scholarly journals Drug toxicoderma: possible causes, clinical manifestations and approaches to management at the outpatient’s stage

2021 ◽  
Vol 98 (11-12) ◽  
pp. 745-751
Author(s):  
V. N. Larina ◽  
T. A. Gaydina ◽  
A. S. Dvornikov ◽  
K. E. Nazimkin
Keyword(s):  
General Practitioners ◽  
Clinical Manifestations ◽  
New Drugs ◽  
Drug Reactions ◽  
Self Medication ◽  
Treatment And Prevention ◽  
Primary Health ◽  
Cutaneous Drug Reactions ◽  
Repeated Contact ◽  
Systemic Drug

Adverse cutaneous drug reactions are skin manifestations resulting from systemic drug administration. Toxicoderma under medication treatment is the most common adverse cutaneous reaction with difficulty to diagnose, especially at early stages. The development and active introduction of new drugs into practice, uncontrolled self-medication of patients, polypharmacy, and repeated contact with one and the same preparation, contribute to the growth of toxicoderma. Doctors should treat patients with toxicoderma carefully, as it can be developed at any time and have different clinical manifestations. The pathogenesis of toxicoderma is not fully understood, which limits the possibility of the diagnosis, treatment and prevention. The benefit/risk ratio evaluation of prescribing medications is the basis of pharmacological safety and doctors, especially of primary health care (general practitioners), should always put it into practice.

scholarly journals A Review of Adverse Cutaneous Drug Reactions Resulting from the Use of Interferon and Ribavirin

2009 ◽  
Vol 23 (10) ◽  
pp. 677-683 ◽  
Author(s):  
Nisha Mistry ◽  
Jonathan Shapero ◽  
Richard I Crawford
Keyword(s):  
Side Effects ◽  
Drug Reactions ◽  
Drug Induced ◽  
Common Cause ◽  
Injection Site Reactions ◽  
Drug Eruptions ◽  
Fixed Drug ◽  
Life Threatening ◽  
Cutaneous Drug Reactions ◽  
Systemic Drug

Drug-induced cutaneous eruptions are named among the most common side effects of many medications. Thus, cutaneous drug eruptions are a common cause of morbidity and mortality, especially in hospital settings. The present article reviews different presentations of drug-induced cutaneous eruptions, with a focus on eruptions reported secondary to the use of interferon and ribavirin. Presentations include injection site reactions, psoriasis, eczematous drug reactions, alopecia, sarcoidosis, lupus, fixed drug eruptions, pigmentary changes and lichenoid eruptions. Also reviewed are findings regarding life-threatening systemic drug reactions.

scholarly journals A clinical study of cutaneous adverse drug reactions

2017 ◽  
Vol 6 (4) ◽  
pp. 919
Author(s):  
Riddhi Shah ◽  
Sakshi Agrawal ◽  
Neela Bhuptani
Keyword(s):  
Adverse Drug Reactions ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Drug Reactions ◽  
Diagnostic Challenge ◽  
Female Ratio ◽  
Medical College ◽  
Causative Agents ◽  
Cutaneous Drug Reactions ◽  
Morbilliform Rash

Background: Adverse cutaneous drug reactions pose a diagnostic challenge due to a myriad of clinical manifestations and wide variety of causative agents. Present study aims to record various clinical patterns of adverse drug reactions, their causative agents and to study the pattern of morbidity and mortality in patients with severe cutaneous adverse drug reactions.Methods: 150 patients with adverse cutaneous drug reactions were included who came to Department of Dermatology, Venereology and Leprosy at PDU Govt. Medical College and Hospital, Rajkot, Gujarat from September 2009 to September 2011. Thorough history with all routine haematological and biochemical investigations, septic screening were done. HIV testing was done in severe reactions. Appropriate specific treatment was given with counselling regarding the offending drug.Results: The most common age group was 21-30 years (26.67%) with male to female ratio being 0.92:1. Morbilliform rash was the most common clinical type (42.67%) in both HIV reactive and non-reactive patients. Antimicrobials were the most common group (29.33%) and nevirapine was the most common offending drug (27.33%). Mortality rate was 2% (3 out of 150 cases) and all the patients were of toxic epidermal necrolysis.Conclusions: The pattern of cutaneous adverse drug reactions and the causative drugs are remarkably different in our study. Knowledge of the pattern and the causative agent helps in better management and reduced consequences in these patients particularly in severe adverse cutaneous drug reactions.

