Delayed Onset of Central Diabetes Insipidus With Ketamine Sedation: A Report of 2 Cases

2019 ◽  
pp. 089719001988226 ◽  
Author(s):  
Leah B. Herity ◽  
Cassandra Baker ◽  
Christin Kim ◽  
Denise K. Lowe ◽  
William D. Cahoon
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Adverse Effects ◽  
Diabetes Insipidus ◽  
Drug Effect ◽  
Laboratory Data ◽  
Multimodal Analgesia ◽  
Central Diabetes Insipidus ◽  
Probability Scale ◽  
Delayed Onset

Ketamine is being prescribed with greater frequency due to an emphasis on multimodal analgesia. With increasing use, uncommon adverse effects associated with ketamine are likely to surface. Limited reports of transient central diabetes insipidus (DI) occurring early after initiation (ie, within 10 hours) of ketamine have been reported. We present 2 cases of delayed onset (32 hours or more after initiation), ketamine-induced, transient central DI in patients cannulated for venovenous extracorporeal membranous oxygenation. No other causes of central DI were determined based upon physical examination or laboratory data, and both patients responded to treatment with desmopressin/vasopressin. The Naranjo adverse drug reaction probability scale noted a probable causation for each case. These cases demonstrate the possibility of a rare but serious complication of ketamine. Improvement after discontinuation of ketamine and administration of desmopressin/vasopressin appear to support a drug–effect association.

Mirtazapine-Induced Pancreatitis—A Case Report

2018 ◽  
Vol 32 (5) ◽  
pp. 586-588 ◽  
Author(s):  
Riley D. Bowers ◽  
Sara M. Valanejad ◽  
Ashley A. Holombo
Keyword(s):  
Emergency Department ◽  
Adverse Drug Reaction ◽  
Acute Pancreatitis ◽  
Drug Reaction ◽  
Insulin Infusion ◽  
Serum Triglyceride ◽  
African American Female ◽  
Converting Enzyme ◽  
Probability Scale ◽  
Recent Alcohol Use

Acute pancreatitis has numerous etiologies, with the most common including gallstones, alcohol abuse, and medications such as angiotensin-converting enzyme (ACE) inhibitors, statins, and diuretics. Mirtazapine has been associated with increased serum cholesterol and serum triglyceride levels. However, few studies have reported dangerously elevated triglyceride levels resulting in acute pancreatitis. This report discusses a case of mirtazapine-induced pancreatitis in a 46-year-old African American female. The patient presented to the emergency department with pancreatitis, presumably alcohol-induced as with a prior admission, but she denied any recent alcohol use. Mirtazapine then became the suspected cause of her hypertriglyceridemia-induced pancreatitis and was discontinued. After discontinuing mirtazapine, and utilizing an insulin infusion, her triglyceride levels normalized and symptoms of pancreatitis resolved. Using the Naranjo Adverse Drug Reaction Probability Scale, a total score of 5 was calculated indicating a probable adverse drug reaction of acute pancreatitis from mirtazapine.

Severe Tachycardia Following Low-Dose Clozapine Treatment

2005 ◽  
Vol 13 (1) ◽  
pp. 80-82 ◽  
Author(s):  
Hans Stampfer ◽  
Peter Swanepoel
Keyword(s):  
Heart Rate ◽  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Case Report ◽  
Low Dose ◽  
Reaction Probability ◽  
Probability Scale ◽  
Clozapine Treatment ◽  
Probable Relationship ◽  
Clinical Detection

Objective: To reporta case of severe and sustained tachycardia that developed asymptomatically on a low dose of clozapine (ISO mg daily). Method: Case report. Results: Serially monitored 24 h heart rate after the introduction of clozapine showed an increase in the 24 h mean from 87 to 126 bpm, a reduction of pulse variability and anomalies in sleep-wake regulation. Cessation of clozapine was followed by a rapid return to preclozapine activity. Application of the Naranjo Adverse Drug Reaction Probability Scale indicated a probable relationship between clozapine and the sustained tachycardia. Conclusions: Severe and sustained tachycardia can develop asymptomatically with a relatively low dose of clozapine and a slow titration rate. The severity of the tachycardia may not be revealed in isolated pulse measurements and may escape clinical detection without closer monitoring of heart rate.

Drug-induced neurological disease

2018 ◽  
Author(s):  
Robin Ferner ◽  
Anthony Cox
Keyword(s):  
Adverse Drug Reaction ◽  
Nervous System ◽  
Drug Reaction ◽  
Adverse Effects ◽  
Adverse Drug Reactions ◽  
Neurological Disease ◽  
Specific Treatment ◽  
Vascular Diseases ◽  
Drug Reactions ◽  
Drug Induced

An adverse drug reaction is defined as ‘an appreciably harmful or unpleasant reaction, resulting from an intervention related to the use of a medicinal product; adverse effects usually predict hazard from future administration and warrant prevention, or specific treatment, or alteration of the dosage regimen, or withdrawal of the product’ (p. 1255, Edwards IR and Aronson JK. Adverse drug reactions: Definitions, diagnosis, and management. Lancet 2000; 356: 1255–9). Adverse drug reactions can cause or contribute to central and peripheral nervous system disorders, including traumatic, infective, neoplastic, demyelinating, and vascular diseases.

