Supportive Care of Patients Undergoing Immunotherapy

2016 ◽  
Vol 12 (01) ◽  
pp. 25 ◽  
Author(s):  
Ronwyn van Eeden ◽  
Bernardo L Rapoport ◽  
◽  
Keyword(s):  
Side Effects ◽  
Adverse Events ◽  
Supportive Care ◽  
Clinical Oncology ◽  
Broad Spectrum ◽  
Paradigm Shift ◽  
Early Recognition ◽  
Morbidity And Mortality ◽  
Targeted Drugs ◽  
Aggressive Management

Immunotherapy was announced by the America Society of Clinical Oncology (ASCO) as the top cancer advance of 2015. There has been a paradigm shift towards immuno-oncology therapy, and its side effects are often referred to as immune-related adverse events (irAEs). These side effects are, in some cases, unique and very different than those associated with chemotherapy or targeted drugs. Clinicians should be aware that there is a broad spectrum of additional toxicities that can be both unpredictable and severe. Early recognition and aggressive management of irAEs are essential to decrease morbidity and mortality.

Definition and Incidence of Adverse Events

2018 ◽  
pp. 136-140
Author(s):  
David Fagin
Keyword(s):  
Side Effects ◽  
Adverse Events ◽  
Supportive Care ◽  
American Academy ◽  
Procedural Sedation ◽  
Patient Harm ◽  
Timely Manner ◽  
Psychological Conditions ◽  
American Academy Of Pediatrics ◽  
National Organizations

To perform effective and safe procedural sedation, one must be knowledgeable about the adverse events that can occur with the administration of various sedatives and analgesics. Adverse events (sometimes thought of as complications of care) are often predictable if the sedationist properly assesses the patient’s physiologic and psychological conditions and understands the side effects of the medications administered and the procedural conditions that may exacerbate risk. With such preparation, the sedationist can monitor for the event and can either prevent it or provide supportive care in a timely manner. The American Academy of Pediatrics and other national organizations have developed guidelines for caring for patients requiring procedural sedation with the intent of informing sedationists of the risks involved in sedation care and the skills and equipment needed to ameliorate or prevent patient harm. Adverse events can be classified as minor, moderate, and major.

Piperacillin/Tazobactam Therapy for Diabetic Foot Infection

1998 ◽  
Vol 19 (3) ◽  
pp. 169-172 ◽  
Author(s):  
Anneke M. Zeillemaker ◽  
Karin-Ellen Veldkamp ◽  
Marian G.J. van Kraaij ◽  
Joost B.L. Hoekstra ◽  
Arthur A.G.M. Hoynck van Papendrecht ◽  
...  
Keyword(s):  
Side Effects ◽  
Adverse Events ◽  
Clinical Response ◽  
Broad Spectrum ◽  
Diabetic Foot ◽  
Diabetic Foot Infection ◽  
Broad Spectrum Antibiotics ◽  
Efficacy Of Treatment

In this study, 29 patients were hospitalized with a diabetic foot infection and were treated with piperacillin/tazobactam. Of these 23 patients who were evaluated for efficacy of treatment, 22 patients improved or were clinically cured. In seven patients (30%), there was persistence of one of the baseline pathogens. Adverse events were reported in 15 patients (58%), three of which were serious. Piperacillin/tazobactam may be useful as monotherapy in diabetic foot infection giving an adequate clinical response and the level of side effects equivalent to those of other broad-spectrum antibiotics.

scholarly journals A Systematic Review on COVID-19 Vaccine Strategies, Their Effectiveness, and Issues

Vaccines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1387
Author(s):  
Shahad Saif Khandker ◽  
Brian Godman ◽  
Md. Irfan Jawad ◽  
Bushra Ayat Meghla ◽  
Taslima Akter Tisha ◽  
...  
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Adverse Events ◽  
Drug Administration ◽  
Food And Drug Administration ◽  
Morbidity And Mortality ◽  
European Medicines Agency ◽  
Vaccine Candidates ◽  
Online Databases ◽  
The Us

