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.
{"title":"Stimulant pharmacotherapy for adults with attention deficit hyperactivity disorder: cardiovascular effects and risk of sudden cardiac death","authors":"M. Pucci","doi":"10.1097/FAD.0000000000000019","DOIUrl":"https://doi.org/10.1097/FAD.0000000000000019","url":null,"abstract":"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.","PeriodicalId":39261,"journal":{"name":"Adverse Drug Reaction Bulletin","volume":"299 1","pages":"1155–1158"},"PeriodicalIF":0.0,"publicationDate":"2016-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/FAD.0000000000000019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61684650","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}
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.
{"title":"Drugs that lower the seizure threshold","authors":"Andrew W. Hitchings","doi":"10.1097/FAD.0000000000000016","DOIUrl":"https://doi.org/10.1097/FAD.0000000000000016","url":null,"abstract":"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.","PeriodicalId":39261,"journal":{"name":"Adverse Drug Reaction Bulletin","volume":"298 1","pages":"1151–1154"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/FAD.0000000000000016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61684639","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}
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.
{"title":"Adverse reactions to intravenous acetylcysteine in paracetamol poisoning","authors":"E. Sandilands, E. Morrison, D. Bateman","doi":"10.1097/FAD.0000000000000015","DOIUrl":"https://doi.org/10.1097/FAD.0000000000000015","url":null,"abstract":"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.","PeriodicalId":39261,"journal":{"name":"Adverse Drug Reaction Bulletin","volume":"297 1","pages":"1147–1150"},"PeriodicalIF":0.0,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/FAD.0000000000000015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61684629","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}
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.
{"title":"Ulceration from nicorandil","authors":"R. Ferner","doi":"10.1097/FAD.0000000000000014","DOIUrl":"https://doi.org/10.1097/FAD.0000000000000014","url":null,"abstract":"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.","PeriodicalId":39261,"journal":{"name":"Adverse Drug Reaction Bulletin","volume":"2017 1","pages":"1143–1146"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/FAD.0000000000000014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61684589","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}
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.
{"title":"Addressing DRESS (drug reaction with eosinophilia and systemic symptoms)","authors":"Catherine M. McGrath, Karamjit Khangura","doi":"10.1097/FAD.0000000000000013","DOIUrl":"https://doi.org/10.1097/FAD.0000000000000013","url":null,"abstract":"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.","PeriodicalId":39261,"journal":{"name":"Adverse Drug Reaction Bulletin","volume":"295 1","pages":"1139–1142"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/FAD.0000000000000013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61684582","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}
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.
{"title":"Safe prescribing in the autosomal dominant acute porphyrias: a practical approach: Part II","authors":"Cerys D. Lockett, M. Badminton","doi":"10.1097/fad.0000000000000012","DOIUrl":"https://doi.org/10.1097/fad.0000000000000012","url":null,"abstract":"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.","PeriodicalId":39261,"journal":{"name":"Adverse Drug Reaction Bulletin","volume":"294 1","pages":"1135–1138"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/fad.0000000000000012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61684569","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}
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.
{"title":"Safe prescribing in the autosomal dominant acute porphyrias: a practical approach: Part I","authors":"Cerys D. Lockett, M. Badminton","doi":"10.1097/FAD.0000000000000011","DOIUrl":"https://doi.org/10.1097/FAD.0000000000000011","url":null,"abstract":"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.","PeriodicalId":39261,"journal":{"name":"Adverse Drug Reaction Bulletin","volume":"293 1","pages":"1131–1134"},"PeriodicalIF":0.0,"publicationDate":"2015-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/FAD.0000000000000011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61684524","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}
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.
{"title":"Blood pressure-lowering medication and erectile dysfunction: are the drugs to blame?","authors":"M. Pucci, Rikesh Patel","doi":"10.1097/FAD.0000000000000010","DOIUrl":"https://doi.org/10.1097/FAD.0000000000000010","url":null,"abstract":"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.","PeriodicalId":39261,"journal":{"name":"Adverse Drug Reaction Bulletin","volume":"292 1","pages":"1127–1130"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/FAD.0000000000000010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61684508","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}
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.
{"title":"Adverse reactions to anticholinergic agents used in the management of obstructive pulmonary disease","authors":"Christopher M. Jones, Lucy M.R. Nell","doi":"10.1097/FAD.0000000000000009","DOIUrl":"https://doi.org/10.1097/FAD.0000000000000009","url":null,"abstract":"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.","PeriodicalId":39261,"journal":{"name":"Adverse Drug Reaction Bulletin","volume":"291 1","pages":"1123–1126"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/FAD.0000000000000009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61684454","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}
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.
{"title":"Photosensitivity reactions and skin tumours associated with voriconazole","authors":"J. Aronson","doi":"10.1097/FAD.0000000000000008","DOIUrl":"https://doi.org/10.1097/FAD.0000000000000008","url":null,"abstract":"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.","PeriodicalId":39261,"journal":{"name":"Adverse Drug Reaction Bulletin","volume":"290 1","pages":"1119–1122"},"PeriodicalIF":0.0,"publicationDate":"2015-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/FAD.0000000000000008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61684429","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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