scholarly journals Nimesulide induced toxic epidermal necrolysis: a rare case report

2017 ◽  
Vol 6 (12) ◽  
pp. 2939
Author(s):  
Vineet Kumar ◽  
Manju Gari ◽  
Kishor Chakraborty ◽  
Ravi Ranjan ◽  
Anshuman Chandra ◽  
...  
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Adverse Drug Reactions ◽  
Drug Reactions ◽  
Over The Counter ◽  
Medical Practitioners ◽  
Rare Case Report ◽  
Prescribed Medicines ◽  
Anti Fungal ◽  
Possible Cause ◽  
Antipyretic Action

Adverse drug reactions to the prescribed medicines are the major obstacles in continuation of drug treatment. Nimesulide, a selective cyclo-oxygenase (COX-2) inhibitor was first launched in Italy in 1985 and subsequently marketed in more than 50 countries including India. Due to its better and faster antipyretic action, it has gained popularity among physicians and paediatricians. Here, we report a case of 60 years old male patient who developed toxic epidermal necrolysis (TEN) following ingestion of tablet nimesulide. The patient was managed with parenteral corticosteroids, antibiotics, emollients, anti-fungal and supportive care. This case highlights the importance of nimesulide and other NSAIDs as possible cause of TEN. Nimesulide has never been approved in countries like USA, Canada, Britain, New Zealand, Australia. But in India it is available as over the counter drug and is used for various indications like fever, myalgia, arthralgia. Therefore, the drugs which are banned outside India should be used with caution and medical practitioners should report all the adverse drug reactions to such drugs. 

scholarly journals Nimesulide induced Stevens Johnson Syndrome: a case report

2017 ◽  
Vol 6 (8) ◽  
pp. 2094
Author(s):  
Shagupta A. Naikwadi ◽  
Rupali B. Jadhav
Keyword(s):  
Case Report ◽  
Supportive Care ◽  
Adverse Drug Reactions ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Over The Counter ◽  
Johnson Syndrome ◽  
Inflammatory Drugs ◽  
Prescribed Medicines ◽  
Possible Cause

Adverse drug reactions to the prescribed medicines are the major obstacles in continuation of drug treatment. Stevens- Johnson Syndrome (SJS) is a severe, episodic, acute mucocutaneous reaction which is most commonly elicited by drugs and occasionally by infections. Common drugs associated with SJS are sulphonamide antibiotics, anticonvulsants, non- steroidal anti-inflammatory drugs (NSAIDS) and allopurinol. Nimesulide is an NSAID with analgesic and antipyretic properties. Here, we report a case of 21 years old male patient who developed Stevens Johnson Syndrome following ingestion of tablet Nimesulide. The patient was managed with parenteral corticosteroids, antibiotics, emollients, and supportive care. This case highlights the importance of Nimesulide and other NSAIDs as possible cause of SJS. Nimesulide has never been approved in countries like USA, Canada, Australia. But in India it is available as over the counter drug and is used for various indications like fever, myalgia, arthralgia. Therefore, the drugs which are banned outside India should be used with caution and practitioners should report all the adverse drug reactions to such drugs.

scholarly journals NEUROPSYCHIATRIC ADVERSE EFFECTS OF ANTIBACTERIAL AGENTS

2021 ◽  
pp. 1-8
Author(s):  
SANTA TREASA CYRIAC ◽  
DIVYA SARA IYPE
Keyword(s):  
Adverse Effects ◽  
Adverse Events ◽  
Adverse Drug Reactions ◽  
Bacterial Growth ◽  
Antibacterial Agents ◽  
Acute Psychosis ◽  
Drug Reactions ◽  
Medical Practitioners ◽  
General Management ◽  
Neuropsychiatric Adverse Effects

Anti-bacterial are agents that inhibit bacterial growth or kills bacteria and are a sub-type of antimicrobials. These are drugs used to treat infections, but they sometimes pose a threat of adverse events. Some of these adverse events are neuropsychiatric, which are generally hard to diagnose and is often paid less attention. They account for about 30% of total Adverse drug reactions (ADRs) caused by drugs in patients without mental abnormalities. The spectrum ranges from episodes of seizure to acute psychosis. The article emphasizes the frequency of such adverse events and means to raise awareness among medical practitioners regarding the same. The various neuropsychiatric adverse effects and the agents responsible have been reviewed, along with their possible mechanisms and general management. The information for writing this review was selected by searching for keywords such as Neurotoxicity, GABA, Psychosis, Naranjo scale, and Antibiomania in databases such as Google Scholar, PubMed, Elsevier, etc. After searching the articles in the above-mentioned databases, the articles were screened concerning their importance with our work and according to their title and abstract. Additional articles were discovered by checking the references in the current study's citations. Using this method, the various neuropsychiatric adverse effects of Antibacterial agents were summarized in this review.

