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Life-Threatening Drug-Induced Rashes

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21. Refractory extrapulmonary sarcoidosis: infliximab

and the organs involved depending on the ethnicity of the person. Treatment is not recommended for everyone because of the high rate of spontaneous remission and the risk of adverse effects. The treatment decision is usually based on symptoms, the extent of symptomatic disease, whether the sarcoidosis is acute or chronic, and the risk of life-threatening complications. First-line treatment is usually with corticosteroids such as prednisolone. T opical corticosteroid creams and eye drops may be effective (...) experienced no recurrence of symptoms during the follow-up period of 4–42 months. Infliximab was discontinued in 1 patient due to drug- induced lupus, which resolved after treatment was stopped. The other 8 patients experienced no major adverse effects. Van Rijswijk et al. 2013 Retrospective case review in the Netherlands (n=45, main indication extrapulmonary sarcoidosis in 22 patients). After receiving infliximab, 2 patients with cardiac sarcoidosis experienced an improvement in left ventricular ejection

2017 National Institute for Health and Clinical Excellence - Advice

24. Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults: an AUA/SUFU Guideline

and bladder ultrasound should not be used in the initial workup of the uncomplicated patient. Clinical Principle 4. OAB is not a disease; it is a symptom complex that generally is not a life- threatening condition. After assessment has been performed to exclude conditions requiring treatment and counseling, no treatment is an acceptable choice made by some patients and caregivers. Expert Opinion 5. Clinicians should provide education to patients regarding normal lower urinary tract function, what is known (...) shifts during periods of postural changes. A rectal/ genitourinary exam to rule out pelvic floor disorders (e.g., pelvic floor muscle spasticity, pain, pelvic organ prolapse) in females and prostatic pathology in males should be performed. In menopausal females, atrophic vaginitis should be assessed as a possible contributing factor to incontinence symptoms. The examiner should assess for perineal skin for rash or breakdown. The examiner also should assess perineal sensation, rectal sphincter tone

2019 American Urological Association

25. Appropriate prescribing of psychotropic medication for non-cognitive symptoms in people with dementia

. The assessment needs to be performed by a nurse or doctor who is competent in assessing a person with dementia who may be distressed. 2 The presence of evident, real or substantial risk or harm. 3 Please refer to glossary for definitions of Parkinson’s disease dementia and dementia with Lewy bodies. Extreme caution is required in prescribing antipsychotics to a person with dementia with Lewy bodies, as they can have life-threatening adverse reactions to antipsychotic medications. 4 Please refer to glossary (...) , Parkinson’s disease dementia, and dementia with Lewy bodies, but it is NOT recommended to be prescribed solely for the treatment of non-cognitive symptoms in a person with dementia. 3 Please refer to glossary for definitions of Parkinson’s disease dementia and dementia with Lewy bodies. Extreme caution is required in prescribing antipsychotics to a person with dementia with Lewy bodies, as they can have life-threatening adverse reactions to antipsychotic medications. 4 Please refer to glossary

2019 National Clinical Guidelines (Ireland)

26. Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults

. At the clinician's discretion, a urine culture and/or post-void residual assessment may be performed and information from bladder diaries and/or symptom questionnaires may be obtained. Clinical Principle 3. Urodynamics, cystoscopy and diagnostic renal and bladder ultrasound should not be used in the initial workup of the uncomplicated patient. Clinical Principle 4. OAB is not a disease; it is a symptom complex that generally is not a life-threatening condition. After assessment has been performed to exclude (...) . Guideline Statement 4 OAB is not a disease; it is a symptom complex that generally is not a life-threatening condition. After assessment has been performed to exclude conditions requiring treatment and counseling, no treatment is an acceptable choice made by some patients and caregivers. Expert Opinion × Discussion Initiating treatment for OAB generally presumes that the patient can perceive an improvement in his or her QOL. In patients who cannot perceive symptom improvements, treatment may

2019 American Urological Association

27. British Association of Dermatologists guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in children and young people Full Text available with Trip Pro

of diagnostic uncertainty, a skin biopsy or frozen section of a blister roof will identify the plane of cleavage (intraepidermal cleavage for SSSS; subepidermal cleavage for SJS/TEN). Performing a biopsy to exclude immunobullous disorders is rarely necessary in children, but these disorders should be considered, as they may be lifethreatening, can have a similar plane of cleavage, and require different treatment strategies compared with SJS/TEN (Table ). In post‐transplant children, the TEN associated (...) with acute graft‐versus‐host disease (GVHD) can appear identical to druginduced TEN, but differentiation is crucial in this population because they are managed differently. Erythema multiforme is regarded as a reactive mucocutaneous disorder that is distinct from SJS/TEN. It is usually precipitated by infection and characterized by typical target lesions that start on acral surfaces and progress proximally. Erythema multiforme major (EMM) is typically accompanied by mucosal erosions and ulceration

2019 British Association of Dermatologists

31. Erectile Dysfunction

not complain of loss of libido. Drug-induced erectile dysfunction - many commonly used drugs can cause or contribute to erectile dysfunction. (Table 3) Table 3: Drugs associated with erectile dysfunction Drug class Examples Diuretics Thiazides, spironolactone Antihypertensives Methyldopa, clonidine, beta-blockers*, calcium channel blockers Fibrates Clofibrate, gemfibrozil Antipsychotics Chlorpromazine, haloperidol, risperidone, olanzapine Antidepressants Tricyclics, monoamine oxidase inhibitors , selective (...) arrhythmias Poor control or recent emergence of symptoms of potentially contributing conditions (e.g. diabetes, hypertension) Medication therapy which has the potential to cause or exacerbate erectile dysfunction (Table 3).There is a strong temporal relationship between starting a drug and appearance of ED. If this relationship is not evident (eg. no medication changes in several months prior to emergence of ED), ED is unlikely to be medication-induced. Consider making a recommendation to the doctor

