Dermatologicaldrugs, mostly corticosteroids and isotretinoin, cause different psychiatricadverseeffects. During steroid therapy, a wide range ofpsychiatric conditions, from minor clinical symptoms like insomnia and anxiety to serious psychiatric syndromes like psychosis and delirium might be seen. In medical literature, a causal connection is usually suggested between “isotretinoin”, which is used for treatment of acne vulgaris and depression and suicide attempts. However, there are no statistically significant double-blind randomized studies that support this connection. Clinicians must know patient’s psychiatric history before using any dermatological treatment known as causing psychiatricadverseeffects, and psychiatric consultation should be established whenever necessary. (Turkderm 2010; 44 Suppl 1: 52-4)
Once schizophrenic patients are theorically exposed to several drugs with a potential to lead to either intraocular pressure abnormalities or glaucoma, it is important to evalute both their IOP and their eye fundus in order to detect possible glaucomatous changes as early as possible and prevent their complications such as blindness. In addition, it is always useful in management of this group of patients to know ad- verse effects related to psychiatric medications to guide phy- sicians with more effective treatments enabling them to offer prompt specific treatment regarding their complications or switch to another class ofdrugs with equivalent therapeutic efficacy. Another relevant point is that the use of atypical antipsychotics has become more common and there is little knowledge on the possible ocular adverseeffectsof these drugs.
The calcineurin inhibitors (CNIs), cyclosporin A (CsA) and tacrolimus, as well as the mTOR (mammalian target of rapamycin) inhibitor, rapamycin, are frequently used immunosuppressive agents (IA) to prevent rejection after solid organ transplantation and treat autoimmune diseases (Scherer et al., 2007). However, standard recommended doses are associated with the development of metabolic complications, including hyperlipidemia, and new-onset diabetes after transplantation (NODAT) (Parekh et al., 2012). The reported prevalence of these conditions has varied greatly, with estimates up to 50% for diabetes (Montori et al., 2002) and 20% to 80% for dyslipidemia (Kesten et al., 1997; Parekh et al., 2012), depending on the population, diagnostic criteria, mean follow-up time and type of IA therapy. These complications are well known risk factors for cardiovascular diseases and are associated with reduced graft and patient survival in transplant recipients (Massy, 2001). Clinical studies have shown that the IA increase serum levels of cholesterol, triglycerides and low-density lipoprotein (LDL), usually in a dose-dependent manner (Ichimaru et al., 2001; Li et al., 2012; Morrisett et al., 2002; Spinelli et al., 2011). In addition, rapamycin increases plasma free fatty acids (FFA) levels (Morrisett et al., 2002). Although CsA and tacrolimus are similar in terms of their mechanism of action, tacrolimus is associated with less adverseeffects on the patient’s lipid profile (Bakar et al., 2009; Ichimaru et al., 2001; Vincenti et al., 2007), and one study even suggested beneficial effects (Perrea et al., 2008).
This study aimed at evaluating the incidence ofadverseeffects leading to treatment discontinuation of antihypertensive drugs within the same therapeutic class. Individual medical records were searched to identify those hypertensive patients who had been commenced on antihypertensive therapy during a 24- month period and who had subsequently for a reason(s) discontinued the therapy. The results showed variation in discontinuation rates for drugs within same class, and that might be related to the relative frequency of specific adverseeffects. Cough was the reason cited for discontinuation of angiotensin converting enzyme inhibitors, with linosopril appearing to be better tolerated than captopril (39% vs 48%) ; peripheral oedema with calcium channel blockers, with amlodipine appearing to be better tolerated than nifedipine (29% vs 38%) and bradycardia with beta adrenergic receptor blockers, with propranolol better tolerated than atenolol (0% vs 48%). Diuretics showed the lowest discontinuation rate (3.3%) mainly due to hypokalemia, with thiazide better tolerated than frusemide (11% vs 43%).
Still, the factors for the diseases development, as well as their evolution through treatment were considered. As result, it was observed that the majority of respondents were women (21.5 ± 5.06 years), with a prevalence of 22.3% psychoactive drugs usage, being Escitalopram, most cited as antidepressant and Clonazepam as anxiolytic. The Social Work course stood out with the largest number of those affected by the study diseases (46%). It is noteworthy that 40% of participants had already experienced the desire to be injured or to be dead. Finally, this study contributes to the valorization of discussions about the mental health of undergraduating students and how the university context can exert positive or negative influence.
The incretins are a group of intestinal hormones that stimulate insulin secretion. During the last decade, several hypoglycemic drugs based on incretin have gained widespread use as treatments for patients with type 2 diabetes. Incretin-based drugs are classified as inhibitors of incretin-degrading protease Dipeptidyl Peptidase 4 (DPP-4) or as incretin hormone Glucagon-Like Peptide 1 (GLP-1) receptor agonists. DPP-4 inhibitors and GLP-1 receptor agonists lower fasting and postprandial glucose, but do not produce hypoglycemia and are not associated with body weight gain or reduced in blood pressure (Nauck, 2013).
