scholarly journals Misoprostol Induced Hyperpyrexia associated with Seizures in Postpartum Parturient: Rare Side Effect and its Management in Critical Care Settings

Author(s):  
Dheeraj Kapoor ◽  
Manju Sharma ◽  
Manpreet Singh ◽  
Shraddha Sinha ◽  
Binish Kathuria

Misoprostol is a synthetic prostaglandin E1 analogue and has been reccommended as a safe, effective, easy to administer, cost efficient next in line drug after oxytocin, for the treatment and prevention of postpartum haemorrhage (PPH). Notwithstanding, it causes certain undesirable side effects compared to oxytocin such as nausea, vomiting, shivering, diarrhoea and transient fever. Transient pyrexia is commonly related with misoprostol administration, due to shift of hypothalamic set point. However, hyperpyrexia clubbed with seizures is a rare yet self-limiting side effect and requires prompt management strategies. There have been case reports describing fever following misoprostol administration but only few describing hyperpyrexia and even fewer describing with seizures. We report a case of hyperpyrexia associated with delayed presentation of generalised sezuires after administration of rectal misoprotol and its successful management in critical care settings.

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Florence Jaguga

Abstract Background Stuttering is a rare side effect of clozapine. It has been shown to occur in the presence of one or more factors such as abnormal electrophysiological findings and seizures, extrapyramidal symptoms, brain pathology, and a family history of stuttering. Few case reports have documented the occurrence of clozapine-induced stuttering in the absence of these risk factors. Case presentation A 29-year-old African male on clozapine for treatment-resistant schizophrenia presented with stuttering at a dosage of 400 mg/day that resolved with dose reduction. Electroencephalogram findings were normal, and there was no clinical evidence of seizures. The patient had no prior history or family history of stuttering, had a normal neurological examination, and showed no signs of extrapyramidal symptoms. Conclusion Clinicians ought to be aware of stuttering as a side effect of clozapine, even in the absence of known risk factors. Further research should investigate the pathophysiology of clozapine-induced stuttering.


2019 ◽  
Vol 26 (4) ◽  
pp. 1032-1036
Author(s):  
So Yi Lam ◽  
Chung-Shien Lee ◽  
Sandhya Sharma ◽  
Kit Cheng

Introduction Anti-angiogenic treatment in adjunct with chemotherapy is widely used for the treatment of various cancers. These agents inhibit vascular endothelial growth factor (VEGF) signaling thereby inhibiting tumor proliferation and invasion. Dysphonia, or voice changes, has been documented, but is an underreported side effect of anti-angiogenic agents. We report a case of intermittent dysphonia in a patient with metastatic, platinum-refractory ovarian cancer treated with bevacizumab. Case report A 48-year-old female with high grade mixed type ovarian adenocarcinoma and concurrent left sided breast cancer was transitioned to palliative therapy with gemcitabine-bevacizumab for her ovarian cancer. At a follow-up visit after three cycles of the new therapy, the patient complained of intermittent changes in her voice, describing periods of hoarseness or softness in her voice after the chemotherapy—sometimes to the point that her voice was inaudible. Management and outcome: A new pelvic thrombus was discovered upon assessment of the patient’s disease. Bevacizumab was held and she was referred to ear, nose, and throat evaluation for dysphonia. Laryngoscopic examination showed normal vocal cord, with normal movements and no lesion or necrosis. During subsequent follow-up, the patient reported improvement in her voice with no additional dysphonia. Discussion Vocal adverse effects of anti-VEGF agents have been documented in landmark trials and case reports; however, clinicians are often unaware of this rare side effect. Although VEGF-induced dysphonia may be rare and may not impede the patient’s quality of life in some cases, it is critical to acknowledge and not underestimate this adverse effect.


1993 ◽  
Vol 60 (4) ◽  
pp. 354-356
Author(s):  
Y. Talmon ◽  
M. Guy ◽  
S. Eisenkraft ◽  
N. Guy

Three chronic paranoid schizophrenic patients were treated with clozapine, a new anti-psychotic agent. Retrograde ejaculation developed as a side-effect. Stopping the drug therapy or reducing the dosage caused the side-effect to disappear. Re-challenge caused the return of the side-effect. We discuss this rare side-effect to clozapine, and the pathophysiological mechanisms of ejaculation disturbances, with emphasis on those that are drug-induced.