scholarly journals Prevalence and pattern of adverse cutaneous drug reactions presenting to a tertiary care hospital

2017 ◽  
Vol 3 (1) ◽  
pp. 74
Author(s):  
B. Janardhan ◽  
D. Shailendra
Keyword(s):  
Drug Reaction ◽  
Adverse Drug Reactions ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Care Hospital ◽  
Drug Reactions ◽  
Medical Sciences ◽  
Female Ratio ◽  
The Mean ◽  
Cutaneous Drug Reactions

<p class="abstract"><strong>Background:</strong> An adverse cutaneous drug reaction (ACDR) is defined as an undesirable clinical manifestation resulting from administration of a particular drug. With an ever increasing number of drugs and varied formulations being continuously made available it is important that a close watch on the risks of adverse drug reactions is looked for, to ensure safe use of medicines in the interest of the patient. In the present study our aim is to study the prevalence &amp; pattern of cutaneous adverse drug reactions reported to department of dermatology at MediCiti Institute of Medical Sciences, Hyderabad, India<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> All suspected cutaneous adverse drug reactions reported to the department of dermatology at MediCiti Institute of Medical Sciences during the two year period from January 2013 to December 2014 were included in this study. A thorough clinical examination of all these cases &amp; details related to the drug use and clinical manifestations of the cutaneous adverse drug reaction were documented using a structured proforma. Naranjo scale was used to assess causality in all the causes of cutaneous adverse drug reactions.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of the patients was 42 years (age range: 1-64 years). Most of them were in the age group of 30-39 years. The male to female ratio was 1.78:1. The most common type of skin eruptions observed were maculopapular rash (35.55%), urticaria (26.19%) and fixed drug eruption (17.87%). The mean duration between drug intake and appearance of rash was 4 days (range: 1-120 days)<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> The pattern of ACDRs and the drugs causing them in this study were similar to that reported in other studies both in terms of disease burden and clinical pattern. Knowledge of adverse cutaneous drug reactions will help to identify common medications contributing to dermatological reactions, so as to anticipate, prevent and limit their undue consequences<span lang="EN-IN">.</span></p>

scholarly journals CUTANEOUS ADVERSE DRUG REACTIONS IN GENERAL PRACTICE - AN ANALYSIS

2016 ◽  
Author(s):  
*G. Rajaram ◽  
P. Sugirda ◽  
R. Lenin
Keyword(s):  
Urban Area ◽  
General Practitioners ◽  
Adverse Drug Reactions ◽  
Maculopapular Rash ◽  
New Drugs ◽  
Drug Reactions ◽  
Fixed Drug Eruption ◽  
Fixed Drug ◽  
The Common ◽  
Reported Data

Aim: To study the pattern of cutaneous adverse drug reactions presenting to general practitioners in a semi urban area.  Methodology and Results: This study was conducted among general practitioners of Villupuram, a semi urban area in Tamilnadu State. During the study, a total of 60 CADRs were reported. Data were collected using standard CDSCO ADR form. The majority of CADRs were observed in the age group of 20-40 years. According to WHO causality assessment, 48 were probable and 12 were possible. The severity assessment using modified hartwig and seigel revealed 18 mild, 41 moderate and one severe CADRs. The common drug groups implicated are antibiotics followed by NSAIDS and anticonvulsants. Maculopapular rash was the most common presentation of CADRs.Conclusion: Among the various types of CADRs seen in this study, Maculopapular rash was the most common followed by fixed drug eruption. studies antimicrobials were the most common causative agent followed by NSAIDs and anti- convulsants. This study on CADRs gains importance as the pattern of drug use is changing periodically and everyday many new drugs enter the market.

scholarly journals An observational study of cutaneous adverse drug reactions in tertiary hospital