This version was administered to a group of consecutive out- patients in the Epilepsy Section of Hospital São Paulo, a tertiary care center of the Universidade Federal de São Paulo, Brazil, with the aim of testing and assessing the adequacy and comprehension of the language used in the translated version. Patients older than 18 with a conﬁrmed diagnosis of epilepsy were included in the study if they were taking AEDs at a stable dose for at least 1 month and if they were able to understand and answer the questions by themselves. Patients with concomitant degenerative or chronic diseases and those with symptomatic epilepsy caused by progressive diseases were excluded. The subjects were recruited after ethics committee approval and gave their written informed consent for the study.
With regard to the stages of identiication and measu- rement of the tracking criteria and adverseeffects from drugs, the medical iles were reviewed from the discharge summary or from the form for authorization of hospital admission within SUS, in order to collect general information on the following: primary and secondary diagnoses, duration of hospitalization and patient sociodemographic data. The review of the medical iles was based on the prescriptions and the laboratory results. The records relating to patient evolution, made by the physician and nursing team, were examined to look for changes in consciousness, rashes, somnolence, falls, low blood pressure, nausea, vomiting and complementary information on the medi- cation. After inding the tracking criterion, occurrences ofadverseeffects soon afterwards were investigated. If such events were found, they were described and classiied. The medications were recorded.
Buprenorphine comes in intravenous, sublingual and transdermal forms, with the last the only type available in Brazil and the most currently studied. Adhesives are available in five, 10 and 20 mcg/h forms, with seven day release. Unlike other drugs, buprenorphine has no systemic accumulation, with mainly intestinal elimination, and is considered safe for patients with renal insufficiency. Its transdermal route of administration prevents first- pass metabolism, contributing to lower rates of drug interactions and adverseeffects such as respiratory depression and immunosuppression 29,42,45 .
Furthermore, the presence of strong residual effects (comorbid alcoholism-adjusted) of AST/ALT elevations on natural deaths in modeling statistics indicate that methamphetamine could have a direct effect on the organ systems leading to death that is attributed to illness in that organ system. The possible mechanisms of methamphetamine toxicity in humans are difficult to determine from experimental studies due to the illicit nature of metham- phetamine and ethical constraints. However, the findings of animal studies could help shed light on the harm of methamphet- amine in humans. In rats, a study  investigated transaminase activity in response to persistent 4-week administration of amphetamine sulfate and revealed marked increases in serum AST levels and mild increases in ALT levels. In dogs, amphetamine increased plasma levels of both AST and ALT , although a later study reported significant increases in AST level, but no change in ALT level . The increase in plasma AST and ALT levels could reflect an effect of amphetamine on the plasma membrane of cells in the organ .
data, almost all of the participants agreed on the impor- tance of collecting a detailed history pre-transfusion and checking the patient’s name on the blood bag. It was possible to observe a divergence between participants regarding the item ‘‘practice of deliberate hypotension by drugs’’, the AR remained unfavorable, but the agreement and disagreement scores were identical (40%). However, a meta-analysis of randomized clinical trials with 636 patients found that delib- erate hypotension proved to be significantly effective in reducing the need for blood transfusion. 26 Thus, it contrasts
Neuropsychiatric manifestations in autoimmune diseases are often observed; they are associated with increased morbid- ity and mortality and with a poorer quality of life. Although their classification is carried out on a more systematic basis in systemic lupus erythematosus (SLE) when compared to other diseases – in part because of its prevalence and diagnos- tic difficulties – their importance cannot be ignored in other rheumatic diseases.
It is also important to point out that a natural resource boom can also have positive developmental effects, including crowding in effects on industrialization. This is the staple thesis view, originating in the work of Canadian economic historians, which emphasizes the role of linkages generated by different primary export activities and the nature of returns to scale in the sectors that benefit directly from the expansion of primary exports. Suppose, for example, that the non tradable goods sectors which benefit from the increase in the natural resource rents and its spending operate under increasing returns to scale — transport infrastructure, say, stimulated by the expansion of the agricultural frontier — and that at the same time, the labor supply is elastic, due to the presence of surplus labor in the economy or to workers migration, so that the spending effectsof the natural resource boom have little effects on wages. Under these conditions, the relative price of non-tradable inputs (transport costs in the example mentioned) used by manufacturing will tend to fall, rather than increase, with the expansion of the primary export sector. The natural resource boom leads then to real exchange rate depreciation as the relative price of non-tradables, in terms of manufactures, falls as a result of productivity increases (coming from the presence of increasing returns to scale in the production of non tradable inputs) that are larger than the rise of real wages (held down by the
Objective: To determine the profile of medications used for self-medication by the elderly. Methods: A cross-sectional study based on interviews with elderly seen at a reference center for Elderly Health of a teaching hospital, from July 2014 to July 2015. Clinical, demographic and pharmacotherapeutic data were collected. Results: A total of 170 elderly were interviewed, 85.9% female, and the median age was 76 years. The frequency of self-medication was 80.5%. The most used medications for self-medication were central acting muscle relaxants, analgesics and antipyretics, non-steroidal anti-inflammatory and antirheumatic agents. Among the elderly who practiced self-medication, 55.5% used drugs that were inappropriate for the elderly, according to Beers criteria of 2015, and 56.9% used medications that showed therapeutic duplicity with the prescribed drugs. We identified 57 drugs used for self-medication, of which 30 (52.6%) were classified as over-the-counter and 27 (47.4%) as prescription drugs. Approximately 68.6% of elderly had at least one interaction involving drugs prescribed and those used for self-medication. Conclusion: The practice of self-medication was frequent in the elderly studied. The widespread use of over-the-counter drugs and/or potentially inappropriate medications for elderly increases the risk of drug interactions and adverse events.
