Pub Date : 2009-04-01DOI: 10.1097/FAD.0b013e32832c0ce1
S. Chew
The incidence of cardiovascular disease is higher in the elderly, who therefore derive greater absolute benefit from appropriate prophylaxis with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins). However, there is also a high prevalence of polypharmacy in the elderly that predisposes them to statin-induced myopathy and adverse drug interactions. Here I seek to identify the predisposing factors and clinical presentation of statin-induced myopathy in the elderly. Part 2 will cover the diagnosis and management of statin-induced myopathy so that statins can be prescribed appropriately and safely in the elderly.
{"title":"Statin-induced myopathy in the elderly: Part 1","authors":"S. Chew","doi":"10.1097/FAD.0b013e32832c0ce1","DOIUrl":"https://doi.org/10.1097/FAD.0b013e32832c0ce1","url":null,"abstract":"The incidence of cardiovascular disease is higher in the elderly, who therefore derive greater absolute benefit from appropriate prophylaxis with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins). However, there is also a high prevalence of polypharmacy in the elderly that predisposes them to statin-induced myopathy and adverse drug interactions. Here I seek to identify the predisposing factors and clinical presentation of statin-induced myopathy in the elderly. Part 2 will cover the diagnosis and management of statin-induced myopathy so that statins can be prescribed appropriately and safely in the elderly.","PeriodicalId":39261,"journal":{"name":"Adverse Drug Reaction Bulletin","volume":"&NA; 1","pages":"979–982"},"PeriodicalIF":0.0,"publicationDate":"2009-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/FAD.0b013e32832c0ce1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61684463","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 : 2009-02-01DOI: 10.1097/FAD.0b013e32832a0b18
J. Aronson
Drugs are effective only if they reach their site of action. This can be achieved by direct application or in many indirect ways, usually via the bloodstream. Here I describe the uses and characteristic adverse effects of commonly used routes of administration. In part 1 I dealt with intramuscular injection and subcutaneous injection. Here I consider several other routes.
{"title":"Routes of drug administration: uses and adverse effects: Part 2: sublingual, buccal, rectal, and some other routes","authors":"J. Aronson","doi":"10.1097/FAD.0b013e32832a0b18","DOIUrl":"https://doi.org/10.1097/FAD.0b013e32832a0b18","url":null,"abstract":"Drugs are effective only if they reach their site of action. This can be achieved by direct application or in many indirect ways, usually via the bloodstream. Here I describe the uses and characteristic adverse effects of commonly used routes of administration. In part 1 I dealt with intramuscular injection and subcutaneous injection. Here I consider several other routes.","PeriodicalId":39261,"journal":{"name":"Adverse Drug Reaction Bulletin","volume":"&NA; 1","pages":"975–978"},"PeriodicalIF":0.0,"publicationDate":"2009-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/FAD.0b013e32832a0b18","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61684419","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 : 2008-12-01DOI: 10.1097/FAD.0b013e328329bb21
J. Aronson
Drugs are effective only if they reach their site of action. This is usually achieved by oral administration, but other routes are possible. Here I describe the uses and characteristic adverse effects of commonly used routes of administration. In this part I deal with intramuscular and subcutaneous injection and in part 2 other routes.
{"title":"Routes of drug administration: uses and adverse effects: Part 1: Intramuscular and subcutaneous injection","authors":"J. Aronson","doi":"10.1097/FAD.0b013e328329bb21","DOIUrl":"https://doi.org/10.1097/FAD.0b013e328329bb21","url":null,"abstract":"Drugs are effective only if they reach their site of action. This is usually achieved by oral administration, but other routes are possible. Here I describe the uses and characteristic adverse effects of commonly used routes of administration. In this part I deal with intramuscular and subcutaneous injection and in part 2 other routes.","PeriodicalId":39261,"journal":{"name":"Adverse Drug Reaction Bulletin","volume":"&NA; 1","pages":"971–974"},"PeriodicalIF":0.0,"publicationDate":"2008-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/FAD.0b013e328329bb21","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61684409","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 : 2008-08-01DOI: 10.1097/FAD.0b013e32831844cb
N. Gogtay, U. Kulkarni, T. Panchabhai
An increase in the number of immunocompromised hosts has led to an increase in the incidence of fungal infections, predominantly those caused by Candida and Aspergillus spp. The older drugs amphotericin B and flucytosine continue to be used but are associated with major adverse effects such as nephrotoxicity, hepatotoxicity and bone marrow depression, respectively. The older imidazoles used topically for superficial mycoses can produce local reactions. Triazoles as a class can cause hepatotoxicity and are susceptible to drug interactions due to their metabolism by CYP450 enzymes. Visual disturbances and photosensitivity are associated with the use of voriconazole. Echinocandins can provoke infusion-related reactions.