2018 ◽  
Vol 4 (2) ◽  
pp. 254
Author(s):  
Tejashwani . ◽  
Dipti Patel ◽  
Neela Bhuptani
Keyword(s):  
Adverse Drug Reactions ◽  
Clinical Manifestations ◽  
Medical Practitioner ◽  
Maculopapular Rash ◽  
Skin Lesions ◽  
Tertiary Hospital ◽  
Drug Reactions ◽  
Diagnostic Challenge ◽  
Female Ratio ◽  
Cutaneous Drug Reactions

<p class="abstract"><strong>Background:</strong> Adverse cutaneous drug reactions include reactions due to overdose, side effects and idiosyncratic reactions. They pose a diagnostic challenge due to wide variety of causative agents and varied clinical manifestations. Our study aims to record various clinical patterns of adverse drug reactions, their offending drugs and to study the pattern of morbidity and mortality in patients with severe cutaneous adverse drug reactions especially in the HIV era.</p><p class="abstract"><strong>Methods:</strong> 90 patients with adverse cutaneous drug reactions were included who came to Dept. of Dermatology, Venereology and Leprosy at P.D.U. Govt. Medical College and Hospital, Rajkot, Gujarat from October 2011 to November 2017. Thorough history with all routine haematological and biochemical investigations and septic screening was done. The morphology of skin lesions was noted. The offending drug was withdrawn in the patients and appropriate treatment was given.<strong></strong></p><p class="abstract"><strong>Results:</strong> The most common age group observed was 31-40 years (24.44%) with male to female ratio being 1.2:1. Maculopapular rash was the most common clinical type (16.66%). NSAIDS were the most common offending drugs (16.66%). Among the individual drugs, carbamazepine was the most common offending drug(14.44%). Drug was prescribed by a medical practitioner in 86 cases (95.55%), while self administered in 4 cases (4.44%). History of some cutaneous drug reaction in the past was present in 17 patients (18.88%). Lesions were generalised in 76 cases (84.44%) and localised in 14 cases (15.55%).</p><p class="abstract"><strong>Conclusions:</strong> Knowledge of the pattern and the offending drug helps in better management and reduced complications in these patients and also helps in preventing recurrences.</p>

Dilemmas at a Primary Health Care Center: a baseline study for Computer-Supported Cooperative Health Care Work

1992 ◽  
Vol 31 (03) ◽  
pp. 204-209 ◽  
Author(s):  
T. Timpka ◽  
J. M. Nyce
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
General Practitioners ◽  
Group Process ◽  
Critical Incident ◽  
Care Work ◽  
Work Activity ◽  
Health Care Center ◽  
Health Care Work ◽  
Primary Health

Abstract:For the development of computer-supported cooperative health care work this study investigated, based upon activity theory, daily dilemmas encountered by the members of interprofessional primary health care work groups. The entire staff at four Swedish primary health care centers were surveyed, 199 personal interviews being conducted by the Critical Incident Technique. Medical dilemmas were mainly reported by general practitioners and nurses, organizational dilemmas by laboratory staff, nurses’ aides, and secretaries, and dilemmas in the patient-provider relation by nurses, nurses’ aides, and secretaries. Organizational and communication dilemmas reported by nurses, nurses’ aides, and secretaries often had their cause outside the control of the individual professional. These dilemmas were often “caused” by other group members (general practitioners or nurses), e.g., by not keeping appointment times or by not sharing information with patients. The implication for computer-supported cooperative health care work is that computer support should be planned on two levels. Collective work activity as a whole should benefit from individual clinical decision support for general practitioners and nurses. However, since most patient communication and organizational problems occurred at group level, group process support is required in these areas.

