Do Ethanol and Metronidazole Interact to Produce a Disulfiram-Like Reaction?

2000 ◽  
Vol 34 (2) ◽  
pp. 255-257 ◽  
Author(s):  
Caroline S Williams ◽  
Kevin R Woodcock
Keyword(s):  
Drug Reaction ◽  
Case Reports ◽  
Convincing Evidence ◽  
Data Sources ◽  
Data Synthesis ◽  
Medline Search

OBJECTIVE: To obtain and evaluate evidence about the supposed disulfiram-like interaction between metronidazole and ethanol. DATA SOURCES: MEDLINE search from January 1964 to June 1999, using the terms metronidazole, ethanol, and drug reaction. DATA SYNTHESIS: The manufacturer's warnings include a disulfiram-like reaction between metronidazole and ethanol. However, review of reports published between 1969 and 1982 produced no convincing evidence that this reaction exists. Six case reports involving eight patients were evaluated. CONCLUSIONS: Four of the eight cases were serious, including one death, but the authors of all the reports presumed the metronidazole–ethanol reaction to be an established pharmacologic fact. None provided evidence that could justify their conclusions.

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.

Levodopa Therapy and the Risk of Malignant Melanoma

2000 ◽  
Vol 34 (3) ◽  
pp. 382-385 ◽  
Author(s):  
Jolene F Siple ◽  
Diana C Schneider ◽  
Wendy A Wanlass ◽  
Burton K Rosenblatt
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Malignant Melanoma ◽  
English Language ◽  
Case Reports ◽  
Levodopa Therapy ◽  
Data Sources ◽  
Data Synthesis ◽  
Medline Search ◽  
Search Terms

OBJECTIVE: To evaluate the use of levodopa therapy in patients with Parkinson's disease and malignant melanoma. DATA SOURCES: A MEDLINE search (January 1966–September 1999) of English-language articles was conducted. Key search terms included levodopa, melanoma, and Parkinson's disease; 34 case reports were identified. DATA SYNTHESIS: Carbidopa/levodopa continues to be a mainstay in the treatment of Parkinson's disease. Since the late 1970s, a warning has appeared in the prescribing literature for levodopa regarding the risk of activating malignant melanoma. An evaluation was conducted of the case reports in which a causal relationship between levodopa and melanoma was suggested. CONCLUSIONS: There is an unlikely association between levodopa and induction or exacerbation of malignant melanoma.

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.

Foscarnet-Associated Penile Ulcerations

1994 ◽  
Vol 10 (5) ◽  
pp. 215-217
Author(s):  
Richard M. Cadle ◽  
Richard J. Hamill
Keyword(s):  
Adverse Effect ◽  
Case Reports ◽  
Human Herpesvirus ◽  
Antiviral Agent ◽  
Review Literature ◽  
Data Sources ◽  
Data Synthesis ◽  
Manual Search ◽  
Search Index ◽  
Genital Hygiene

Objective: To report a case of foscarnet-induced penile ulcerations and review literature related to this adverse effect. Data Sources: Case reports and review articles identified by a computerized search (MEDLINE) and manual search (Index Medicus). Data Synthesis: Foscarnet is a pyrophosphate analog antiviral agent that is approved by the Food and Drug Administration for treating cytomegalovirus retinitis in patients with AIDS. It also is used investigationally for other indications and human herpesvirus infections. Adverse effects include nephrotoxicity, anemia, ionized calcium abnormalities, and penile ulcerations. The majority of penile ulcers have developed within two weeks following initiation of foscarnet therapy with dosages of 180–200 mg/kg/d. Most cases required discontinuation of foscarnet to resolve the penile lesions. A postulated mechanism for this effect is inflammatory contact dermatitis from exposure to urine with elevated concentrations of foscarnet. We report a case of foscarnet-induced penile ulcerations that resolved after discontinuing this agent. Conclusions: Foscarnet can induce penile ulcerations. Increased awareness of this phenomenon, along with meticulous genital hygiene and urination practices, are required for its prevention.