This study analyzed the effectsof the use of dexametha- sone beginning between 10 and 14 days of life in very low birth weight infants and dependent on mechanical ventila- tion. We analyzed the incidence of BPD and its evolution, the duration of mechanical ventilation and oxygen therapy, the adverseeffects and mortality with the purpose of evalu- ating the hypothesis that this corticosteroid can benefit the respiratory evolution of these newborns even though its use also has some adverseeffects.
The perception that youth are pro- curing prescription medications from family and friends reflect phenomena that are going on across the nation. Substance Abuse and Mental Health Services Administration, re- ported that 68% of those using prescription medications non-medically procured them from friends and family . This was found to be true for this study as well. More than one-third (39%) of clinic consumers re- ported that they got their prescription drugs from a friend who had obtained the drug illegally, 14% reported that they got it from a family member who had a prescription for the drug, and 14% reported that they got it from a family member who had gotten it illicitly. However, the largest sources for getting prescription drugs used by clinic consumers were physicians and street deal- ers. More than one half (61%) of clinic con- sumers report that they have received a pre- scription for drugs from a physician for pain. Many of these clients were "doctor shopping" as evidenced by the large number of physicians they reported seeing. How- ever, the vast majority (75%) of methadone clinic consumers reported that they have purchased their prescription drugs from a street source.
Five of the ten most prescribed drugsof this study have generic versions available on the Mexican market (“genéricos intercambiables” or bioequivalent drugs) and approved by the Mexican health authorities (ciprofloxacin, ranitidine, oral ketorolac, parenteral ketorolac, amoxicillin and paracetamol). However, Mexican health professionals and patients do not trust enough non-brand name substitutes because of the existence on the market of several pharmaceutical products (“innovators”, “bioequivalent drugs”, “generics” and “similars”) that lead to misunderstanding and confusion. We suppose that for this reason, general practitioners in our study did not use generic names for prescribing and did not even prescribe bioequivalent drugs. We also think that a consequence of this, was the medication duplicity errors found for paracetamol, the seventh most prescribed drug in our study. If physicians did not have enough information about drugs contained in medications and they used to prescribe by brand name, duplicities could appear and patient could be exposed to supratherapeutic doses of certain drugs, as observed in this study for paracetamol.
Passive energy dissipation in a vibrating structure mainly occurs due to internal stressing, rubbing, cracking, and plastic deformations . When facing a dynamic event, the amplitude of the structural vibrations varies inversely with the capacity of the structure to dissipate energy. As some structures show very low damping, they may experience large amplitudes of vibration even for moderately strong earth- quakes. Increasing the energy dissipation capacity of a structure is a very effective method to reduce the amplitudes of vibration. A great variety of different devices providing supplemental damping exist and have been already installed in structures all over the world, enhancing their energy dissipation capacity by converting kinetic energy into heat. These devices operate on principles such as frictional sliding, defor- mation of viscoelastic solids or fluids, yielding of metals and phase transformations in metals or alloys. The latter method includes SE, which allows the material to dissipate a considerable amount of energy through hysteresis, while recovering from large nonlinear strains .
Summary : Severe cutaneous adverse reactions to drugs ( SCARD ) generally require hospitalization, and at times in the intensive therapy or burn care unit for observation of the vital signs and the viscera function. The aim of this study is to describe these reactions in order to facilitate recognition and treatment. This group of drug reactions includes anaphylaxis, Stevens-Johnson syndrome ( SJS ), toxic epidermal necrolysis ( TEN ) and, depending on the systemic invol- vement, erythroderma. In this article we approach the characteristics and treatment of some adverse reactions to drugs: anaphylaxis, erythroderma, Stevens-Johnson syndrome ( SJS ) and toxic epidermal necrolysis ( TEN ).