Genetic Editing and Pharmacogenetics in Current And Future Therapy Of Neurocognitive Disorders

2020 ◽  
Vol 17 (3) ◽  
pp. 238-258 ◽  
Author(s):  
Michal Prendecki ◽  
Marta Kowalska ◽  
Ewa Toton ◽  
Wojciech Kozubski
Keyword(s):  
Lewy Bodies ◽  
Hepatic Metabolism ◽  
New Drugs ◽  
Glutamate Excitotoxicity ◽  
Factors Affecting ◽  
Treatment And Prevention ◽  
Expression Of Genes ◽  
Dementia Risk ◽  
Antidementia Drugs ◽  
Butyrylcholinesterase Activity

: Dementia is an important issue in western societies, and in the following years, this problem will also rise in the developing regions, such as Africa and Asia. The most common types of dementia in adults are Alzheimer’s Disease (AD), Dementia with Lewy Bodies (DLB), Frontotemporal Dementia (FTD) and Vascular Dementia (VaD), of which, AD accounts for more than half of the cases. : The most prominent symptom of AD is cognitive impairment, currently treated with four drugs: Donepezil, rivastigmine, and galantamine, enhancing cholinergic transmission; as well as memantine, protecting neurons against glutamate excitotoxicity. Despite ongoing efforts, no new drugs in the treatment of AD have been registered for the last ten years, thus multiple studies have been conducted on genetic factors affecting the efficacy of antidementia pharmacotherapy. The researchers investigate the effects of variants in multiple genes, such as ABCB1, ACE, CHAT, CHRNA7, CYP2C9, CYP2C19, CYP2D6, CYP3A4, CYP3A5, CYP3A7, NR1I2, NR1I3, POR, PPAR, RXR, SLC22A1/2/5, SLC47A1, UGT1A6, UGT1A9 and UGT2B7, associated with numerous pathways: the development of pathological proteins, formation and metabolism of acetylcholine, transport, metabolism and excretion of antidementia drugs and transcription factors regulating the expression of genes responsible for metabolism and transport of drugs. The most promising results have been demonstrated for APOE E4, dementia risk variant, BCHE-K, reduced butyrylcholinesterase activity variant, and CYP2D6 UM, ultrarapid hepatic metabolism. Further studies investigate the possibilities of the development of emerging drugs or genetic editing by CRISPR/Cas9 for causative treatment. : In conclusion, the pharmacogenetic studies on dementia diseases may improve the efficacy of pharmacotherapy in some patients with beneficial genetic variants, at the same time, identifying the carriers of unfavorable alleles, the potential group of novel approaches to the treatment and prevention of dementia.

Cutaneous drug reactions to piroxicam

1998 ◽  
Vol 39 (3) ◽  
pp. 145-145 ◽  
Author(s):  
Christina Vasconcelos ◽  
Sofia Magina ◽  
Paula Quirino ◽  
Maria Antónia Barros ◽  
José Mesquita-Guimaraes
Keyword(s):  
Drug Reactions ◽  
Cutaneous Drug Reactions

scholarly journals The Main Challenges in Systemic Lupus Erythematosus: Where Do We Stand?

2021 ◽  
Vol 10 (2) ◽  
pp. 243
Author(s):  
Matteo Piga ◽  
Laurent Arnaud
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Systemic Disease ◽  
Unmet Need ◽  
Clinical Manifestations ◽  
New Drugs ◽  
Systemic Lupus ◽  
Major Step ◽  
Damage Accrual

Systemic lupus erythematosus (SLE) is an immune-mediated multi-systemic disease characterized by a wide variability of clinical manifestations and a course frequently subject to unpredictable flares. Despite significant advances in the understanding of the pathophysiology and optimization of medical care, patients with SLE still have significant mortality and carry a risk of progressive organ damage accrual and reduced health-related quality of life. New tools allow earlier classification of SLE, whereas tailored early intervention and treatment strategies targeted to clinical remission or low disease activity could offer the opportunity to reduce damage, thus improving long-term outcomes. Nevertheless, the early diagnosis of SLE is still an unmet need for many patients. Further disentangling the SLE susceptibility and complex pathogenesis will allow to identify more accurate biomarkers and implement new ways to measure disease activity. This could represent a major step forward to find new trials modalities for developing new drugs, optimizing the use of currently available therapeutics and minimizing glucocorticoids. Preventing and treating comorbidities in SLE, improving the management of hard-to-treat manifestations including management of SLE during pregnancy are among the remaining major unmet needs. This review provides insights and a research agenda for the main challenges in SLE.

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