COVID-19 vaccines are indispensable, with the number of cases and mortality still rising, and currently no medicines are routinely available for reducing morbidity and mortality, apart from dexamethasone, although others are being trialed and launched. To date, only a limited number of vaccines have been given emergency use authorization by the US Food and Drug Administration and the European Medicines Agency. There is a need to systematically review the existing vaccine candidates and investigate their safety, efficacy, immunogenicity, unwanted events, and limitations. The review was undertaken by searching online databases, i.e., Google Scholar, PubMed, and ScienceDirect, with finally 59 studies selected. Our findings showed several types of vaccine candidates with different strategies against SARS-CoV-2, including inactivated, mRNA-based, recombinant, and nanoparticle-based vaccines, are being developed and launched. We have compared these vaccines in terms of their efficacy, side effects, and seroconversion based on data reported in the literature. We found mRNA vaccines appeared to have better efficacy, and inactivated ones had fewer side effects and similar seroconversion in all types of vaccines. Overall, global variant surveillance and systematic tweaking of vaccines, coupled with the evaluation and administering vaccines with the same or different technology in successive doses along with homologous and heterologous prime-booster strategy, have become essential to impede the pandemic. Their effectiveness appreciably outweighs any concerns with any adverse events.

Proton Pump Inhibitors in 2021: Pros, Cons, and Everything in Between

2021 ◽  
pp. 263451612110217
Author(s):  
Joshua A. Sloan ◽  
Philip O. Katz
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Adverse Events ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Drug Class ◽  
Life Threatening

The medical and lay literature has exploded with reports of adverse events associated with proton pump inhibitors over the last 10 to 15 years. The dissemination of these reports to patients and clinicians have created substantial concerns regarding what has been an exceptionally valuable drug class, dramatically improving patient quality of life, and in many cases preventing life threatening side effects of other medication. Patients are more frequently seeking to avoid these medications, and practitioners are reducing or discontinuing them to the patient’s detriment due to a misunderstanding of the data. This review will discuss the data regarding the most commonly publicized adverse events and attempt to put them in perspective.

scholarly journals Efficacy and Safety of Modified Huang-Lian-Jie-Du Decoction Cream on Cancer Patients with Skin Side Effects Caused by EGFR Inhibition

Processes ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 1081
Author(s):  
Ming-Yang Lee ◽  
Mei-Yi Lin ◽  
Yu-Ju Chang ◽  
Yu-Ting Tseng ◽  
I-An Huang ◽  
...  
Keyword(s):  
Side Effects ◽  
Adverse Events ◽  
Kinase Inhibitors ◽  
Target Therapy ◽  
Herbal Medicines ◽  
Skin Toxicity ◽  
Dry Skin ◽  
Egfr Inhibition ◽  
The Mean ◽  
Skin Conditions

(1) Background: The epidermal growth factor inhibitors (EGFRIs)/tyrosine kinase inhibitors (TKIs) are effective for cancer target therapy, but acneiform rashes or so-called inflammatory papulopustular exanthemas are common (50% to 90%). The conventional therapy for EGFRIs/TKIs-induced skin toxicity is steroids and antibacterial drugs, but it is still ineffective for some patients, and EGFRIs/TKIs dose reduction/interruption may be needed. In this study, a modified Chinese herbal medicine, Huang-Lian-Jie-Du decoction cream with Yin-Cold (YC) medicine characteristic, was investigated for the effect on patients suffering EGFRIs/TKIs-induced skin toxicity. (2) Methods: The modified Huang-Lian-Jie-Du (mHLJD) decoction cream was made from 10 herbal medicines, including 4 major medicines (Huanglian, Huangqin, Huangbo, and Zhizi) in traditional HLJD decoction. Patients with EGFRIs/TKIs-induced skin toxicity were enrolled. Patients were excluded if they also used other cream for skin toxicity. Skin conditions were monitored by follow up every 2 weeks. The patients’ characteristics, the skin toxicities, treatment response, and adverse events were recorded and analyzed until skin problems resolved or the study ended. (3) Results: The mHLJD decoction cream and its sub-packages were stored at 4 °C before use. Thirty-four patients who had grade 1–3 skin toxicities after receiving EGFRIs/TKIs were enrolled. Seven patients withdrew or were excluded. Finally, data from 27 patients were analyzed. The mean grade of rash acneiform was significantly decreased from 2.19 (ranged 1 to 3) to 0.88 (ranged 0 to 2) after mHLJD decoction cream treatment for 4 weeks and to 0.55 (ranged 0 to 2) after mHLJD decoction cream treatment for 8 weeks. Additionally, the mean grade of dry skin was also significantly decreased from 1.57 (ranged 1 to 2) to 0.71 (ranged 0 to 1) after mHLJD decoction cream treatment for 4 weeks. The changes of skin toxicity were significant, with no obvious adverse events. (4) Conclusions: In summary, the mHLJD decoction cream provides benefits for alleviation of EGFRIs/TKIs-induced skin rash acneiform and dry skin. Additionally, no obvious side effects were found in patients using mHLJD decoction cream.

