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Life-Threatening Drug-Induced Rashes

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61. Propofol-induced death in children: at a Univ. Hospital

therapeutic value since nineties[1]. Dr SUNAHARA, Shigeichi is a pioneer of randomized controlled trials in Japan. He said: "Drugs, being foreign to the human body, only by chance evolve therapeutic value and it is more or less inevitable that they harbor some undesirable effects. To prevent drug-induced suffering, the following 4 caveats are essential: (1) develop a drug with the least possible hazards; (2) collect as detailed information as possible about adverse reactions to the drug even after careful (...) ed. Proceedings of the Kyoto International Conference Against Drug-Induced Sufferings 1979, Excerpta Medica, 1980 Editorial C M ED HECK -The Informed Prescriber Translated from the editorial in Med Check-TIP (in Japanese) 2015; 15 (May:#59); 50.MED CHECK - TIP AUGUST 2015 / Vol.1 No.2 · Page 17 New Products New Products Dabigatran: potentially harmful The safe use is compromised without monitoring and an antagonist Optimal dose may be lower: Subgroup analysis indicates Translated and revised

2015 Med Check - The Informed Prescriber

62. Clinical predictors of response and discontinuation of belimumab in patients with systemic lupus erythematosus in real life setting. Results of a large, multicentric, nationwide study. (PubMed)

Clinical predictors of response and discontinuation of belimumab in patients with systemic lupus erythematosus in real life setting. Results of a large, multicentric, nationwide study. To investigate efficacy, safety and survival of belimumab and to identify predictors of drug response and drug discontinuation in patients with active SLE in clinical practice.Data of SLE patients, treated with belimumab, from 11 Italian prospective cohorts were analyzed. SLEDAI-2K, anti-dsDNA, C3, C4, prednisone (...) manifestations, which required the use of belimumab, were polyarthritis (45.2%) and skin rashes (25.5%). SRI-4 was achieved by 77.0% and 68.7% of patients at 12 and 24-months. Independent predictors of 12-month response were SLEDAI-2K ≥ 10 (OR 40.46, p = 0.001) and polyarthritis (OR 12.64, p = 0.001) and of 24-month response were SLEDAI-2K ≥ 10 (OR 15.97, p = 0.008), polyarthritis (OR 32.36, p = 0.006), and prednisone ≥7.5 mg/day (OR 9.94, p = 0.026). We observed a low rate of severe adverse events. Fifty

2017 Journal of Autoimmunity

63. Effect of Different Exercises on Quality of Life of Leukemia Patients.

Effect of Different Exercises on Quality of Life of Leukemia Patients. Effect of Different Exercises on Quality of Life of Leukemia Patients. - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Effect (...) of Different Exercises on Quality of Life of Leukemia Patients. The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03147365 Recruitment Status : Recruiting First Posted : May 10, 2017 Last Update Posted : February 5, 2019 See

2017 Clinical Trials

64. Skin toxicity evaluation in patients treated with cetuximab for metastatic colorectal cancer: a new tool for more accurate comprehension of quality of life impacts (PubMed)

Skin toxicity evaluation in patients treated with cetuximab for metastatic colorectal cancer: a new tool for more accurate comprehension of quality of life impacts The effectiveness of evaluation of the severity of epidermal growth-factor receptor inhibitor (EGFRI)-associated dermatological toxicities remains a topic of debate. This study was designed to assess the correlation between quality of life (QoL) and severity of dermatological toxicity, evaluated using the National Cancer Institute's (...) ) was evaluated using the Skindex-29 and Skindex-17 dermatology-specific instruments. Correlations between QoL and skin toxicity severity were assessed using Spearman's rank tests. Interclass correlation coefficients were used to assess interoperator agreement for ESS and NCI-CTCAE v4.0 scoring.A positive correlation was identified between dermatology HRQoL and the severity of dermatological toxicities assessed using the NCI-CTCAE v4.0 scale for cutaneous papulopustular acneiform rash; however, a stronger

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2017 OncoTargets and therapy

65. Lupus Erythematosus, Drug-Induced (Diagnosis)

implicate thymic activity, possibly indicating the persistence of thymic activity into advanced adult life. Virtually all lupus-inducing drugs undergo oxidative metabolism, whereas analogous non–lupus-inducing drugs do not. In a mouse model, reactive metabolites of procainamide injected into the thymus have been shown to result in lupuslike autoantibodies. Unlike drug hypersensitivity reactions, this process takes months to years of drug exposure for symptoms to develop. A second theory (...) Lupus Erythematosus, Drug-Induced (Diagnosis) Drug-Induced Lupus Erythematosus: Background, Pathophysiology, Etiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTA2NTA4Ni1vdmVydmlldw== processing > Drug

