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Adverse Drug Reaction Bulletin最新文献

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Stimulant pharmacotherapy for adults with attention deficit hyperactivity disorder: cardiovascular effects and risk of sudden cardiac death 成人注意缺陷多动障碍的兴奋剂药物治疗:心血管效应和心源性猝死的风险
Q4 Medicine Pub Date : 2016-08-01 DOI: 10.1097/FAD.0000000000000019
M. Pucci
SummaryDrugs for attention deficit hyperactivity disorder are increasingly being used in adults. There have been concerns about the cardiovascular safety of stimulant attention deficit hyperactivity disorder drugs. Overall, studies in adults have shown small but statistically significant increases in heart rate and DBP and SBP, but have been relatively short term. Epidemiological studies have not clearly demonstrated an increased risk of sudden cardiac death, but a small increase in the risk cannot be ruled out.
治疗注意力缺陷多动障碍的药物越来越多地被用于成人。人们一直担心兴奋剂治疗注意力缺陷多动障碍药物的心血管安全性。总体而言,对成人的研究显示,心率、舒张压和收缩压的增加幅度不大,但在统计学上有显著意义,但时间相对较短。流行病学研究尚未明确表明心脏性猝死风险增加,但不能排除风险小幅增加的可能性。
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引用次数: 1
Drugs that lower the seizure threshold 降低癫痫发作阈值的药物
Q4 Medicine Pub Date : 2016-06-01 DOI: 10.1097/FAD.0000000000000016
Andrew W. Hitchings
SummaryDrugs with potential to lower the seizure threshold are numerous and diverse. Whether they contribute to clinically overt seizures depends on the dosage in which they are taken, the time-course of their effects and the susceptibility of the patient. Crucially, however, their contribution to seizure risk is potentially modifiable.
具有降低癫痫发作阈值潜力的药物种类繁多。它们是否会导致临床上明显的癫痫发作取决于它们的服用剂量、作用的时间过程和患者的易感性。然而,至关重要的是,它们对癫痫发作风险的贡献是可以改变的。
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引用次数: 14
Adverse reactions to intravenous acetylcysteine in paracetamol poisoning 乙酰半胱氨酸静脉注射治疗扑热息痛中毒的不良反应
Q4 Medicine Pub Date : 2016-04-01 DOI: 10.1097/FAD.0000000000000015
E. Sandilands, E. Morrison, D. Bateman
SummaryIntravenous acetylcysteine is used for the management of paracetamol overdose worldwide. Recently, there has been increasing recognition of its adverse effects. This article reviews the features of these reactions, the factors that affect their frequency, and ways to reduce their frequency and severity.
在世界范围内,静脉注射乙酰半胱氨酸用于治疗扑热息痛过量。最近,人们越来越认识到它的副作用。本文回顾了这些反应的特点,影响其发生频率的因素,以及减少其发生频率和严重程度的方法。
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引用次数: 2
Ulceration from nicorandil 尼可地尔引起的溃疡
Q4 Medicine Pub Date : 2016-02-01 DOI: 10.1097/FAD.0000000000000014
R. Ferner
SummaryNicorandil is a vasodilator used to treat symptoms of angina pectoris. It is associated with painful ulceration of the skin and mucous membranes in the mouth, gastrointestinal tract, genital tract, and eye. The ulcers do not heal unless the drug is withdrawn or the dosage is at least reduced.
尼可地尔是一种用于治疗心绞痛症状的血管扩张剂。它与口腔、胃肠道、生殖道和眼睛的皮肤和粘膜的疼痛性溃疡有关。除非停药或至少减少剂量,否则溃疡不会愈合。
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引用次数: 1
Addressing DRESS (drug reaction with eosinophilia and systemic symptoms) 解决DRESS(伴嗜酸性粒细胞增多和全身症状的药物反应)
Q4 Medicine Pub Date : 2015-12-01 DOI: 10.1097/FAD.0000000000000013
Catherine M. McGrath, Karamjit Khangura
SummaryThe syndrome of drug reaction with eosinophilia and systemic symptoms (DRESS) is the manifestation of a severe idiosyncratic drug-induced reaction with variable latency period. DRESS occurs in one in 1000 to one in 10 000 of drug exposures with high rates of long-term sequelae and mortality of around 10%. There are several classes of drugs historically associated with DRESS – aromatic antiepileptics such as carbamazepine and related compounds, nonsteroidal anti-inflammatory drugs, antiretroviral drugs and antibiotics as well as drugs such as sulfasalazine, allopurinol and dapsone. There is growing recognition of the role of genetic predisposition. Implicated alleles can sometimes be used for predrug screening. DRESS can be associated with reactivation of human herpes viruses, which may be important in a prolonged and severe disease course. Prompt recognition of DRESS, withdrawal of the suspect drug under clinical supervision and supportive care are vital.
