Pub Date : 2024-01-31DOI: 10.1136/dtb.2024.251305rep
Maunoo Lee, Joshua McCarron, Aaron Balinski, Richard Bower
In conjunction with BMJ Case Reports, DTB will feature occasional drug-related cases that are likely to be of interest to readers. These will include cases that involve recently marketed drugs for which there is limited knowledge of adverse effects and cases that highlight unusual reactions to drugs that have been marketed for several years. A woman in her mid-60s, without known liver disease, was admitted to the hospital with a partial malignant colonic obstruction. Over a 6-day course, she received a total of 13 g of intravenous acetaminophen not exceeding 4 g over a 24-hour period. She developed encephalopathy and an international normalised ratio of 6.1 meeting criteria for acute liver failure (ALF). She was treated with intravenous N-acetyl cysteine and other causes of liver failure were excluded. The patient was discharged with subsequent resolution of encephalopathy and improvement of her liver chemistries. Though ALF is rare, in countries where acetaminophen is readily available, almost 50% of ALF cases are acetaminophen-induced hepatotoxicity and most have been documented as oral ingestion of acetaminophen. We present a rare case of intravenous acetaminophen-induced ALF. Acute liver failure (ALF) is defined as new onset coagulopathy with international normalised ratio (INR) ≥1.5 and encephalopathy without pre-existing cirrhosis.1 Drug-induced liver injury (DILI) is the most common cause of ALF in the USA occurring at a rate of 20 cases per 100 000 persons.2 3 Of all DILI cases, acetaminophen-induced hepatotoxicity accounts for up to 46% of ALF cases.2 The two main aetiologies of acetaminophen overdoses are either intentional, often in context of suicide attempts, and unintentional overdoses, also known as therapeutic misadventures.3 4 Bower et al conducted a population-based surveillance for ALF that noted 55% of all acetaminophen-related ALF cases to be therapeutic misadventures.5 Current US Food and Drug Administration packaging …
{"title":"Intravenous acetaminophen associated with acute liver failure","authors":"Maunoo Lee, Joshua McCarron, Aaron Balinski, Richard Bower","doi":"10.1136/dtb.2024.251305rep","DOIUrl":"https://doi.org/10.1136/dtb.2024.251305rep","url":null,"abstract":"In conjunction with BMJ Case Reports, DTB will feature occasional drug-related cases that are likely to be of interest to readers. These will include cases that involve recently marketed drugs for which there is limited knowledge of adverse effects and cases that highlight unusual reactions to drugs that have been marketed for several years. A woman in her mid-60s, without known liver disease, was admitted to the hospital with a partial malignant colonic obstruction. Over a 6-day course, she received a total of 13 g of intravenous acetaminophen not exceeding 4 g over a 24-hour period. She developed encephalopathy and an international normalised ratio of 6.1 meeting criteria for acute liver failure (ALF). She was treated with intravenous N-acetyl cysteine and other causes of liver failure were excluded. The patient was discharged with subsequent resolution of encephalopathy and improvement of her liver chemistries. Though ALF is rare, in countries where acetaminophen is readily available, almost 50% of ALF cases are acetaminophen-induced hepatotoxicity and most have been documented as oral ingestion of acetaminophen. We present a rare case of intravenous acetaminophen-induced ALF. Acute liver failure (ALF) is defined as new onset coagulopathy with international normalised ratio (INR) ≥1.5 and encephalopathy without pre-existing cirrhosis.1 Drug-induced liver injury (DILI) is the most common cause of ALF in the USA occurring at a rate of 20 cases per 100 000 persons.2 3 Of all DILI cases, acetaminophen-induced hepatotoxicity accounts for up to 46% of ALF cases.2 The two main aetiologies of acetaminophen overdoses are either intentional, often in context of suicide attempts, and unintentional overdoses, also known as therapeutic misadventures.3 4 Bower et al conducted a population-based surveillance for ALF that noted 55% of all acetaminophen-related ALF cases to be therapeutic misadventures.5 Current US Food and Drug Administration packaging …","PeriodicalId":11277,"journal":{"name":"Drug and Therapeutics Bulletin","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139656072","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}
{"title":"ADHD medication shortages: more than just a supply issue.","authors":"Alexandra Lewis, Teck K Khong","doi":"10.1136/dtb.2023.000062","DOIUrl":"10.1136/dtb.2023.000062","url":null,"abstract":"","PeriodicalId":11277,"journal":{"name":"Drug and Therapeutics Bulletin","volume":" ","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139545913","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}
Overview of: Siraj RA, Bolton CE, McKeever TM. Association between antidepressants with pneumonia and exacerbation in patients with COPD: a self-controlled case series (SCCS). Thorax. 2023. doi:10.1136/thorax-2022-219736 [Epub ahead of print 19 June 2023].