2014 eMedicine.com

66. Drug-Induced Pseudolymphoma Syndrome (Diagnosis)

and cutaneous lymphoma: facts and controversies. Clin Dermatol . 2010 Sep-Oct. 28(5):568-74. . Albrecht J, Fine LA, Piette W. Drug-associated lymphoma and pseudolymphoma: recognition and management. Dermatol Clin . 2007 Apr. 25(2):233-44, vii. . Bocquet H, Bagot M, Roujeau JC. Drug-induced pseudolymphoma and drug hypersensitivity syndrome (Drug Rash with Eosinophilia and Systemic Symptoms: DRESS). Semin Cutan Med Surg . 1996 Dec. 15(4):250-7. . Callot V, Roujeau JC, Bagot M, Wechsler J, Chosidow O (...) Drug-Induced Pseudolymphoma Syndrome (Diagnosis) Cutaneous Pseudolymphoma: Background, Pathophysiology, Etiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTA5OTE4OC1vdmVydmlldw== processing > Cutaneous

2014 eMedicine.com

67. Drug-Induced Pulmonary Toxicity (Diagnosis)

Gefitinib is a selective tyrosine kinase inhibitor (TKI) of the epidermal growth factor receptor (EGFR) used to treat adults with EGFR mutation-positive non-small-cell lung cancer (NSCLC). Clinical trials have reported a broad range of adverse pulmonary events with ILD most commonly reported. Gefitinib-induced ILD is often life-threatening; its mortality is approximately 30-40%. [ ] Clinical manifestations of gefitinib-induced pulmonary toxicity include an unproductive cough, dyspnea, and serious (...) is characteristic of amiodarone toxicity. A positive gallium scan result is seen in almost all patients with amiodarone pneumonitis and can help to differentiate it from pulmonary embolism and congestive heart failure. Withdrawal of the drug is the cornerstone of treatment for amiodarone-induced lung disease. Glucocorticoids seem to be useful in more severe or persistent cases. Because of amiodarone's long elimination half-life (approximately 45 d), pulmonary toxicity may initially progress despite drug

2014 eMedicine.com

68. Drug-Induced Hepatotoxicity (Diagnosis)

Drug-Induced Hepatotoxicity (Diagnosis) Drug-Induced Hepatotoxicity: Overview, Metabolism of Drugs, Clinical and Pathological Manifestations of Drug-Induced Liver Disease Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTY5ODE0LW92ZXJ2aWV3 processing > Drug-Induced Hepatotoxicity Updated: Dec 08, 2016 Author: Nilesh Mehta, MD; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, MCCM Share Email Print Feedback Close Sections Sections Drug-Induced Hepatotoxicity Overview Overview Background Drugs are an important cause of liver injury. More than 900 drugs, toxins, and herbs have been reported to cause liver injury, and drugs account for 20-40% of all instances of fulminant hepatic failure. Approximately 75% of the idiosyncratic

2014 eMedicine.com

69. Lupus Erythematosus, Drug-Induced (Overview)

implicate thymic activity, possibly indicating the persistence of thymic activity into advanced adult life. Virtually all lupus-inducing drugs undergo oxidative metabolism, whereas analogous non–lupus-inducing drugs do not. In a mouse model, reactive metabolites of procainamide injected into the thymus have been shown to result in lupuslike autoantibodies. Unlike drug hypersensitivity reactions, this process takes months to years of drug exposure for symptoms to develop. A second theory (...) Lupus Erythematosus, Drug-Induced (Overview) Drug-Induced Lupus Erythematosus: Background, Pathophysiology, Etiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTA2NTA4Ni1vdmVydmlldw== processing > Drug

2014 eMedicine.com

70. Drug-Induced Pseudolymphoma Syndrome (Overview)

and cutaneous lymphoma: facts and controversies. Clin Dermatol . 2010 Sep-Oct. 28(5):568-74. . Albrecht J, Fine LA, Piette W. Drug-associated lymphoma and pseudolymphoma: recognition and management. Dermatol Clin . 2007 Apr. 25(2):233-44, vii. . Bocquet H, Bagot M, Roujeau JC. Drug-induced pseudolymphoma and drug hypersensitivity syndrome (Drug Rash with Eosinophilia and Systemic Symptoms: DRESS). Semin Cutan Med Surg . 1996 Dec. 15(4):250-7. . Callot V, Roujeau JC, Bagot M, Wechsler J, Chosidow O (...) Drug-Induced Pseudolymphoma Syndrome (Overview) Cutaneous Pseudolymphoma: Background, Pathophysiology, Etiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTA5OTE4OC1vdmVydmlldw== processing > Cutaneous

