 28.1 % of cases, including 19.1 % of patients (14.1 %) had serious side effects that required discontinuation of the drug.Findings. In most cases, infliximab is safe for use in actual clinical practice. Patients should be informed about the risks of undesirable effects and the need for a rheumatologist's examination before each infliximab administration before prescribing therapy.

scholarly journals Pharmacogenomics: introduction and use in clinical practice

2020 ◽  
Vol 58 (2) ◽  
pp. 69-74
Author(s):  
Hollie Saunders ◽  
Dana Harris ◽  
Răzvan M. Chirilă
Keyword(s):  
Clinical Practice ◽  
Side Effects ◽  
Adverse Effects ◽  
Genetic Code ◽  
Drug Response ◽  
Effective Response ◽  
Basic Principles ◽  
Direct To Consumer ◽  
Wide Range ◽  
Consumer Testing

AbstractPharmacogenomics describes the link between the genetic code and variations in drug response or adverse effects. It is rapidly gaining in both interest and accessibility. The knowledge of the gene-drug pairing for a wide range of medications will allow the clinician to select drugs with the best efficacy, appropriate dose and lowest likelihood of serious side effects.In order to apply this knowledge, practitioners need to be familiar with the basic principles of pharmacodynamics and pharmacokinetics and how these relate to drug response. Once these are understood, so can be the genetic variations that lead to different phenotypes. Our review explains these concepts and uses examples of commonly prescribed medications and their gene pairings. At the present time, the Food and Drug Administration (FDA) guidelines remain sparse in regards to pharmacogenomic testing but, despite this, direct-to-consumer testing is widely available. In this context, we detail how to interpret a pharmacogenomic report, we review the indications for testing, as well as its limitations.This information is a step ahead towards invidualized medicine, in the hope that tailoring medications and doses to an individual’s genetic make-up will predict a safe and effective response.

TRIAMCINOLONE THERAPY IN THE ADRENOGENITAL SYNDROME

PEDIATRICS ◽  
1961 ◽  
Vol 27 (2) ◽  
pp. 292-299
Author(s):  
Orville C. Green ◽  
William W. Cleveland ◽  
Lawson Wilkins
Keyword(s):  
Rheumatoid Arthritis ◽  
Nephrotic Syndrome ◽  
Side Effects ◽  
Lupus Erythematosus ◽  
Adrenal Hyperplasia ◽  
Adrenogenital Syndrome ◽  
Margin Of Safety ◽  
Cortisone Therapy

Triamcinolone has the unique advantage that it is not a salt-retaining steroid, and therefore it has been found useful to physicians dealing with pharmacologic doses in serious diseases such as rheumatoid arthritis, lupus erythematosus, and the nephrotic syndrome. In the physiologic dosage ranges utilized in the adrenogenital syndrome, salt retention and other side effects are not complications of cortisone therapy. Our results would indicate that triamcinolone is 8 to 10 times as potent as cortisone when comparing adrenal suppressive ability. However, the increased potency of this compound is accompanied by a reduced margin of safety, and cortisone, hydrocortisone, or prednisone remain the drugs of choice in treatment of congenital virilizing adrenal hyperplasia.

scholarly journals FRI0125 IMPACT OF RAMADAN DIURNAL INTERMITTENT FASTING ON CHRONIC MEDICATIONS INTAKE IN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 644.2-644
Author(s):  
K. Maatallah ◽  
D. Ben Nessib ◽  
H. Ferjani ◽  
D. Kaffel ◽  
W. Hamdi
Keyword(s):  
Rheumatoid Arthritis ◽  
Side Effects ◽  
Adverse Effects ◽  
Rheumatic Diseases ◽  
Biological Agents ◽  
Intermittent Fasting ◽  
Ramadan Fasting ◽  
Chronic Medications ◽  
Disease Modifying ◽  
The Impact

Background:Fasting during Ramadan, the ninth month of Islamic calendar, requires the abstinence from food and drink from sunrise to sunset [1]. Muslims are allowed to consume two major meals per day, one shortly before dawn (Suhoor) and the other immediately after sunset (Iftar). Although some previous investigations have reported a beneficent impact of fasting on rheumatic diseases’ activity [1,2], very few studies have dealt with the possible impact of intermittent fasting on chronic medications intake.Objectives:The objective of this study was to assess the impact of Ramadan intermittent fasting on adherence and tolerance of Disease-Modifying Anti-Rheumatic Drugs (DMARDs) in patients with rheumatoid arthritis (RA).Methods:This is a prospective monocentric study including patients with rheumatoid arthritis (RA) who fasted Ramadan 2019. Each patient was evaluated during 2 visits: 6 months before starting Ramadan fasting and after fasting at least 7 days. The following parameters were assessed: compliance with treatments, tolerability and timing of intake (Iftar meal, evening, Suhoor meal).Results:Thirty-six patients were enrolled: 7 men and 29 women. The average age of patients was 57.5 years ± 10.9 [39-79] and the mean disease duration was 6.7 years ± 3.3 [1-13]. Biological agents, methotrexate (MTX), Salazopyrin (SLZ) and Leflunomide (LFN) were respectively prescribed in 8, 22, 4 and 4 patients.Ramadan fasting did not affect either compliance with biological agents or tolerance. No additional side effects have been reported during this period.The compliance to MTX was comparable before and during fasting in 68.4% of cases. It was impaired by fasting in the rest with a full stop in 26.3% of patients. MTX was taken away from meals (as recommended) by 42.8% of patients. The timing of drug intake was the Iftar meal in 21.4% of patients, the Suhoor meal in 14.3% of patients and the evening in 64.3% of patients.Except 1 patient, adherence to SLZ was adequate during Ramadan fasting. It was taken with the 2 major meals in 50% of cases and during the evening in 50% of cases.Patients under LFN did not report any discontinuation.The reported reasons of discontinuations of Conventional Synthetic Disease-Modifying Anti-Rheumatic Drugs (csDMARDs) were: objective adverse effects (25%), apprehension of gastrointestinal adverse effects (25%) and lack of time between the two major meals (50%) (since they were advised to take MTX away from meals).Regarding the tolerance, gastrointestinal side effects of MTX were reported to be more frequent during Ramadan by 20% of patients, fewer by 13.3% of patients and unchanged by the rest of the patients. The gastrointestinal tolerance of SLZ and LFN was similar before and during Ramadan fasting.Conclusion:Even if the tolerability of chronic medications was not impaired by Ramadan fasting in the majority of patients, adherence to conventional DMARDs was reported to be reduced by more than a quarter of patients, mainly because of a lack of time between the two major meals. Physicians should be aware of the impact of Ramadan fasting on chronic drugs intake because they have a crucial role in helping patients with RA adjust medications safely.References:[1]Adawi M, Damiani G, Bragazzi NL, et al (2019) The Impact of Intermittent Fasting (Ramadan Fasting) on Psoriatic Arthritis Disease Activity, Enthesitis, and Dactylitis: A Multicentre Study. Nutrients 11[2]Bragazzi NL, Watad A (2017) The Impact of Fasting on Rheumatic Diseases. Isr Med Assoc J IMAJ 19:378–379Disclosure of Interests:None declared

Sign in / Sign up

Export Citation Format

Share Document