药物反应伴嗜酸性粒细胞增多及全身症状综合征(DRESS)是一种具有可变潜伏期的严重特异性药物反应的表现。药物接触者中有千分之一至万分之一发生DRESS,长期后遗症发生率高,死亡率约为10%。历史上有几类药物与DRESS -芳香族抗癫痫药有关,如卡马西平及相关化合物、非甾体抗炎药、抗逆转录病毒药物和抗生素,以及磺胺氮嗪、别嘌呤醇和氨苯砜等药物。人们越来越认识到遗传易感性的作用。牵连等位基因有时可用于药物前筛选。DRESS可能与人类疱疹病毒的再激活有关,这在长期和严重的疾病过程中可能很重要。及时识别DRESS,在临床监督下停用可疑药物和支持性护理至关重要。
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引用次数: 4
Safe prescribing in the autosomal dominant acute porphyrias: a practical approach: Part II 常染色体显性急性卟啉症的安全处方:一种实用方法:第二部分
Q4 Medicine Pub Date : 2015-10-01 DOI: 10.1097/fad.0000000000000012
Cerys D. Lockett, M. Badminton
SummaryThe autosomal dominant acute hepatic porphyrias – principally acute intermittent porphyria, variegate porphyria, and hereditary coproporphyria – can present with potentially fatal acute neurological crisis as a consequence of exposure to various precipitants including legal and illegal drugs. Part 1 of this review covered the assessment of drugs’ porphyinogenicity and described grading systems that are in use worldwide. Part 2 covers the complex safety assessments that should be undertaken when deciding whether drug treatment is appropriate or not. A clinical porphyria specialist can provide help in these circumstances.
常染色体显性急性肝性卟啉症——主要是急性间歇性卟啉症、多样性卟啉症和遗传性比例卟啉症——由于暴露于包括合法和非法药物在内的各种沉淀剂,可呈现潜在致命的急性神经危象。本综述的第1部分涵盖了药物致卟啉性的评估,并描述了世界范围内使用的分级系统。第2部分涵盖了在决定药物治疗是否适当时应进行的复杂安全性评估。在这种情况下,临床卟啉症专家可以提供帮助。
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引用次数: 0
Safe prescribing in the autosomal dominant acute porphyrias: a practical approach: Part I 常染色体显性急性卟啉症的安全处方:一种实用方法:第一部分
Q4 Medicine Pub Date : 2015-08-01 DOI: 10.1097/FAD.0000000000000011
Cerys D. Lockett, M. Badminton
SummaryThe autosomal dominant acute hepatic porphyrias – principally acute intermittent porphyria, variegate porphyria, and hereditary coproporphyria – can present with potentially fatal acute neurological crisis as a consequence of exposure to various precipitants including legal and illegal drugs. Information from clinical experience, and animal and cell culture experiments as well as pharmacological assessment is used to predict the likelihood that a drug may trigger an acute attack and whether it should be avoided. European specialist services have agreed a common approach, with the development of a searchable drug database, that classifies risk according to standard categories. It is usually possible to choose a well tolerated drug, but there remain situations in which a drug is required for which safety data are absent or conflicting; there are also rare circumstances wherein the clinical benefit of using an unsafe medication in a porphyria patient outweighs the risk. A clinical porphyria specialist can provide help in these circumstances.