2021 ◽  
pp. 878-883
Author(s):  
Neethi Dasu ◽  
Yaser Khalid ◽  
Kirti Dasu ◽  
Lucy Joo ◽  
Brian Blair

Kayexalate has been used in the USA since 1975 for the treatment of hyperkalemia. Prior case reports have shown that sorbitol added to kayexalate has been known to cause rare side effects of colonic necrosis. We present a unique case report of gastric pneumatosis as a complication of kayexalate.


2018 ◽  
Vol 25 (4) ◽  
pp. 980-986 ◽  
Author(s):  
David B Zhen ◽  
Rachel L McDevitt ◽  
Mark M Zalupski ◽  
Vaibhav Sahai

Irinotecan (Camptosar©, CPT-11), a topoisomerase I inhibitor, is a commonly used cytotoxic chemotherapeutic in the treatment of multiple malignancies, particularly of gastrointestinal origin. Dysarthria secondary to irinotecan has been described as a rare side effect in a few case reports with limited data to recommend appropriate management. We describe herein a large single institution experience of patients with gastrointestinal malignancies who experienced dysarthria while being treated with irinotecan-based chemotherapy regimens (FOLFIRINOX or FOLFIRI+/−bevacizumab). Eighteen patients developed neurological manifestations during irinotecan infusion with the majority ( n = 17) developing dysarthria. Patients also experienced other known side effects including cholinergic effects (abdominal bloating, diarrhea, facial flushing, diaphoresis, and rhinorrhea), nausea, fatigue, perioral paresthesia and musculoskeletal discomfort. The dysarthria occurred as early as with the first infusion of irinotecan ( n = 9), but several patients did not develop symptoms until subsequent infusions (range, 1–6). Dose alterations of irinotecan did not obviously impact the reccurrence or severity of dysarthria. Management strategies included close observation, atropine, slower irinotecan infusion rate, and reassurance. Dysarthria resolved without consequence in all patients within hours of completion of the infusion. Oncologists and pharmacists should be aware of irinotecan-associated dysarthria as a rare, self-limited phenomenon with no long-term sequelae, and appropriately counsel patients and infusion nurses to avoid inadvertently withholding potentially beneficial therapy for patients with gastrointestinal malignancies.


2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Yüksel Kıvrak ◽  
İbrahim Yağcı ◽  
Mehmet Fatih Üstündağ ◽  
Halil Özcan

Hair loss is a rare side effect of psychotropic drugs. The most related drug class with this side effect is the mood stabilizers. Studies reporting the sertraline-induced alopecia are limited in number. Sertraline is a potent antidepressant which inhibits the serotonin reuptake from the presynaptic terminals selectively. The reason for hair loss could not be elucidated completely. Psychotropic drugs are usually considered to lead to hair loss through influencing the telogen phase of hair follicle. This paper reports a 21-year-old male with diffuse hair loss induced by sertraline use and improved by quitting the drug. To the best of our knowledge, there are no other case reports on sertraline-induced alopecia within 2 weeks.


2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
A. Justine Landi ◽  
Robert Burkes

Drug-induced thrombocytopenia is a poorly understood, yet common phenomenon widely encountered in clinical practice. We present a case of suspected levofloxacin-induced thrombocytopenia, a rare side effect of a ubiquitous antibiotic, in a patient without similar effect to ciprofloxacin. This report builds upon other isolated case reports of fluoroquinolone-induced thrombocytopenia and demonstrates our algorithmic approach to the issue as well as a literature review pertaining to fluoroquinolone-induced thrombocytopenia.


2019 ◽  
Vol 4 (1) ◽  
pp. 64
Author(s):  
Nur Aisyah Zainordin ◽  
Fatimah Zaherah Mohamed Shah ◽  
Rohana Abdul Ghani

A 49-year old patient presented with symptoms of adrenal suppression following an attempt to withdraw Depo-Provera or Depot Medroxyprogesterone Acetate (DMPA) injection. She had been receiving DMPA injections for the past 16 years for contraception. She was initially prescribed DMPA by her gynaecologist but later on began obtaining the medication directly from a private pharmacy without prior consultation from her gynaecologist. Clinically, she had been experiencing significant weight gain and appeared cushingoid. Blood investigations confirmed partial adrenal suppression with presence of an adrenal incidentaloma. This case reports a known side effect of DMPA but occurring at a much lower dose than previously described. It also highlights the need to increase the awareness of the insidious side effect of DMPA and to avoid unsupervised use of the drug.


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