scholarly journals A case of nimesulide induced toxic epidermal necrolysis

2020 ◽  
Vol 9 (5) ◽  
pp. 810
Author(s):  
Suja Xaviar ◽  
Mirunalini Ravichandran
Keyword(s):  
Mortality Rate ◽  
Toxic Epidermal Necrolysis ◽  
Skin Disease ◽  
The Body ◽  
Drug Induced ◽  
Over The Counter ◽  
Life Threatening ◽  
Cox 2 ◽  
Adequate Management ◽  
Possible Cause

Toxic epidermal necrolysis (TEN) is a rare life-threatening drug-induced mucocutaneous skin disease with a mortality rate of approximately 30%. Nimesulide is a preferential cyclo-oxygenase (COX-2) inhibitor which is frequently used for its antipyretic, anti-inflammatory and analgesic activity. Here, we report a case of nimesulide induced toxic epidermal necrolysis in a 57 years old male patient. This patient was admitted in the hospital with symptoms of epidermal sloughing and fluid filled blisters all over the body following over the counter intake of nimesulide for fever. The drug was promptly stopped, and patient was managed with steroids, antibiotics and other adequate supportive measures. The patient showed significant recovery following stoppage of drug and adequate management. This case highlights the importance of nimesulide and other NSAIDs as possible cause of TEN.

Cutaneous Adverse Drug Reactions

2018 ◽  
Author(s):  
Neil H. Shear ◽  
Sandra Knowles ◽  
Lori Shapiro
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Toxic Epidermal Necrolysis ◽  
Adverse Drug Reactions ◽  
Skin Necrosis ◽  
Drug Eruption ◽  
Hypersensitivity Syndrome ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Cutaneous Eruption

An adverse drug reaction is defined as any noxious, unintended, and undesired effect of a drug that occurs at doses used in humans for prophylaxis, diagnosis, or therapy. A cutaneous eruption is one of the most common manifestations of an adverse drug reaction. This chapter reviews the epidemiology, etiology, diagnosis, clinical manifestations, and differential diagnosis of adverse drug reactions, as well as laboratory tests for them. Also discussed are the types of cutaneous eruption: exanthematous eruption, urticarial eruption, blistering eruption, pustular eruption, and others. The simple and complex forms of each type of eruption are reviewed. The chapter includes 4 tables and 12 figures. Tables present the warning signs of a serious drug eruption, clinical features of hypersensitivity syndrome reaction and serum sickness-like reaction, characteristics of Stevens-Johnson Syndrome and toxic epidermal necrolysis, and clinical pearls to identify anticoagulant-induced skin necrosis. Figures illustrate hypersensitivity syndrome reaction, a fixed drug eruption from tetracycline, pseudoporphyria from naproxen, linear immunoglobulin A disease induced by vancomycin, pemphigus foliaceus from taking enalapril, pemphigus vulgaris from taking penicillamine, toxic epidermal necrolysis after starting phenytoin therapy, acneiform drug eruption due to gefitinib, acute generalized exanthematous pustulosis from cloxacillin, coumarin-induced skin necrosis, a lichenoid drug eruption associated with ramipril, and leukocytoclastic vasculitis from hydrochlorothiazide. This chapter contains 106 references.

Patch testing in severe cutaneous adverse drug reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis

1996 ◽  
Vol 35 (4) ◽  
pp. 234-236 ◽  
Author(s):  
Pierre Wolkenstein ◽  
Oliver Chosidow ◽  
Marie-Laure Fléchet ◽  
Odile Robbiola ◽  
Muriel Paul ◽  
...  
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Adverse Drug Reactions ◽  
Patch Testing ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Johnson Syndrome

scholarly journals Self-Medication With Over-the-counter Medicines Among the Working Age Population in Metropolitan Areas of Thailand

2021 ◽  
Vol 12 ◽  
Author(s):  
Sineenart Chautrakarn ◽  
Waraporn Khumros ◽  
Phanupong Phutrakool
Keyword(s):  
Adverse Drug Reactions ◽  
Metropolitan Areas ◽  
Easy Access ◽  
Drug Reactions ◽  
Self Medication ◽  
Over The Counter ◽  
Medication Knowledge ◽  
Antibiotic Drug ◽  
Working Age ◽  
Working Age Population