2014 eMedicine.com

71. Drug-Induced Pulmonary Toxicity (Overview)

Gefitinib is a selective tyrosine kinase inhibitor (TKI) of the epidermal growth factor receptor (EGFR) used to treat adults with EGFR mutation-positive non-small-cell lung cancer (NSCLC). Clinical trials have reported a broad range of adverse pulmonary events with ILD most commonly reported. Gefitinib-induced ILD is often life-threatening; its mortality is approximately 30-40%. [ ] Clinical manifestations of gefitinib-induced pulmonary toxicity include an unproductive cough, dyspnea, and serious (...) is characteristic of amiodarone toxicity. A positive gallium scan result is seen in almost all patients with amiodarone pneumonitis and can help to differentiate it from pulmonary embolism and congestive heart failure. Withdrawal of the drug is the cornerstone of treatment for amiodarone-induced lung disease. Glucocorticoids seem to be useful in more severe or persistent cases. Because of amiodarone's long elimination half-life (approximately 45 d), pulmonary toxicity may initially progress despite drug

2014 eMedicine.com

72. Drug-Induced Hepatotoxicity (Overview)

Drug-Induced Hepatotoxicity (Overview) Drug-Induced Hepatotoxicity: Overview, Metabolism of Drugs, Clinical and Pathological Manifestations of Drug-Induced Liver Disease Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTY5ODE0LW92ZXJ2aWV3 processing > Drug-Induced Hepatotoxicity Updated: Dec 08, 2016 Author: Nilesh Mehta, MD; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, MCCM Share Email Print Feedback Close Sections Sections Drug-Induced Hepatotoxicity Overview Overview Background Drugs are an important cause of liver injury. More than 900 drugs, toxins, and herbs have been reported to cause liver injury, and drugs account for 20-40% of all instances of fulminant hepatic failure. Approximately 75% of the idiosyncratic

2014 eMedicine.com

73. Drug-Induced Hepatotoxicity (Treatment)

Drug-Induced Hepatotoxicity (Treatment) Drug-Induced Hepatotoxicity: Overview, Metabolism of Drugs, Clinical and Pathological Manifestations of Drug-Induced Liver Disease Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTY5ODE0LW92ZXJ2aWV3 processing > Drug-Induced Hepatotoxicity Updated: Dec 08, 2016 Author: Nilesh Mehta, MD; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, MCCM Share Email Print Feedback Close Sections Sections Drug-Induced Hepatotoxicity Overview Overview Background Drugs are an important cause of liver injury. More than 900 drugs, toxins, and herbs have been reported to cause liver injury, and drugs account for 20-40% of all instances of fulminant hepatic failure. Approximately 75% of the idiosyncratic

2014 eMedicine.com

74. Drug-Induced Hepatotoxicity (Follow-up)

Drug-Induced Hepatotoxicity (Follow-up) Drug-Induced Hepatotoxicity: Overview, Metabolism of Drugs, Clinical and Pathological Manifestations of Drug-Induced Liver Disease Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTY5ODE0LW92ZXJ2aWV3 processing > Drug-Induced Hepatotoxicity Updated: Dec 08, 2016 Author: Nilesh Mehta, MD; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, MCCM Share Email Print Feedback Close Sections Sections Drug-Induced Hepatotoxicity Overview Overview Background Drugs are an important cause of liver injury. More than 900 drugs, toxins, and herbs have been reported to cause liver injury, and drugs account for 20-40% of all instances of fulminant hepatic failure. Approximately 75% of the idiosyncratic

2014 eMedicine.com

75. ESMO Clinical Practice Guidelines for the Management of Refractory Symptoms at the End of Life and the Use of Palliative Sedation

consultation with experts in palliative medi- cineisstronglyencouraged. talkingtopatientsapproachingtheendoflife Oncologists caring for patients with advanced cancer typically need to engage in repeated, emotionally challenging conversa- tions with patients and their families. This is one of the most dif?cultaspectsoftheoncologist’srole[54,55]. Patients are dealing with the emotional impact of the life- threatening illness, often complex treatment decisions, and limited likelihood of bene?t, while (...) to the nature of the symptoms being addressed, it is muchmoredif?culttoestablishthattheyaretrulyrefractory. ? The severity of distress of some symptoms may be very dynamic and idiosyncratic; in such cases, psychological adap- tationandcopingarecommon. ? The standard treatment approaches to address severe psycho- logical symptoms or existential distress are not intrinsically life-threatening, such as the use of psychotherapy, religious counselling,andspiritualsupport. ? The presence of these symptoms does

2014 European Society for Medical Oncology

76. Gluten challenge induces skin and small bowel relapse in long-term gluten-free diet-treated dermatitis herpetiformis. (PubMed)

Gluten challenge induces skin and small bowel relapse in long-term gluten-free diet-treated dermatitis herpetiformis. Dermatitis herpetiformis (DH) is an extra-intestinal manifestation of coeliac disease causing an itchy, blistering rash. Skin IgA deposits are pathognomonic for DH, and the treatment of choice is a life-long gluten-free diet (GFD). Preliminary evidence suggests that there are DH patients who redevelop gluten tolerance after adherence to a GFD treatment. To examine this, we (...) , and 12 had small bowel villous atrophy. In addition, three patients without rash or skin immune deposits developed villous atrophy, while one patient persisted without any signs of relapse. In conclusion, 95% of the DH patients were unable to tolerate gluten even after long-term adherence to a GFD. Therefore, life-long GFD treatment remains justified in all DH patients.Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.

