Tramadol-induced parkinsonism: a case report of a 75-year-old woman

Abstract Adverse drug reaction (ADR) is a form of unwanted reaction and is the crucial reason for illness and death. Tramadol-induced parkinsonism is a kind of ADR that occurs after the repeated intake of tramadol. Long-term exposure to tramadol has been known to induce tremor and alter the functioning of dopamine. This case report introduces a 75-year-old woman diagnosed with tramadol-induced parkinsonism due to the administration of tramadol for the treatment of post-operated (breast cancer) acute onset of severe pain on the left side of the chest. The assessment of the offending drug was carried out via Naranjo probability scale. A score of 6 was reported for this patient, defining tramadol as a probable cause of this reaction. For the management of the drug-induced parkinsonism, levodopa/carbidopa was prescribed and the symptoms related to parkinsonism resolved within a week. The age of the patient and the female gender is considered to be the main risk factor for the occurrence of such reaction. This case report is an attempt to spread awareness about the negative consequences of long-term use of tramadol in old patients. Thus, the medical practitioners must be very careful while administering tramadol to the old aged population.

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Lithium-Induced Parathyroid Dysfunction: A Case Report and Review of the Literature

Annals of Pharmacotherapy ◽

10.1177/106002809302700904 ◽

1993 ◽

Vol 27 (9) ◽

pp. 1040-1043 ◽

Cited By ~ 6

Author(s):

Jerry W. Taylor ◽

Angela J. Bell

Keyword(s):

Case Report ◽

Clinical Presentation ◽

Lithium Carbonate ◽

Suspected Drug ◽

Current Management ◽

Therapy Discontinuation ◽

Drug Induced ◽

Parathyroid Dysfunction ◽

Management Recommendations

OBJECTIVE: Twenty-six cases of lithium-induced hyperparathyroidism have been reported in the literature. This article describes an additional case that illustrates current management recommendations. DESIGN: Case report. Clinical presentation and proposed mechanisms of the suspected drug-induced effect are discussed. CONCLUSIONS: Serum calcium concentrations should be determined before and periodically during long-term lithium carbonate therapy. Discontinuation of therapy in patients who develop lithium-induced parathyroid dysfunction generally corrects calcium and parathyroid hormone concentrations. Surgery is indicated in patients with complications of hyperparathyroidism.

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CARBAMAZEPINE INDUCED SLE-A RARE AND SERIOUS ADR

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2017v9i1.14630 ◽

2016 ◽

Vol 9 (1) ◽

pp. 319

Author(s):

Sai Keerthana P. C. ◽

Anila K. N.

Keyword(s):

Systemic Lupus Erythematosus ◽

Autoimmune Disease ◽

Lupus Erythematosus ◽

Low Risk ◽

Probability Scale ◽

Systemic Lupus ◽

Drug Induced ◽

Rare Phenomenon ◽

Causality Score

<p style="line-height: 150%; margin-bottom: 0cm;" align="justify">Carbamazepine is a commonly used antiseizure medication. Carbamazepine-induced SLE (Systemic Lupus Erythematosus) is a very rare phenomenon. Drug-induced SLE is an autoimmune disease caused by long-term use of certain drugs. Carbamazepine is a drug with low risk for causing lupus symptoms. The process that leads to drug-induced SLE are not entirely understood. A very few cases are reported with carbamazepine association with SLE. Herein we report a case of 4 y old girl with SLE induced by carbamazepine showing a causality score of 8 by Naranjo ADR probability scale.</p>

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Acute onset clozapine-induced hyperglycaemia: A case report

General Psychiatry ◽

10.1136/gpsych-2018-100045 ◽

2019 ◽

Vol 32 (2) ◽

pp. e100045 ◽

Cited By ~ 2

Author(s):

Pradeep Kumar ◽

Dheerendra Kumar Mishra ◽

Nimisha Mishra ◽

Sunil Ahuja ◽

Gyanendra Raghuvanshi ◽

...

Keyword(s):

Metabolic Syndrome ◽

Case Report ◽

Side Effects ◽

Atypical Antipsychotic ◽

Time Frame ◽

Acute Onset ◽

Antipsychotic Medications ◽

Pathophysiological Mechanisms ◽

Hypoglycaemic Agent

Clozapine is an atypical antipsychotic which is described to have higher efficacy among all available antipsychotic medications. Clozapine is reserved especially for resistant schizophrenia due to its side effects. Clozapine-induced metabolic syndrome and hyperglycaemia are common long-term side effects and are responsible for increased mortality in patients with schizophrenia. In this case, a patient with resistant schizophrenia was presented with acute-onset hyperglycaemia and delirium with the use of clozapine within a week. Withdrawal of clozapine in the patient led to the improvement in delirium and hyperglycaemia without the use of any hypoglycaemic agent. This case supports the notion that in certain cases clozapine can induce hyperglycemia through possible direct pathophysiological mechanisms within a shorter time frame.