{"title":"Adverse reactions to antifungal agents","authors":"N. Gogtay, U. Kulkarni, T. Panchabhai","doi":"10.1097/FAD.0b013e32831844cb","DOIUrl":"https://doi.org/10.1097/FAD.0b013e32831844cb","url":null,"abstract":"An increase in the number of immunocompromised hosts has led to an increase in the incidence of fungal infections, predominantly those caused by Candida and Aspergillus spp. The older drugs amphotericin B and flucytosine continue to be used but are associated with major adverse effects such as nephrotoxicity, hepatotoxicity and bone marrow depression, respectively. The older imidazoles used topically for superficial mycoses can produce local reactions. Triazoles as a class can cause hepatotoxicity and are susceptible to drug interactions due to their metabolism by CYP450 enzymes. Visual disturbances and photosensitivity are associated with the use of voriconazole. Echinocandins can provoke infusion-related reactions.","PeriodicalId":39261,"journal":{"name":"Adverse Drug Reaction Bulletin","volume":"&NA; 1","pages":"963–966"},"PeriodicalIF":0.0,"publicationDate":"2008-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/FAD.0b013e32831844cb","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61684380","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 : 2008-06-01DOI: 10.1097/FAD.0b013e32830ceb2e
R. Flanagan
All the available evidence must be taken into account when investigating a death if poisoning is suspected. An overall knowledge of the circumstances, time course, clinical/postmortem observations, poisons thought to be involved and their toxicology and metabolism, is important, as well as knowledge of the samples available for analysis and the analytical methods used. Part 1 of this review discussed operational considerations in postmortem toxicology, including the importance of proper sample collection. Some further problems and pitfalls in the interpretation of quantitative data, especially as regards the possibility of postmortem increases in blood concentrations (postmortem redistribution), are outlined in this second part. Despite the problems listed above, toxicological analysis of specimens obtained postmortem can often provide evidence of exposure and sometimes also an estimate of the magnitude of exposure, provided always that interpretation of the analytical results is undertaken with due caution.
{"title":"Interpretation of postmortem toxicology: more complicated than it might seem – Part 2","authors":"R. Flanagan","doi":"10.1097/FAD.0b013e32830ceb2e","DOIUrl":"https://doi.org/10.1097/FAD.0b013e32830ceb2e","url":null,"abstract":"All the available evidence must be taken into account when investigating a death if poisoning is suspected. An overall knowledge of the circumstances, time course, clinical/postmortem observations, poisons thought to be involved and their toxicology and metabolism, is important, as well as knowledge of the samples available for analysis and the analytical methods used. Part 1 of this review discussed operational considerations in postmortem toxicology, including the importance of proper sample collection. Some further problems and pitfalls in the interpretation of quantitative data, especially as regards the possibility of postmortem increases in blood concentrations (postmortem redistribution), are outlined in this second part. Despite the problems listed above, toxicological analysis of specimens obtained postmortem can often provide evidence of exposure and sometimes also an estimate of the magnitude of exposure, provided always that interpretation of the analytical results is undertaken with due caution.","PeriodicalId":39261,"journal":{"name":"Adverse Drug Reaction Bulletin","volume":"95 1","pages":"959–962"},"PeriodicalIF":0.0,"publicationDate":"2008-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/FAD.0b013e32830ceb2e","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61684364","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 : 2008-04-01DOI: 10.1097/FAD.0b013e32830ceaea
R. Flanagan
The aim of postmortem toxicology is to help establish the role that drugs or other poisons played in a death, or in events immediately before death. It was thought that concentrations of poisons measured in blood obtained at autopsy reflected the situation perimortem. However, we now know that interpretation of postmortem toxicology must take into consideration what is known of the clinical pharmacology, including pharmacokinetics, and toxicology of the agent(s) in question, the circumstances under which death occurred, including the possible mechanism(s) of exposure and other factors such as the age of the deceased. Further important considerations include that changes may occur in the composition of body fluids, especially blood, after death.Part 1 of this review discusses operational considerations in postmortem toxicology, including sample collection. Some further problems and pitfalls in the interpretation of quantitative data, especially as regards the possibility of postmortem increases in blood concentrations (postmortem redistribution), are outlined in Part 2.
