side effect profile
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2021 ◽  
Vol 28 (1) ◽  
Author(s):  
Deeba Nazir ◽  
Zaid Ahmad Wani ◽  
Fahd Bukhari ◽  
Shabir Ahmad Dar ◽  
Yuman Kawoosa

Abstract Background Clozapine is an atypical second-generation antipsychotic belonging to the family of dibenzodiazepines. There is lack of literature on clozapine from this part of the world. So, our aim was to study the socio demographic, clinical and side effect profile of patients on clozapine in Kashmir. Results The mean age of the study group was 32.6 ± 8.9 years with majority being males (78.4%), unmarried (78.4%), unemployed (77.2%), and belonging to nuclear families (77.2%). Almost half of them resided in urban localities (51.1%) and studied upto middle school (55.7%). Around three- fourth (75%) of the patients had diagnosis of treatment-resistant schizophrenia. The mean dose of clozapine was 338.92 ± 158.11 mgs. Sedation (76.1%), hypersalivation (69.5%), constipation (46.6%), and weight gain (34.1%) were most common side effects noted in patients. 4.5% cases developed seizures while on clozapine. 2.3% patients developed agranulocytosis while 4.5% patients developed neutropenia on clozapine. The neutropenia was more pronounced in patients of schizophrenia with suicidal tendencies with doses of more than 400 mg. Conclusions We have used clozapine in a wide range of indications. Our patients seem to tolerate and respond to higher doses of clozapine and the prevalence of blood dyscrasias in our study sample was much higher than the rest of India.


2021 ◽  
Author(s):  
Mpumelelo Sibanyoni ◽  
Ntombiyethu Biyase ◽  
Palesa Motshabi Chakane

Abstract Background and purpose of the study: Intrathecal morphine (ITM) provides optimal postoperative analgesia in patients who are scheduled for total knee and hip operation with spinal anaesthesia. However, the ideal dose at which maximal analgesic effect occurs with minimal side effects is not known. This study aimed to describe the use of two doses of ITM, and side effect profile in patients undergoing elective hip and knee arthroplasty.Methods: This was a prospective, descriptive, and contextual study conducted on patients who had total hip and knee replacement at Chris Hani Baragwanath Academic Hospital from 1 September to 30 November 2020. The sample size consisted of 66 patients who were 18 years and older, American Society of Anaesthesiology (ASA) classification 1-3, patients who had received either 100 mcg or 150 mcg ITM dose under spinal anaesthesia and sent to the ward postoperatively. Visual Analogue Scale (VAS) score was used to assess pain in the first 24 hours, consumption of rescue analgesia and reported side effects were documented.Results: There was no relationship between age, weight, ASA classification or type of surgery and VAS score classification groups. Patients who received 100 mcg ITM had a higher median VAS pain score 2 (1-5) compared to those who received 150 mcg ITM 1 (0-2), p = 0.01. The need for rescue analgesia between the two groups was marginally less in the 150mcg ITM group (p =0.098). There was no difference in the rate of side effects between the 100 mcg ITM group [12 (41%)] and the 150 mcg ITM group [17 (59%)], p = 0.92. Rescue analgesia was marginally different between groups, p = 0.09. There were no real differences in the VAS pain scores between the total knee and total hip surgeries. None of the patients experienced clinically significant respiratory depression. Conclusion: The 150mcg ITM dose provided good analgesic effects with longer duration of action and comparable side effect profile to the 100mcg ITM dose. This dose was not associated with development of respiratory depression can therefore be administered safely to patients who are discharged to the ward postoperatively in a resource constraint environment.


2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A22-A22
Author(s):  
A Aishah ◽  
K Loffler ◽  
B Tonson ◽  
S Mukherjee ◽  
R Adams ◽  
...  

Abstract Introduction Single-night studies with noradrenergic and anti-muscarinics have recently been shown to improve upper-airway function and reduce obstructive sleep apnoea (OSA) severity. This study aimed to determine the safety, tolerability, and efficacy profile of longer-term use of different doses of the noradrenergic agent atomoxetine combined with the anti-muscarinic oxybutynin (ato-oxy) in people with OSA. Methods Thirty-nine people with predominantly severe OSA received either 80/5mg ato-oxy, 40/5mg ato-oxy, 40/2.5mg ato-oxy or placebo nightly for 30 days according to a double-blind, randomised, parallel design. Safety and tolerability were assessed via weekly phone calls for adverse events, vital signs and objective measures of alertness and memory. Participants completed 3 in-laboratory sleep studies (baseline, night 1 and night 30) to assess efficacy. Results Side effects were generally mild and consistent with the known side-effect profile of each drug alone (e.g. dose-dependent increases in dry mouth with oxybutynin). Heart rate increased by night 30 in two of the drug arms versus placebo (e.g. 80/5mg ~9 beats/min, p=0.01). Blood pressure and measures of alertness and memory did not change between conditions. AHI4 and hypoxic burden decreased by ~50% in the 80/5mg arm on night 1 with similar magnitude reductions at night 30. ~50% of participants indicated willingness to continue taking the medication post-study. Discussion 1 month of nightly noradrenergic and anti-muscarinic combination therapy is generally well-tolerated with a side effect profile consistent with each agent alone. These findings also further highlight the potential to target noradrenergic and anti-muscarinic mechanisms for OSA pharmacotherapy development.


2021 ◽  
Vol 38 (04) ◽  
pp. 438-444
Author(s):  
Joseph Ray Ness ◽  
Christopher Molvar

AbstractIntrahepatic cholangiocarcinoma is the second most common primary hepatic malignancy and poses a therapeutic challenge owing to its late-stage presentation and treatment-resistant outcomes. Most patients are diagnosed with locally advanced, unresectable disease and are treated with a combination of systemic and local regional therapies. Transarterial radioembolization offers a survival benefit and a favorable side effect profile, with a growing body of evidence to support its use. Herein, we review patient selection and detail outcomes of radioembolization for intrahepatic cholangiocarcinoma, together with mention of competing treatments.


2021 ◽  
Vol 12 (11) ◽  
pp. 2813-2816
Author(s):  
Catherine Aiken ◽  
Jane Tarry-Adkins ◽  
Imogen Grant ◽  
Rebecca Reynolds ◽  
Susan Ozanne

Author(s):  
Sarah Ashaari ◽  
Hafiz Ahmed Sohaib ◽  
Kenneth Bolger

Abstract Background The Covid-19 pandemic has led to rapid development of Covid-19 vaccine. Centers for Disease Control and Prevention (CDC) has recently reported increase in myopericarditis incidence post Covid-19 vaccination. Post-vaccination myo-pericarditis as side effect has been reported however is infrequent. We described a case of pericarditis post- first dose of Pfizer-BioNTech vaccine. Case Summary A patient presented with typical symptoms of pericarditis and related ECG and echocardiogram changes, 7 days post receiving the first dose of Covid-19 vaccine. No other causes were identified from series of investigations. Patient had good symptomatic relief with non-steroidal anti- inflammatory medication. Conclusion The incidence of pericarditis post-vaccination is rare, with limited reporting in previous literatures. No causal relationship has yet to be established due to small number of cases. The benefits of Covid-19 vaccination currently outweigh the side effect profile and recommended as the first line approach to control the current pandemic.


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