Evaluation of the Reproducibility of the Naranjo Adverse Drug Reaction Probability Scale Score in Published Case Reports

2014 ◽  
Vol 34 (11) ◽  
pp. 1159-1166 ◽  
Author(s):  
Ruby Liang ◽  
Bjug Borgundvaag ◽  
Mark McIntyre ◽  
Crystal Thwaites ◽  
Kelsey Ragan ◽  
...  
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Scale Score ◽  
Case Reports ◽  
Reaction Probability ◽  
Probability Scale

Adverse drug reaction and its management in tuberculosis patients with multidrug resistance: a retrospective study

2021 ◽  
Vol 32 (4) ◽  
pp. 783-787
Author(s):  
Wenny Putri Nilamsari ◽  
Muhammad Fajar Rizqi ◽  
Natasya Olga Regina ◽  
Prastuti Asta Wulaningrum ◽  
Umi Fatmawati
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Adverse Effects ◽  
Adverse Drug Reactions ◽  
Multidrug Resistant ◽  
Small Samples ◽  
Drug Reactions ◽  
Outpatient Unit ◽  
Resistant Tuberculosis ◽  
Mdr Tb

Abstract Objectives This study was conducted to assess adverse drug reactions and their management in MDR-TB patients. Indonesia is the fifth highest country with multidrug-resistant tuberculosis (MDR-TB) high burden around the world. The number of MDR-TB patients in Indonesia is increasing every year, but the data regarding ADRs are still limited. Therefore, more data on their characteristics and their management is very valuable for clinicians and pharmacists. Methods The study is a descriptive study, using retrospective data of MDR-TB patients who completed therapy from January 1st, 2015 to December 31st, 2015 at the Tuberculosis Outpatient unit at the Dr. Soetomo Teaching Hospital Indonesia. Each adverse effect was judged with standards of the clinic and was documented in patients’ medical records. Results There were 40 patients included in this study. During therapy, 70% of patients developed at least one adverse drug reaction. The five most prevalent adverse effects found in this study were hyperuricemia (52.5%) followed by gastrointestinal (GI) disturbances (40%), ototoxicity (37.5%), hypokalemia (27.5%), and athralgia (12.5%). Managements that were undertaken to overcome the adverse drug reactions were adding symptomatic drugs and/or modifying the treatment regimen. Conclusions Because of the small samples we cannot attain a general conclusion. However, the result of this study is very imperative as this data gives us insight regarding adverse effects in MDR-TB patients in Indonesia.

scholarly journals Epileptic Convulsions Probably Induced by Desloratadine, a Second-Generation H1-Antihistamine

2020 ◽  
Author(s):  
Xiaonian Han ◽  
Xin Zan ◽  
Fengmei Xiong ◽  
Xiaojing Nie ◽  
Lirong Peng
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Drug Therapy ◽  
Side Effects ◽  
Second Generation ◽  
Healthy Children ◽  
Probability Scale ◽  
H1 Antihistamines ◽  
History Of ◽  
History Of Epilepsy

Second-generation H1-antihistamines are generally considered to be safe. Here we describe a healthy boy who developed left-arm convulsions after repeated exposure to a dry suspension of desloratadine combined with Huatengzi granules. The boy had no family or disease history of epilepsy, convulsions, or any other drug therapy. The Naranjo Adverse Drug Reaction Probability Scale was used to determine that the convulsions were probably related to desloratadine. Our findings suggest that desloratadine (a second-generation H1-antihistamine) can cause epileptic convulsions in healthy children, and so clinicians should be vigilant of the possibility of central side effects.

scholarly journals Study of adverse drug reaction and causality assessment of antidiabetic drugs

2018 ◽  
Vol 8 (1) ◽  
pp. 56
Author(s):  
Shanthi M. ◽  
Madhavrao C.
Keyword(s):  
Adverse Effect ◽  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Adverse Effects ◽  
Tertiary Care ◽  
Antidiabetic Drugs ◽  
Care Hospital ◽  
Drug Adverse Effects ◽  
Relationship Of ◽  
Effects Assessment

