Pub Date : 2021-11-01DOI: 10.1177/00694770211056889
J. Dill, T. Mcevoy
A retrospective review of critically ill adult patients was performed to assess the association between oseltamivir and bradycardia. A total of 203 critically ill adults with presumed influenza who had received at least 2 doses of oseltamivir were included in the assessment. The primary outcome was the occurrence of bradycardia (heart rate: ≤59 beats/min) while receiving oseltamivir or a decrease of at least 20 beats/min compared with the lowest heart rate before initiating oseltamivir. Results: Less than half of the patients (43.4%) had documented bradycardia, 59 had a heart rate ≤ 59 beats/min, 19 with a heart rate decrease of at least 20 beats/min, and 10 with both. The time of onset from first dose to bradycardia was 51.4 hours. Approximately half (54.6%) of the patients received treatment for bradycardia. A multivariate logistic regression showed that bradycardia was associated with baseline heart rate, age, past medical history of neurologic issues, and positive influenza status. Based on the results of this study, the authors concluded that oseltamivir was associated with clinically relevant bradycardia in critically ill patients. They suggested that critically ill patients who receive oseltamivir should be monitored for bradycardia. Oseltamivir [Oseltamivir] MacLaren R et al (Robert MacLaren: Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, 12850 East Montview Blvd, C238, Aurora, CO 80045; e-mail: rob.maclaren@cuanschutz.edu) Oseltamivirassociated bradycardia in critically ill patients. Ann Pharmacotherapy 55:1318–1325 (Nov) 2021
对危重成人患者进行回顾性研究，以评估奥司他韦与心动过缓之间的关系。共有203名疑似流感的危重成人患者接受了至少2剂奥司他韦，并被纳入评估。主要终点是接受奥司他韦时发生心动过缓(心率≤59次/分)或与开始使用奥司他韦前的最低心率相比至少下降20次/分。结果:不到一半的患者(43.4%)表现为心动过缓，59例心率≤59次/分，19例心率下降至少20次/分，10例两者兼有。从第一次给药到心动过缓的时间为51.4小时。大约一半(54.6%)的患者接受了心动过缓的治疗。多因素logistic回归分析显示，心动过缓与基线心率、年龄、既往神经系统病史和流感阳性相关。基于这项研究的结果，作者得出结论，奥司他韦与危重患者临床相关的心动过缓有关。他们建议对接受奥司他韦治疗的危重患者进行心动过缓的监测。奥司他韦[奥司他韦]MacLaren R等人(Robert MacLaren:科罗拉多大学斯卡格斯药学院临床药学系，East Montview Blvd 12850, C238, Aurora, CO 80045;电子邮件:rob.maclaren@cuanschutz.edu)危重病人的奥司他病毒相关性心动过缓。Ann药物治疗55:1318-1325(11月)2021
{"title":"Reporting on Adverse Clinical Events","authors":"J. Dill, T. Mcevoy","doi":"10.1177/00694770211056889","DOIUrl":"https://doi.org/10.1177/00694770211056889","url":null,"abstract":"A retrospective review of critically ill adult patients was performed to assess the association between oseltamivir and bradycardia. A total of 203 critically ill adults with presumed influenza who had received at least 2 doses of oseltamivir were included in the assessment. The primary outcome was the occurrence of bradycardia (heart rate: ≤59 beats/min) while receiving oseltamivir or a decrease of at least 20 beats/min compared with the lowest heart rate before initiating oseltamivir. Results: Less than half of the patients (43.4%) had documented bradycardia, 59 had a heart rate ≤ 59 beats/min, 19 with a heart rate decrease of at least 20 beats/min, and 10 with both. The time of onset from first dose to bradycardia was 51.4 hours. Approximately half (54.6%) of the patients received treatment for bradycardia. A multivariate logistic regression showed that bradycardia was associated with baseline heart rate, age, past medical history of neurologic issues, and positive influenza status. Based on the results of this study, the authors concluded that oseltamivir was associated with clinically relevant bradycardia in critically ill patients. They suggested that critically ill patients who receive oseltamivir should be monitored for bradycardia. Oseltamivir [Oseltamivir] MacLaren R et al (Robert MacLaren: Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, 12850 East Montview Blvd, C238, Aurora, CO 80045; e-mail: rob.maclaren@cuanschutz.edu) Oseltamivirassociated bradycardia in critically ill patients. Ann Pharmacotherapy 55:1318–1325 (Nov) 2021","PeriodicalId":102871,"journal":{"name":"Clin-Alert®","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132682671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.1177/00694770211051270
J. Dill, T. Mcevoy
A 70-year-old male patient developed worsening pain and swelling of the left breast of 1 month duration. Medications at the time of medical evaluation included bicalutamide (50 mg daily for 12 months), atorvastatin (20 mg daily), allopurinol, acetylsalicylic acid, and tamsulosin. No vitamins or herbal supplements were noted on the medication history. A physical examination revealed a tender enlarged left breast without bleeding or discharge. Imaging studies indicated an enlarged left breast with normal glandular tissues and vascularity. Laboratory values were within normal limits. Treatment included the substitution of ezetimibe (10 mg daily) for atorvastatin, resulting in symptomatic improvement by 3 months without recurrence. The authors concluded that this patient developed atorvastatin-related gynecomastia based on the temporal relationship between the administration of the drug and the appearance and resolution of symptoms. According to the Naranjo causality scale, this relationship between the drug and causality was classified as probable. Atorvastatin [Atorvastatin] Famularo G et al (Giuseppe Famularo: San Camillo Hospital, Rome, Italy; e-mail: None provided) Atorvastatin-associated gynecomastia. Ann Pharmacotherapy 55(10):1300–1301 (Oct) 2021