Background and Objectives: Self-medication with over-the-counter (OTC) medicines is becoming an increasingly popular practice around the world. The global prevalence rate of self-medication ranges from 11.2% to 93.7%, depending on the target population and country. However, there is a lack of data on the prevalence and practices of self-medication among the working-age population, particularly in Thailand metropolitan areas. The current study describes the prevalence of self-medication practices, adverse drug reactions and severity, reasons for self-medication, and basic medication knowledge among people of working age in metropolitan areas in Thailand.Methods: We conducted an online cross-sectional study between December 2020 and January 2021. Descriptive statistics were used to analyze self-medication data. A chi-square test was used to assess the association between self-medication and sociodemographic characteristics.Results: This study found high prevalence of self-medication among the working-age population in metropolitan areas of Thailand (88.2%). The most commonly used drug groups were NSAIDs (34.8%) and antibiotics (30.2%). Minor illness and easy access to pharmacies were the most common reasons for self-medication. Almost half of the participants' illnesses (42.6%) for which they self-medicated were not always completely cured, necessitating treatment at a hospital or clinic. Although only a small number of participants (ranged from 0.6 to 6.6%) experienced adverse drug reactions as a result of self-medication, some had severe symptoms that disrupted their daily lives or required hospitalization. In terms of basic medication knowledge, we discovered that study participants misunderstood some antibiotic drug concepts.Conclusions: According to the study findings, it is recommended that more information about the risks of self-medication, drug adverse reactions, antibiotic stewardship, more supervision of the prohibition of over-the-counter drugs and selling practices, and adequate facilities for peoples access to medical services be provided at the policy level.

Cutaneous Adverse Drug Reactions

2012 ◽  
Author(s):  
Neil H. Shear ◽  
Sandra Knowles ◽  
Lori Shapiro
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Toxic Epidermal Necrolysis ◽  
Adverse Drug Reactions ◽  
Skin Necrosis ◽  
Drug Eruption ◽  
Hypersensitivity Syndrome ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Cutaneous Eruption

An adverse drug reaction is defined as any noxious, unintended, and undesired effect of a drug that occurs at doses used in humans for prophylaxis, diagnosis, or therapy. A cutaneous eruption is one of the most common manifestations of an adverse drug reaction. This chapter reviews the epidemiology, etiology, diagnosis, clinical manifestations, and differential diagnosis of adverse drug reactions, as well as laboratory tests for them. Also discussed are the types of cutaneous eruption: exanthematous eruption, urticarial eruption, blistering eruption, pustular eruption, and others. The simple and complex forms of each type of eruption are reviewed. The chapter includes 4 tables and 12 figures. Tables present the warning signs of a serious drug eruption, clinical features of hypersensitivity syndrome reaction and serum sickness-like reaction, characteristics of Stevens-Johnson Syndrome and toxic epidermal necrolysis, and clinical pearls to identify anticoagulant-induced skin necrosis. Figures illustrate hypersensitivity syndrome reaction, a fixed drug eruption from tetracycline, pseudoporphyria from naproxen, linear immunoglobulin A disease induced by vancomycin, pemphigus foliaceus from taking enalapril, pemphigus vulgaris from taking penicillamine, toxic epidermal necrolysis after starting phenytoin therapy, acneiform drug eruption due to gefitinib, acute generalized exanthematous pustulosis from cloxacillin, coumarin-induced skin necrosis, a lichenoid drug eruption associated with ramipril, and leukocytoclastic vasculitis from hydrochlorothiazide. This chapter contains 106 references.

Neutrophils initiate and exacerbate Stevens-Johnson syndrome and toxic epidermal necrolysis

2021 ◽  
Vol 13 (600) ◽  
pp. eaax2398
Author(s):  
Manao Kinoshita ◽  
Youichi Ogawa ◽  
Natsumi Hama ◽  
Inkin Ujiie ◽  
Akito Hasegawa ◽  
...  
Keyword(s):  
T Cells ◽  
Immune Responses ◽  
Toxic Epidermal Necrolysis ◽  
Adverse Drug Reactions ◽  
Cytotoxic T Cells ◽  
Formyl Peptide Receptor ◽  
Stevens Johnson Syndrome ◽  
Lipocalin 2 ◽  
Drug Reactions ◽  
Johnson Syndrome

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening mucocutaneous adverse drug reactions characterized by massive epidermal detachment. Cytotoxic T cells and associated effector molecules are known to drive SJS/TEN pathophysiology, but the contribution of innate immune responses is not well understood. We describe a mechanism by which neutrophils triggered inflammation during early phases of SJS/TEN. Skin-infiltrating CD8+ T cells produced lipocalin-2 in a drug-specific manner, which triggered the formation of neutrophil extracellular traps (NETs) in early lesional skin. Neutrophils undergoing NETosis released LL-37, an antimicrobial peptide, which induced formyl peptide receptor 1 (FPR1) expression by keratinocytes. FPR1 expression caused keratinocytes to be vulnerable to necroptosis that caused further release of LL-37 by necroptotic keratinocytes and induced FPR1 expression on surrounding keratinocytes, which likely amplified the necroptotic response. The NETs-necroptosis axis was not observed in less severe cutaneous adverse drug reactions, autoimmune diseases, or neutrophil-associated disorders, suggesting that this was a process specific to SJS/TEN. Initiation and progression of SJS/TEN keratinocyte necroptosis appear to involve a cascade of events mediated by innate and adaptive immune responses, and understanding these responses may contribute to the identification of diagnostic markers or therapeutic targets for these adverse drug reactions.

Sign in / Sign up

Export Citation Format

Share Document