Tocilizumab in Giant Cell Arteritis: A Multicenter Retrospective Study of 34 Patients

2016 ◽  
Vol 43 (8) ◽  
pp. 1547-1552 ◽  
Author(s):  
Alexis Régent ◽  
Serge Redeker ◽  
Alban Deroux ◽  
Pierre Kieffer ◽  
Kim Heang Ly ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Side Effects ◽  
Adverse Events ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Multicenter Study ◽  
Efficacy And Safety ◽  
Severe Adverse Events ◽  
Retrospective Multicenter Study

Objective.To report the efficacy and safety of tocilizumab (TCZ) for giant cell arteritis (GCA).Methods.A retrospective multicenter study that included 34 patients receiving TCZ for GCA.Results.TCZ was effective in all but 6 patients, who still had mild symptoms. Mean glucocorticoid dose was tapered. One patient died and 3 patients had to stop TCZ therapy because of severe adverse events. Twenty-three patients stopped treatment; 8 of these experienced relapses after a mean of 3.5 ± 1.3 months.Conclusion.TCZ is effective in GCA. However, side effects occur. Whether this treatment has only a suspensive effect remains to be determined.

Trying to Improve Care: The Morbidity and Mortality Conference in a Division of Rheumatology

2014 ◽  
Vol 41 (12) ◽  
pp. 2452-2458 ◽  
Author(s):  
Michelle Batthish ◽  
Shirley M.L. Tse ◽  
Brian M. Feldman ◽  
G. Ross Baker ◽  
Ronald M. Laxer
Keyword(s):  
Adverse Events ◽  
Test Procedure ◽  
Morbidity And Mortality ◽  
Error Reporting ◽  
Descriptive Data ◽  
Medication Error Reporting ◽  
Morbidity And Mortality Conference ◽  
System Improvement ◽  
Sick Children ◽  
Mortality Conference

Objective.To describe the frequency and types of reported adverse events and system improvement recommendations in the Morbidity and Mortality Conference (M&MC) within the Division of Rheumatology at The Hospital for Sick Children, Toronto, Ontario, Canada (SickKids).Methods.A 5-year retrospective review of the M&MC within the Division of Rheumatology at SickKids was completed. Descriptive data including the number and types of events reported were collected. Events were categorized using an adaptation of the National Coordinating Council for Medication Error Reporting and Prevention Index. Recommendations were classified according to the Institute for Safe Medication Practices Canada.Results.Between January 2007 and December 2011, 30 regularly scheduled M&MC were held. Eighty-three cases were reviewed. The most common types of reported events were related to “miscommunication” (34.9%), “treatment/test/procedure” (22.9%), “adverse drug reactions” (12.0%), and “medication errors” (8.4%). Category A events (“an event that has the capacity to cause error”) were the most common with 39.8% of the cases, followed by Category C events (“an event occurred that reached the patient, but did not cause harm”) with 28.9%. Eighty-nine recommendations were made. Over half of these were classified as “information” (58.4%), followed by 11 “rules and policies” recommendations (12.4%). Of the 36 action items generated from these recommendations, most are either complete or ongoing.Conclusion.The M&MC within the Division of Rheumatology reviews a variety of events. Increased reporting of adverse events can lead to system improvements, and has the potential to improve and promote safer healthcare.

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