{"title":"Reporting on Adverse Clinical Events","authors":"J. Dill, T. Mcevoy","doi":"10.1177/00694770211051270","DOIUrl":"https://doi.org/10.1177/00694770211051270","url":null,"abstract":"A 70-year-old male patient developed worsening pain and swelling of the left breast of 1 month duration. Medications at the time of medical evaluation included bicalutamide (50 mg daily for 12 months), atorvastatin (20 mg daily), allopurinol, acetylsalicylic acid, and tamsulosin. No vitamins or herbal supplements were noted on the medication history. A physical examination revealed a tender enlarged left breast without bleeding or discharge. Imaging studies indicated an enlarged left breast with normal glandular tissues and vascularity. Laboratory values were within normal limits. Treatment included the substitution of ezetimibe (10 mg daily) for atorvastatin, resulting in symptomatic improvement by 3 months without recurrence. The authors concluded that this patient developed atorvastatin-related gynecomastia based on the temporal relationship between the administration of the drug and the appearance and resolution of symptoms. According to the Naranjo causality scale, this relationship between the drug and causality was classified as probable. Atorvastatin [Atorvastatin] Famularo G et al (Giuseppe Famularo: San Camillo Hospital, Rome, Italy; e-mail: None provided) Atorvastatin-associated gynecomastia. Ann Pharmacotherapy 55(10):1300–1301 (Oct) 2021","PeriodicalId":102871,"journal":{"name":"Clin-Alert®","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132520204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1177/00694770211023525
J. Dill, T. Mcevoy
A prospective observational study in an academic hospital evaluated 23 patients (aged 13-40 years) with acute organophosphate ingestion for delayed neurological effects. Once the cholinergic crisis was treated and resolved, the patients were followed for an additional 6 months for neurologic toxicity. All but one patient had a normal neurological examination hospital discharge. The median hospitalization duration was 6 days. During the 6-month follow-up period, approximately 35% (n = 8) of the patients developed delayed neuropathy associated with organophosphate exposure. Three patients developed symptomatic neuropathy, including persistent foot drop, gait ataxia, and distal paresthesia. A total of 5 patients exhibited subclinical peripheral nerve involvement as assessed in nerve conduction studies. None of the baseline characteristics in this group were predictive of delayed neurological effects. Based on a small observational study, the authors concluded that delayed nerve involvement may occur after recovery from a cholinergic crisis in patients exposed to organophosphate poisoning. Organophosphates [Organophosphates] Pannu AK et al (A Bhalla, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, 4th Floor, F Block, Nehru Hospital, PGIMER, Chandigarh 160012, India; e-mail: bhalla.chd@gmail.com) Organophosphate induced delayed neuropathy after an acute cholinergic crisis in self-poisoning. Clin Toxicol (Phila) 59:488–492 (Jun) 2021
{"title":"Reporting on Adverse Clinical Events","authors":"J. Dill, T. Mcevoy","doi":"10.1177/00694770211023525","DOIUrl":"https://doi.org/10.1177/00694770211023525","url":null,"abstract":"A prospective observational study in an academic hospital evaluated 23 patients (aged 13-40 years) with acute organophosphate ingestion for delayed neurological effects. Once the cholinergic crisis was treated and resolved, the patients were followed for an additional 6 months for neurologic toxicity. All but one patient had a normal neurological examination hospital discharge. The median hospitalization duration was 6 days. During the 6-month follow-up period, approximately 35% (n = 8) of the patients developed delayed neuropathy associated with organophosphate exposure. Three patients developed symptomatic neuropathy, including persistent foot drop, gait ataxia, and distal paresthesia. A total of 5 patients exhibited subclinical peripheral nerve involvement as assessed in nerve conduction studies. None of the baseline characteristics in this group were predictive of delayed neurological effects. Based on a small observational study, the authors concluded that delayed nerve involvement may occur after recovery from a cholinergic crisis in patients exposed to organophosphate poisoning. Organophosphates [Organophosphates] Pannu AK et al (A Bhalla, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, 4th Floor, F Block, Nehru Hospital, PGIMER, Chandigarh 160012, India; e-mail: bhalla.chd@gmail.com) Organophosphate induced delayed neuropathy after an acute cholinergic crisis in self-poisoning. Clin Toxicol (Phila) 59:488–492 (Jun) 2021","PeriodicalId":102871,"journal":{"name":"Clin-Alert®","volume":"155 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122919884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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