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A Case Report of Severe Delirium after Amantadine Withdrawal

Case Reports in Neurology ◽

10.1159/000460814 ◽

2017 ◽

Vol 9 (1) ◽

pp. 44-48 ◽

Cited By ~ 3

Author(s):

Franz Marxreiter ◽

Jürgen Winkler ◽

Martin Uhl ◽

Dominik Madžar

Keyword(s):

Cognitive Impairment ◽

Case Report ◽

Withdrawal Syndrome ◽

Dopamine Agonists ◽

Psychotic Symptoms ◽

Drug Induced ◽

Comt Inhibitors ◽

Mao B ◽

Psychotropic Substance

Amantadine is frequently used in addition to dopaminergic substances like dopamine agonists or L-Dopa in advanced Parkinson disease (PD). However, adverse effects like hallucinations limit its use. PD patients developing severe psychotic symptoms upon treatment with either dopaminergic substances and/or amantadine need to stop intake of any psychotropic substance. Here, we report the case of a 71-year-old PD patient without previously known cognitive impairment. He presented with drug-induced psychotic symptoms due to changes in his therapeutic regimen (increase in COMT inhibitors, newly introduced MAO B inhibitors). Also, amantadine had been part of his long-term medication for more than 2 years. The severity of his psychotic symptoms required a L-Dopa monotherapy. After changing his medication, the patient developed severe delirium that resolved rapidly after i.v. amantadine infusion, suggesting an amantadine withdrawal syndrome. Amantadine withdrawal syndrome is a rare adverse event that may present even in PD patients without cognitive impairment. This case report highlights the need for a gradual withdrawal of amantadine even if acute and severe psychotic symptoms are present. Moreover, this is the first report of a cognitively unimpaired patient developing an amantadine withdrawal syndrome.

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Neurosarcoidosis Presenting as Psychosis and Dementia: A Case Report

The International Journal of Psychiatry in Medicine ◽

10.2190/uyub-bhry-l06c-mpcp ◽

2002 ◽

Vol 32 (4) ◽

pp. 401-403 ◽

Cited By ~ 17

Author(s):

Susan Hatters Friedman ◽

Deborah J. Gould

Keyword(s):

Case Report ◽

Pulmonary Sarcoidosis ◽

Acute Onset ◽

Rare Disorder

Neurosarcoidosis is a rare disorder in which psychosis and dementia may occur. They usually appear subsequently to the diagnosis of pulmonary sarcoidosis. We report on a 39-year-old patient who presented with long-term decline and acute onset of psychosis and delirium, and who was found to have neurosarcoidosis.

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Case Report: Drug induced hyperkalemia presenting as acute flaccid quadriparesis

F1000Research ◽

10.12688/f1000research.15061.1 ◽

2018 ◽

Vol 7 ◽

pp. 737 ◽

Cited By ~ 1

Author(s):

Santhosh Narayanan ◽

Divya Prakash

Keyword(s):

Case Report ◽

Cardiac Disease ◽

Acute Onset ◽

Flaccid Paralysis ◽

Dramatic Improvement ◽

Drug Induced ◽

Emergency Condition ◽

Life Threatening

Hyperkalemia is a life-threatening dyselectrolytemia that commonly affects cardiac conductivity and contractility. Ascending paralysis affecting the extremities associated with hyperkalemia is not commonly seen. Here we report a case of flaccid quadriparesis in a patient who was taking potassium sparing diuretic for cardiac disease. An electrocardiogram showed typical signs of hyperkalemia. The patient was administered antihyperkalemic measures, which led to a dramatic improvement in symptoms. Hyperkalemic paralysis is a completely reversible emergency condition and should always be considered when dealing with acute onset flaccid paralysis.

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Health procrastination: The experience of 35-44 years old men

SHS Web of Conferences ◽

10.1051/shsconf/20184002007 ◽

2018 ◽

Vol 40 ◽

pp. 02007

Author(s):

V. Silkane ◽

I. Austers

Keyword(s):

Time Management ◽

Task Characteristics ◽

Negative Consequences ◽

Medical Practitioners ◽

Seeking Help ◽

Old Men ◽

Age Range ◽

Gains And Losses ◽

Depth Interviews

The focal concept of this study is health procrastination. Delay in seeking help from medical practitioners is an increasing problem in Latvia, particularly with men between the ages of 35-44. Failures in primary and secondary prevention create a number of negative consequences, for instance, longer and more complex treatment; lower recovery prognosis as well as higher treatment costs. Nevertheless, the aforementioned group often avoids medical treatment. The aim of this study was to understand the experience of 35-44 years old men in terms of their health procrastination in qualitative terms. Semi-structured in-depth interviews with 48 men within the age range of 35-44 years were conducted. Data was analysed using inductive thematic analysis. The following dominant themes are: delay of health behaviour, time management, motivation emerged during the analysis: conscientiousness, task avoidance, effort, short-term vs. long-term thinking, gains and losses assessment, and time discounting. Conclusions followed: there are three main concepts – personality traits, discounting and task characteristics – that bring together the experience of health procrastination for 35-44 years old males.

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