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2019 Journal of Investigative Dermatology

77. Oseltamivir induced Stevens-Johnson syndrome/toxic epidermal necrolysis-case report. (PubMed)

Oseltamivir induced Stevens-Johnson syndrome/toxic epidermal necrolysis-case report. Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are 2 rare but life-threatening diseases characterized by detachment of epidermis, bullous skin lesions, and mucous membrane erosions. Drugs are highly suspected to be the causative agents. We report a case of SJS/TEN induced by oseltamivir, which is a very rare event.A 9-year-old girl with upper respiratory tract infections presented (...) with generalized maculopapular rash the second day after taking oseltamivir.The diagnosis of SJS/TEN was made based on cytotoxic skin lesions and mucous membrane involvement.After discontinuing of the drug and combination therapy of corticosteroid and human immunoglobulin initiation, the lesions were improved. Human leukocyte antigen (HLA) gene sequencing was done.The girl was followed-up for 1 year. The skin and mucous membranes symptoms were relieved.We report this case to attract attention to the rare

2019 Medicine

78. Allopurinol-induced toxic epidermal necrolysis featuring almost 60% skin detachment. (PubMed)

Allopurinol-induced toxic epidermal necrolysis featuring almost 60% skin detachment. Toxic epidermal necrolysis (TEN) is a life-threatening, immunologically mediated, and usually drug-induced disease. Rarely, clinical pharmacists participating in finding the etiology have been reported.A 33-year-old male presented to the emergency department with a 1-day history of fever and rash. The patient, being newly diagnosed with gout 10 days ago, received allopurinol at a dose of 250 mg by mouth daily (...) . After 10 days' exposure to allopurinol, the patient manifested with an "influenza-like" prodromal phase (fever of 38°C, throat pains), which was treated with amoxicillin and nonsteroidal anti-inflammatory drugs of the oxicam type. The next day, he developed a worsening fever of 39.5°C, accompanied by a pruriginous rash all over his body.On physical examination, we observed coalescing dusky red macules over >60% of his body surface area, with blisters and detachment of large sheets of necrolytic

2019 Medicine

79. Antibiotic‐associated suspected adverse drug reactions among hospitalized patients in Uganda: a prospective cohort study (PubMed)

(isoniazid), life-threatening difficulty in breathing with shortness of breath (rifampicin) and disabling itchy skin rash with numbness of lower swollen legs (ethambutol, isoniazid) were observed. Pharmaceutical quality testing of implicated antibiotics could be worthwhile. Periodic on-ward collection and analysis of antibiotic-safety-data standardized by consumption is an efficient method of tracking antibiotics with 1%-risk for serious aa-ADRs. (...) Antibiotic‐associated suspected adverse drug reactions among hospitalized patients in Uganda: a prospective cohort study We sought to determine the prevalence at admission and incidence during hospitalization of antibiotic-associated suspected adverse drug reactions (aa-ADRs) among Ugandan inpatients; and to characterize these aa-ADRs. We conducted a prospective cohort study of 762 consented adults admitted on medical and gynecological wards of the 1790-bed Mulago National Referral Hospital

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2017 Pharmacology research & perspectives

80. Drug Reaction with Eosinophilia and Systemic Symptoms: Retrospective Analysis of 104 Cases over One Decade (PubMed)

Drug Reaction with Eosinophilia and Systemic Symptoms: Retrospective Analysis of 104 Cases over One Decade Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe, life-threatening disorder caused by drugs. In the present study, we tried to explore the types of DRESS-inducing drugs, incubation period, features of skin rashes, accompanying visceral damage, and effectiveness of glucocorticoid therapy so as to inform clinical practice.Patients diagnosed with a drug-induced rash (...) ) days. The most common allergy-inducing drugs were antibiotics (n = 37, 35.6%), followed by antiepileptic drugs and traditional Chinese medicines (TCMs). Eighty-two cases (78.8%) had rash with area >50% body surface area (BSA). Liver damage occurred in 90% of cases. Patients were divided into oral antihistamine group and glucocorticoid/immunosuppressive agent/intravenous immunoglobulin (IVIG) group. Sex, age, incubation period, duration of hospital stay, and the number of patients with body

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2017 Chinese medical journal

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