概述:Siraj RA、Bolton CE、McKeever TM。抗抑郁药与慢性阻塞性肺病患者肺炎和病情加重之间的关系:自控病例系列(SCCS)。Thorax.2023. doi:10.1136/thorax-2022-219736 [Epub ahead of print 19 June 2023].
{"title":"Can antidepressants worsen COPD?","authors":"","doi":"10.1136/dtb.2024.000002","DOIUrl":"10.1136/dtb.2024.000002","url":null,"abstract":"<p><p><b>Overview of:</b> Siraj RA, Bolton CE, McKeever TM. Association between antidepressants with pneumonia and exacerbation in patients with COPD: a self-controlled case series (SCCS). Thorax. 2023. doi:10.1136/thorax-2022-219736 [Epub ahead of print 19 June 2023].</p>","PeriodicalId":11277,"journal":{"name":"Drug and Therapeutics Bulletin","volume":" ","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139485223","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}
Overview of: Neligan A, Adan G, Nevitt SJ, et al. Prognosis of adults and children following a first unprovoked seizure. Cochrane Database Syst Rev. 2023:10.1002/14651858.CD013847.pub2.
概述:Neligan A, Adan G, Nevitt SJ, et al. 首次无诱因癫痫发作后成人和儿童的预后。Cochrane Database Syst Rev. 2023:10.1002/14651858.CD013847.pub2。
{"title":"Risk of recurrence after first unprovoked seizure.","authors":"","doi":"10.1136/dtb.2024.000006","DOIUrl":"10.1136/dtb.2024.000006","url":null,"abstract":"<p><p><b>Overview of:</b> Neligan A, Adan G, Nevitt SJ, et al. Prognosis of adults and children following a first unprovoked seizure. Cochrane Database Syst Rev. 2023:10.1002/14651858.CD013847.pub2.</p>","PeriodicalId":11277,"journal":{"name":"Drug and Therapeutics Bulletin","volume":" ","pages":"22"},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139478122","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}
Overview of: McQuilten ZK, Thao LTP, Pasricha SR, et al. Effect of low-dose aspirin versus placebo on incidence of anemia in the elderly: a secondary analysis of the aspirin in reducing events in the elderly trial. Ann Intern Med. 2023;176:913-21.
概述:McQuilten ZK、Thao LTP、Pasricha SR 等:低剂量阿司匹林与安慰剂对老年人贫血发生率的影响:阿司匹林减少老年人贫血试验的二次分析。Ann Intern Med.2023;176:913-21.