{"title":"Interpretation of postmortem toxicology: more complicated than it might seem – Part 1","authors":"R. Flanagan","doi":"10.1097/FAD.0b013e32830ceaea","DOIUrl":"https://doi.org/10.1097/FAD.0b013e32830ceaea","url":null,"abstract":"The aim of postmortem toxicology is to help establish the role that drugs or other poisons played in a death, or in events immediately before death. It was thought that concentrations of poisons measured in blood obtained at autopsy reflected the situation perimortem. However, we now know that interpretation of postmortem toxicology must take into consideration what is known of the clinical pharmacology, including pharmacokinetics, and toxicology of the agent(s) in question, the circumstances under which death occurred, including the possible mechanism(s) of exposure and other factors such as the age of the deceased. Further important considerations include that changes may occur in the composition of body fluids, especially blood, after death.Part 1 of this review discusses operational considerations in postmortem toxicology, including sample collection. Some further problems and pitfalls in the interpretation of quantitative data, especially as regards the possibility of postmortem increases in blood concentrations (postmortem redistribution), are outlined in Part 2.","PeriodicalId":39261,"journal":{"name":"Adverse Drug Reaction Bulletin","volume":"&NA; 1","pages":"955–958"},"PeriodicalIF":0.0,"publicationDate":"2008-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/FAD.0b013e32830ceaea","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61684350","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 : 2008-02-01DOI: 10.1097/FAD.0b013e328302c585
K. Baxter, J. Sharp
Drug interactions are numerous and varied, but not always clinically significant. Here we consider those factors that determine whether or not a drug interaction becomes clinically important, and the drugs commonly implicated in interactions.
{"title":"Adverse drug interactions","authors":"K. Baxter, J. Sharp","doi":"10.1097/FAD.0b013e328302c585","DOIUrl":"https://doi.org/10.1097/FAD.0b013e328302c585","url":null,"abstract":"Drug interactions are numerous and varied, but not always clinically significant. Here we consider those factors that determine whether or not a drug interaction becomes clinically important, and the drugs commonly implicated in interactions.","PeriodicalId":39261,"journal":{"name":"Adverse Drug Reaction Bulletin","volume":"&NA; 1","pages":"951–954"},"PeriodicalIF":0.0,"publicationDate":"2008-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/FAD.0b013e328302c585","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61684338","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 : 2007-12-01DOI: 10.1097/FAD.0b013e328300788f
B. Theron, S. Singhal
The armamentarium of drugs used in the treatment of alcohol abuse has grown with newer and novel therapies introduced to improve compliance and adverse effect profiles. There is now a range of treatments particularly aimed at reducing craving and improving abstinence rates, including opioid antagonists (both long-acting and short-acting) and γ-aminobutyric-acid receptor analogues, which have a good evidence base and are reasonably well tolerated.
{"title":"Adverse reactions to drugs used to treat alcoholism","authors":"B. Theron, S. Singhal","doi":"10.1097/FAD.0b013e328300788f","DOIUrl":"https://doi.org/10.1097/FAD.0b013e328300788f","url":null,"abstract":"The armamentarium of drugs used in the treatment of alcohol abuse has grown with newer and novel therapies introduced to improve compliance and adverse effect profiles. There is now a range of treatments particularly aimed at reducing craving and improving abstinence rates, including opioid antagonists (both long-acting and short-acting) and γ-aminobutyric-acid receptor analogues, which have a good evidence base and are reasonably well tolerated.","PeriodicalId":39261,"journal":{"name":"Adverse Drug Reaction Bulletin","volume":"&NA; 1","pages":"947–250"},"PeriodicalIF":0.0,"publicationDate":"2007-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/FAD.0b013e328300788f","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61684281","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 : 2007-10-01DOI: 10.1097/FAD.0b013e3282fe180f
R. L. Branch, U. Martin
Hypertension is a common adverse effect of pregnancy. Angiotensin-converting enzyme inhibitors and angitoensin-II blocking drugs are commonly used, and some mothers may have been taking them when they became pregnant. Both classes of drugs have severe adverse effects on the developing fetus, and this risk occurs throughout pregnancy.
{"title":"Adverse effects of angiotensin-converting enzyme inhibitors and Angiotensin-II receptor blockers in pregnancy","authors":"R. L. Branch, U. Martin","doi":"10.1097/FAD.0b013e3282fe180f","DOIUrl":"https://doi.org/10.1097/FAD.0b013e3282fe180f","url":null,"abstract":"Hypertension is a common adverse effect of pregnancy. Angiotensin-converting enzyme inhibitors and angitoensin-II blocking drugs are commonly used, and some mothers may have been taking them when they became pregnant. Both classes of drugs have severe adverse effects on the developing fetus, and this risk occurs throughout pregnancy.","PeriodicalId":39261,"journal":{"name":"Adverse Drug Reaction Bulletin","volume":"&NA; 1","pages":"943–946"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/FAD.0b013e3282fe180f","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61684269","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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