Background: Study about adverse drug reaction of antidiabetic drugs helps in ensuring maximum benefits of drug therapy.Methods: An observational study was carried out in patients attending tertiary care hospital in Kanyakumari district from August 2013 to August 2014. Adverse drug reactions due to the use of antidiabetic drugs were collected and adverse effects experienced by the patient was assessed using WHO scale, Naranjo scale, Schumock and Thornton scale and Hartwig and Siegel scale.Results: In this prospective study a total of 76 adverse events (41 male and 35 female) were identified. Most frequently observed adverse effect were hypoglycaemia and the less observed were pruritis. Maximum of 14 adverse effect were observed due to use of insulin. Combination of sulphonylurea and biguanides caused 28 adverse effects. Assessment of adverse effect using WHO scale showed 64% as probable, 16% possible, 7% conditional, 5% unclassifiable, 4% certain, and 4% unlikely. Relationship of adverse reaction to antidiabetic drugs using Naranjo scale showed 92% possibly, 5% probably and 3% as definite. Antidiabetic drug adverse effects were not preventable in 63%, definitely preventable in 19% and probably preventable in 18% as per modified Schumock and Thornton scale. Severity assessment of adverse effects were mild in 75%, moderate in 25% and no severe reactions according to modified Hartwig and Siegel scale.Conclusions: Adverse effect most commonly encountered during the study period were predictable, definitely preventable and without serious effects. Majority of the reactions were due to combination of antidiabetic drugs.

Lisinopril-Induced Alopecia: A Case Report

2016 ◽  
Vol 30 (5) ◽  
pp. 562-566 ◽  
Author(s):  
Vivek Kataria ◽  
Hueyyoung Wang ◽  
Joyce W. Wald ◽  
Yvonne L. Phan
Keyword(s):  
Heart Failure ◽  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Ace Inhibitors ◽  
American Heart ◽  
Causality Assessment ◽  
Heart Association ◽  
Probability Scale ◽  
Heart Failure Clinic ◽  
New Onset

The American College of Cardiology Foundation/American Heart Association (ACCF/AHA) guidelines consider angiotensin-converting enzyme (ACE) inhibitors as one of the mainstay therapies in the management of heart failure. The widespread use of ACE inhibitors has been associated with several notable adverse effects such as hyperkalemia and an increased serum creatinine. There are no previous reports of alopecia associated with lisinopril use; however, a few previous cases of alopecia associated with other ACE inhibitors exist. This report discusses a case of lisinopril-induced alopecia of a 53-year-old male presenting to our outpatient heart failure clinic with a chief complaint of a new onset of alopecia. Upon evaluation, it was suspected that the patient’s alopecia was likely medication induced by lisinopril; therefore, lisinopril was discontinued and switched to an angiotensin receptor blocker (ARB), losartan potassium. Alopecia resolved in 4 weeks after the therapeutic intervention. Our report suggests that the patient likely experienced a medication-induced alopecia, which was successfully resolved through proper identification and removal of the causative agent. Causality assessment between lisinopril and alopecia was determined using the Naranjo Adverse Drug Reaction Probability Scale—a total score of 6 was achieved and thus identified the adverse drug reaction as probable. Clinicians should be aware of the possibility that lisinopril may be an offending agent in a patient with unexplained alopecia.

scholarly journals ADVERSE DRUG REACTION MONITORING OF FLUCONAZOLE IN A TERTIARY CARE HOSPITAL

2020 ◽  
Vol 9 (5) ◽  
Author(s):  
Gomathi .A ◽  
Sudha.K. M
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Liver Function ◽  
Adverse Effects ◽  
Causality Assessment ◽  
Tertiary Care ◽  
Assessment Scale ◽  
Care Hospital ◽  
Severity Assessment ◽  
Serum Transaminases

Objective: To study the incidence and pattern of adverse effects of Antifungal drug Fluconazole and to assess the severity of its adverse effects. Methodology:  The study was approved by Institutional ethics committee and informed consent was obtained from all willing participants. Patients fulfilling inclusion and exclusion criteria were enrolled. Age sex, diagnosis, dose and duration of treatment were recorded. 2ml of blood was collected for liver function test. The adverse drug reaction (ADR) was documented. The causality assessment was done by WHO assessment scale and severity assessment by using modified Hartwig severity assessment scale. Results: In this study, most of the patients were in 31-40 years age group. Among the 100 patients who were on Fluconazole 58 developed adverse drug reactions. 64 percentage of ADRs were reported in patients with treatment duration of more than 12 weeks. The most common adverse drug effect documented was abdominal pain followed by headache. Increase in serum transaminases was noted in 7 percentage of patients who were taking Fluconazole for more than 12 weeks, which did not require treatment termination or dosage alteration. Most of the ADRs were in possible category of causality assessment scale. In severity assessment most of the ADRs were in mild category. Conclusion: Adverse drug reaction to Fluconazole was mostly noted in patients who were on treatment for more than12 weeks of which elevated serum transaminases were observed in 8 patients. Hence regular liver function monitoring is advised in all patients receiving Fluconazole for more than 12 weeks to prevent further liver damage. Keywords: Adverse drug reaction, Fluconazole

Sign in / Sign up

Export Citation Format

Share Document