常染色体显性急性肝性卟啉症——主要是急性间歇性卟啉症、多样性卟啉症和遗传性比例卟啉症——由于暴露于包括合法和非法药物在内的各种沉淀剂,可呈现潜在致命的急性神经危象。来自临床经验、动物和细胞培养实验以及药理学评估的信息用于预测药物可能引发急性发作的可能性以及是否应避免使用。欧洲专家服务部门已经同意了一种共同的方法,即开发一个可搜索的药物数据库,根据标准类别对风险进行分类。通常可以选择一种耐受性良好的药物,但仍然存在安全性数据缺失或相互矛盾的情况;在罕见的情况下,在卟啉症患者中使用不安全药物的临床益处超过了风险。在这种情况下,临床卟啉症专家可以提供帮助。
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引用次数: 0
Blood pressure-lowering medication and erectile dysfunction: are the drugs to blame? 降压药和勃起功能障碍:是药物造成的吗?
Q4 Medicine Pub Date : 2015-06-01 DOI: 10.1097/FAD.0000000000000010
M. Pucci, Rikesh Patel
SummaryErectile dysfunction is very common in hypertensive men and is often attributed to blood pressure-lowering medication. Antihypertensive agents differ in their impact on erectile function. There is little good evidence. Published work suggests that angiotensin receptor antagonists and the highly selective &bgr;1-blocker nebivolol have a neutral or even beneficial effect on erectile function.
勃起功能障碍在高血压男性中很常见,通常归因于降血压药物。降压药对勃起功能的影响不同。几乎没有好的证据。已发表的研究表明,血管紧张素受体拮抗剂和高选择性受体阻滞剂奈比洛尔对勃起功能的作用是中性的,甚至是有益的。
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引用次数: 0
Adverse reactions to anticholinergic agents used in the management of obstructive pulmonary disease 抗胆碱能药物治疗阻塞性肺疾病的不良反应
Q4 Medicine Pub Date : 2015-04-01 DOI: 10.1097/FAD.0000000000000009
Christopher M. Jones, Lucy M.R. Nell
SummaryMuscarinic acetylcholine receptor antagonists are widely used in the management of obstructive airways disease. There nevertheless exists only limited evidence that these receptor antagonists improve prognosis and their use is complicated by systemic adverse reactions affecting many organ systems. Contemporary anticholinergic agents cause fewer adverse reactions and have lower systemic bioavailability than their predecessors, yet their use may be associated with increased cardiovascular morbidity and mortality.
毒蕈碱类乙酰胆碱受体拮抗剂广泛应用于阻塞性气道疾病的治疗。然而,只有有限的证据表明这些受体拮抗剂可以改善预后,并且它们的使用因影响许多器官系统的全身不良反应而复杂化。当代的抗胆碱能药物引起的不良反应较少,其系统生物利用度也低于其前身,但其使用可能与心血管发病率和死亡率的增加有关。
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引用次数: 0
Photosensitivity reactions and skin tumours associated with voriconazole 伏立康唑相关的光敏反应和皮肤肿瘤
Q4 Medicine Pub Date : 2015-02-01 DOI: 10.1097/FAD.0000000000000008
J. Aronson
SummaryUse of voriconazole, a triazole antifungal drug, has often been associated with photosensitivity, and this adverse reaction has been linked to a risk of tumours in light-exposed areas, especially squamous cell carcinomas, but also melanomas. The mechanisms by which voriconazole causes these effects are not clear, but susceptibility factors for a predisposition to skin cancers include duration of use, immunosuppression, ultraviolet (UV) exposure, advanced age, and skin type. Voriconazole should be used carefully, particularly in patients with susceptibility factors for skin cancer. If prolonged voriconazole therapy is required, it is advisable to have frequent diligent skin examinations, to avoid excess sunlight, and to use UV protectants liberally.
伏立康唑(一种三唑类抗真菌药物)的使用通常与光敏性有关,这种不良反应与暴露于光区的肿瘤风险有关,尤其是鳞状细胞癌,但也与黑色素瘤有关。伏立康唑引起这些作用的机制尚不清楚,但易患皮肤癌的易感因素包括使用时间、免疫抑制、紫外线暴露、高龄和皮肤类型。伏立康唑应谨慎使用,特别是有皮肤癌易感因素的患者。如果需要长期伏立康唑治疗,建议经常进行勤奋的皮肤检查,避免过度的阳光照射,并大量使用紫外线保护剂。
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引用次数: 0
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Adverse Drug Reaction Bulletin
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