Nonthrombocytopenic Purpura Associated Sequentially with Nifedipine and Diltiazem

1992 ◽  
Vol 26 (9) ◽  
pp. 1089-1090 ◽  
Author(s):  
Margaret Kuo ◽  
Nancy Winiarski ◽  
Serafino Garella
Keyword(s):  
Adverse Effect ◽  
Channel Blocker ◽  
Case Reports ◽  
Data Extraction ◽  
Data Sources ◽  
Cutaneous Vasculitis ◽  
Laboratory Studies ◽  
Pertinent Literature ◽  
Data Synthesis ◽  
Purpuric Rash

OBJECTIVE: To report the case of a patient who developed nonthrombocytopenic purpura sequentially following the administration of nifedipine and diltiazem. DATA SOURCES: Case reports, MEDLINE review of pertinent literature, and review of relevant studies. DATA EXTRACTION: Data were extracted from direct patient observation and review of laboratory studies and published reports. DATA SYNTHESIS: Nonthrombocytopenic purpura secondary to cutaneous vasculitis is a known, although rare, adverse effect of nifedipine. It has not been reported in association with diltiazem. We report the case of a 75-year-old woman in whom a purpuric rash demonstrated by biopsy to be attributable to cutaneous vasculitis developed in the course of nifedipine therapy. The rash disappeared after discontinuation of the drug; however, it recurred when diltiazem therapy was initiated. CONCLUSIONS: Nonthrombocytopenic purpura may be associated with diltiazem as well as with nifedipine. When this adverse effect occurs following administration of a calcium-channel blocker, caution is advised in using other agents of the same class.

Testosterone Replacement Therapy for Bone Loss Prevention in HIV-Infected Males

2003 ◽  
Vol 37 (4) ◽  
pp. 582-585 ◽  
Author(s):  
Patrick G Clay ◽  
Amy I Lam
Keyword(s):  
Bone Loss ◽  
Hiv Infection ◽  
Data Sources ◽  
Hormone Deficiency ◽  
Testosterone Replacement Therapy ◽  
Data Synthesis ◽  
Medline Search ◽  
Prevention Of Bone Loss ◽  
Endocrine Abnormality ◽  
Hiv Negative

OBJECTIVE: To review the use of testosterone for the prevention of bone loss in men with HIV infection. DATA SOURCES: A MEDLINE search (1966–May 2002) on the use of testosterone in osteoporosis/HIV infection was performed. A reference bibliography search was also completed. DATA SYNTHESIS: Osteopenia/osteoporosis is reported in HIV-infected men due to a myriad of factors. Sex hormone deficiency is a frequent endocrine abnormality in this population. CONCLUSIONS: In HIV-negative men, testosterone may be beneficial for preventing bone loss and hastening the resolution of fractures. Testosterone's role in preventing bone loss in HIV-infected men remains to be defined.

Etiology of Patellar Tendinopathy in Athletes

2005 ◽  
Vol 14 (3) ◽  
pp. 259-272 ◽  
Author(s):  
Sheri A. Hale
Keyword(s):  
Clinical Management ◽  
Data Sources ◽  
Patellar Tendinopathy ◽  
Extrinsic Factors ◽  
Data Synthesis ◽  
Medline Search ◽  
Complex Process ◽  
Study Selection ◽  
Joint Dynamics ◽  
Type Data

Objective:To review the etiology of patellar tendinopathy as it relates to clinical management of chronic patellar-tendon disease in athletes.Data Sources:Information was gathered from a MEDLINE search of literature in English using the key wordspatellar tendinitis, patellar tendonitis, patellar tendinosis, patellar tendinopathy,andjumper’s knee.Study Selection:All relevant peer-reviewed literature in English was reviewed.Data Synthesis:The etiology of patellar tendinopathy is multifactorial, incorporating both intrinsic and extrinsic factors. Age, muscle flexibility, training program, and knee-joint dynamics have all been associated with patellar tendinopathy. The roles of gender, body morphology, and patellar mobility in patellar tendinopathy are unclear.Conclusions:The pathoetiology of patellar tendinopathy is a complex process that results from both an inflammatory response and degenerative changes. There is a tremendous need for research to improve our understanding of the pathoetiology of patellar tendinopathy and its clinical management.