{"title":"Low-dose aspirin and anaemia in older people.","authors":"","doi":"10.1136/dtb.2024.000001","DOIUrl":"10.1136/dtb.2024.000001","url":null,"abstract":"<p><p><b>Overview of:</b> McQuilten ZK, Thao LTP, Pasricha SR, et al. Effect of low-dose aspirin versus placebo on incidence of anemia in the elderly: a secondary analysis of the aspirin in reducing events in the elderly trial. Ann Intern Med. 2023;176:913-21.</p>","PeriodicalId":11277,"journal":{"name":"Drug and Therapeutics Bulletin","volume":" ","pages":"21"},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139478119","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}
Miriam Santer, Esther Burden-Teh, Jane Ravenscroft
Acne vulgaris is very common and can have significant negative impact on people. While sometimes a transient problem, acne may persist for many years and often leads to permanent scars or pigment changes. Guidelines unanimously advise topical treatments as first-line, although differ in recommending either topical benzoyl peroxide or topical retinoid (mainly adapalene) alone or in combination. Guidance published by the National Institute for Health and Care Excellence advises counselling patients regarding avoidance of skin irritation when starting topical treatments and promoting adherence (treatments take 6–8 weeks to work). Oral antibiotics are currently overprescribed for acne but have a role when coprescribed with a non-antibiotic topical treatment. Hormonal treatments, such as the combined contraceptive pill, are also effective and there is growing evidence for the use of spironolactone for women with persistent acne. Recent guidance from the Medicines and Healthcare products Regulatory Agency regarding isotretinoin has implications for specialist prescribing and monitoring, and increasing public awareness of potential risks of mental health problems and sexual dysfunction. Although acne is associated with psychiatric disorder, the mental health effects of isotretinoin remain controversial.
{"title":"Managing acne vulgaris: an update","authors":"Miriam Santer, Esther Burden-Teh, Jane Ravenscroft","doi":"10.1136/dtb.2023.000051","DOIUrl":"https://doi.org/10.1136/dtb.2023.000051","url":null,"abstract":"Acne vulgaris is very common and can have significant negative impact on people. While sometimes a transient problem, acne may persist for many years and often leads to permanent scars or pigment changes. Guidelines unanimously advise topical treatments as first-line, although differ in recommending either topical benzoyl peroxide or topical retinoid (mainly adapalene) alone or in combination. Guidance published by the National Institute for Health and Care Excellence advises counselling patients regarding avoidance of skin irritation when starting topical treatments and promoting adherence (treatments take 6–8 weeks to work). Oral antibiotics are currently overprescribed for acne but have a role when coprescribed with a non-antibiotic topical treatment. Hormonal treatments, such as the combined contraceptive pill, are also effective and there is growing evidence for the use of spironolactone for women with persistent acne. Recent guidance from the Medicines and Healthcare products Regulatory Agency regarding isotretinoin has implications for specialist prescribing and monitoring, and increasing public awareness of potential risks of mental health problems and sexual dysfunction. Although acne is associated with psychiatric disorder, the mental health effects of isotretinoin remain controversial.","PeriodicalId":11277,"journal":{"name":"Drug and Therapeutics Bulletin","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139052829","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}
Overview of: Florez MA, Jaoude JA, Patel RR, et al. Incidence of primary end point changes among active cancer phase 3 randomized clinical trials.JAMA Netw Open2023;6:e2313819.
概述:Florez MA, Jaoude JA, Patel RR, et al. Inidence of primary end point changes among active cancer phase 3 randomized clinical trials.JAMA Netw Open2023;6:e2313819.
{"title":"Changes in primary endpoints in cancer trials.","authors":"","doi":"10.1136/dtb.2023.000064","DOIUrl":"10.1136/dtb.2023.000064","url":null,"abstract":"<p><p><b>Overview of:</b> Florez MA, Jaoude JA, Patel RR, et al. Incidence of primary end point changes among active cancer phase 3 randomized clinical trials.<i>JAMA Netw Open</i>2023;6:e2313819.</p>","PeriodicalId":11277,"journal":{"name":"Drug and Therapeutics Bulletin","volume":" ","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138482156","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}
{"title":"Continuity of care: good for patients, good for prescribing.","authors":"Julian Treadwell","doi":"10.1136/dtb.2023.000033","DOIUrl":"10.1136/dtb.2023.000033","url":null,"abstract":"","PeriodicalId":11277,"journal":{"name":"Drug and Therapeutics Bulletin","volume":" ","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138482157","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}