2018 medSask

34. Treatment for Bipolar Disorder in Adults: A Systematic Review

compared to other antipsychotics. Participants using olanzapine reported more clinically significant weight gain. Participants using carbamazepine reported more severe rash and number of adverse events compared to placebo. For psychosocial interventions, cognitive behavioral training (CBT) was no better for depression or mania symptoms than psychoeducation or other active psychosocial comparators (low-strength evidence). Systematic/collaborative care had no effect on relapse compared to inactive

2018 Effective Health Care Program (AHRQ)

35. Drug Therapy for Early Rheumatoid Arthritis: A Systematic Review Update

-to-target strategy with initial MTX and later combination DMARD treatment • One trial of TCZ plus MTX versus TCZ • One trial of TCZ plus MTX versus MTX • One trial of ETN plus MTX versus MTX • One trial of csDMARD combination therapy versus csDMARD monotherapy • One single-arm study of golimumab. a New medications that FDA has approved since the prior report b Sharp-van der Heijde method for scoring radiographs c As defined by FDA: Life-threatening, requires hospitalization, leads to lasting disability (...) or congenital anomaly, or jeopardizes the patient in any serious way d Rash, upper respiratory tract infection, nausea, pruritus, headache, diarrhea, dizziness, abdominal pain, bronchitis, leukopenia, injection site reactions ACR 20/50/70 = American College of Rheumatology 20/50/70% improvement from baseline; AE = adverse event; csDMARD = conventional synthetic disease-modifying antirheumatic drug; DAS = Disease Activity Score; DMARD = disease-modifying antirheumatic drug; ETN = etanercept; FDA = U.S. Food

2018 Effective Health Care Program (AHRQ)

36. The British Society for Rheumatology biologic DMARD safety guidelines in inflammatory arthritis Full Text available with Trip Pro

failure Heart failure Cardiac failure Ischaemic heart disease Ischaemic heart disease Ischemic heart disease Myocardial infarct* Coronary artery bypass graft NSTEMI STEMI Acute coronary syndrome Respiratory disease Interstitial lung disease Fibrosis Pulmonary fibrosis Uveitis Uveitis Drug induced uveitis Demyelinating disease Demyelinat* Neuro* Optic neuritis Multiple sclerosis Diverticular disease Diverticul* Vaccinations Vaccin* Vaccine Pneumococcal vacc* Influenza vacc* Singles vacc* Hepattiis vac (...) * Monitoring Monitor* Test* Connective tissue disease Drug induced vasculitis Drug AND induced AND lupus Drug induced lupus Haematological disorders Anaemia Neutropenia Pancytopenia Aplastic anaemia Lymphopeni* Thrombocytopeni* Psoriasis Drug induced psoriasis Peri-operative period Postoperative infection Surgery + infection Other terms Elderly Geriatric* Care of the elderly Mortality Safety Topic Search terms used in addition to either: ‘Rheumatoid + arthritis’, ‘Ankylosing spondylitis’, ‘Seronegative

2018 British Society for Rheumatology

37. Avelumab (Bavencio) - Neuroendocrine Tumors

and to treat a life-threatening disease in accordance with Article 3 of Regulation (EC) No 141/2000. The applicant requested consideration of its application for a Conditional Marketing Authorisation in accordance with Article 14(7) of the above mentioned Regulation based on the following claim(s): • The risk-benefit balance of the medicinal product, as defined in Article 1(28a) of Directive 2001/83/EC, is positive. The applicant claims that given the durability of response with features such as responses

2017 European Medicines Agency - EPARs

38. Adalimumab (Cyltezo) - Juvenile Rheumatoid Arthritis, Psoriatic Arthritis, Rheumatoid Arthritis, Ulcerative Colitis, Crohn Disease, Hidradenitis Suppurativa, Psoriasis, Ankylosing Spondylitis, Uveitis

Maximum measured concentration of the analyte in plasma CpB Carboxypeptidase B CPI Critical Process Indicator CPP Critical Process Parameter CQA Critical Quality Attribute CRP C-reactive protein CTD Common Technical Document CV Variation Coefficient CZE Capillary zone electrophoresis DAS28 -ESR Disease Activity Score 28, based on erythrocyte sedimentation rate DF Diafiltration DILI Drug-induced liver injury Medicinal product no longer authorised Assessment report EMA/CHMP/750187/2017 Page 5/115 DMARD

2017 European Medicines Agency - EPARs

39. Neonatal jaundice

may persist past the first week to 10 days of life without any underlying cause. However, early onset jaundice (detectable clinically before 24 hours of age) is a risk factor for severe hyperbilirubinaemia requiring treatment. When jaundice has a high peak level regardless of the cause, treatment is required to prevent brain damage. In addition, some underlying causes of hyperbilirubinaemia are serious or even life- threatening illnesses that require urgent treatment. Investigations are warranted (...) as ‘bronze baby syndrome’ § Gradually disappears after discontinuation of phototherapy § Not a contraindication to phototherapy 70 –consider need for continued phototherapy when the conjugated bilirubin reaches between one third and one half of the total bilirubin o Develop damage to retina of exposed eyes 70 o Increase cutaneous blood flow (photorelaxation) and increase insensible water loss through skin 70,71 o Loose stools 23 o Develop purpura and bullous eruptions 8 o Transient rashes (usually

2018 Queensland Health

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