Divalproex Sodium Therapy in Elderly with Dementia-Related Agitation

2002 ◽  
Vol 36 (10) ◽  
pp. 1625-1628 ◽  
Author(s):  
Crystal E Pratt ◽  
Steven M Davis
Keyword(s):  
Clinical Trials ◽  
Elderly Patients ◽  
Statistical Significance ◽  
Data Sources ◽  
Controlled Trials ◽  
Divalproex Sodium ◽  
Data Synthesis ◽  
Medline Search ◽  
Potential Benefits

OBJECTIVE: To review available literature regarding the use of divalproex sodium in the treatment of agitation in elderly patients with dementia. DATA SOURCES: Clinical trials and review articles were identified by MEDLINE search (1966 — March 2002). DATA SYNTHESIS: The literature provides information regarding the potential benefits and tolerability of divalproex sodium in the treatment of dementia-related agitation. This article analyzes 7 studies to better understand the role of divalproex sodium in the treatment of dementia. CONCLUSIONS: Divalproex sodium may offer a slight benefit to elderly patients suffering from dementia-related agitation. Until better-controlled trials demonstrate statistical significance and comparisons with established treatments are performed, practitioners should use divalproex sodium cautiously.

Safety and Efficacy of Influenza Vaccine in Children

2003 ◽  
Vol 37 (11) ◽  
pp. 1712-1715 ◽  
Author(s):  
Leslie GB Goldstein
Keyword(s):  
Influenza Vaccine ◽  
Asthma Exacerbation ◽  
Data Sources ◽  
Influenza Vaccines ◽  
Data Synthesis ◽  
Safety And Efficacy ◽  
Medline Search ◽  
Asthmatic Children ◽  
Search Terms

OBJECTIVE: To describe the safety and efficacy of influenza vaccines in asthmatic children. DATA SOURCES: Literature was identified by a MEDLINE search (2002–March 2003). Key search terms included asthma, exacerbation, children, vaccine, and influenza. DATA SYNTHESIS: Concerns that the influenza vaccine may exacerbate asthma attacks have kept many asthmatic children from receiving this immunization. Researchers have conducted studies to determine the burden of influenza on asthmatic children, the safety of influenza vaccines, and their benefit in the presence of glucocorticoid burst therapy in the same population. CONCLUSIONS: Influenza vaccines tested are safe and efficacious in asthmatic children.

Weight Gain Associated with Cinnarizine

1992 ◽  
Vol 26 (7-8) ◽  
pp. 928-930 ◽  
Author(s):  
Joaquin Navarro-Badenes ◽  
Inocencia Martínez-Mir ◽  
Vicente Palop ◽  
Elena Rubio ◽  
Francisco J. Morales-Olivas
Keyword(s):  
Weight Gain ◽  
Food Intake ◽  
Randomized Trials ◽  
Case Reports ◽  
Data Extraction ◽  
Data Sources ◽  
Initial Weight ◽  
Data Synthesis ◽  
Previous Level ◽  
The Mean

OBJECTIVE: To report four cases of cinnarizine-induced weight gain. DATA SOURCES: Case reports from a local obesity center and review articles. DATA EXTRACTION: Data were abstracted from spontaneous comments made by patients to one of the authors, who was a doctor at the clinic, and reviewed by the remaining authors. DATA SYNTHESIS: We reviewed the cases of four women, aged 50–57 years without endocrine or metabolic pathologies, that showed weight gain associated with the intake of cinnarizine for one to two years. No other drugs usually were administered during the period in which the women gained weight, although in two cases cinnarizine was associated with dihydroergocristine in the same medicine (Clinadil). The mean weight increase was 6.25 kg (range 4–10). The increases do not appear to be related to whether the patients' initial weight was ideal or excessive. The weight gain was always associated with increased appetite and food intake. One patient discontinued cinnarizine treatment and her weight returned to its previous level. CONCLUSIONS: Cinnarizine is a piperazine derivative used in the treatment of vertigo and in the prophylaxis of migraine. In contrast to related drugs, data about cinnarizine are scarce because randomized trials of cinnarizine have been inconclusive. Our observations indicate that cinnarizine may cause weight gain, as observed with other drugs in the same class.

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