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Life-Threatening Drug-Induced Rashes

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141. Family Practice Notebook Updates 2018

if your device is to speak to you s are still $600 and up to $4900 Another me-too drug ( ) is a new LAMA for at $1100 per month (psych, cd) -laced s have resulted in life threatening bleeding IX. Updates: May 2018 (sports, ) Most common injuries include , , , Keep s in the differential diagnosis (esp. with ) (rheum, ) Diagnosis is typically clinical with onset after age 50 years, pain with activity (esp. late in the day), and pain in fingers, s, hips, knees s, avoiding provocative activity and in some (...) abdominal source, ) (geri, pharm) Consider noncompliance, OTC medications and when evaluating adverse drug events Consider taking a medication away, instead of starting a new medication, in older patients s (esp. ), diabetic medications (esp. ) and account for the most common adverse drug events in elderly (cv, peds, chf) (e.g. , HH6, Kawasaki's, enterovirus) can be life threatening in infants Acute presentations for "URI" may reveal a sicker infant with out of proportion progressing to (derm, id

2019 FP Notebook

142. HR+/HER2- Advanced Breast Cancer and Endocrine Resistance

by at least one of the following criteria: Prior bilateral oophorectomy Age ≥60 Age <60 and amenorrhea for 12 or more months (in the absence of chemotherapy, tamoxifen, toremifene, or ovarian suppression) and FSH and estradiol in the postmenopausal range according to the local laboratory reference. Note: For women with therapy-induced amenorrhea, serial measurements of FSH and/or estradiol are needed to ensure postmenopausal status. OR Pre/perimenopausal if treated with goserelin that was initiated (...) . Leptomeningeal carcinomatosis Advanced, symptomatic visceral spread (visceral crisis) with risk of life-threatening complications in the short term. Concurrent malignancy of any site, except adequately controlled limited basal cell carcinoma or squamous-cell carcinoma of the skin, in situ melanoma or carcinoma in situ of the cervix. Active cardiac disease or a history of cardiac dysfunction including any of the following: History of angina pectoris, symptomatic pericarditis, or myocardial infarction within

2017 Clinical Trials

143. Presence of a single nucleotide polymorphism (RS3758581) in a boy with DRESS syndrome Full Text available with Trip Pro

Presence of a single nucleotide polymorphism (RS3758581) in a boy with DRESS syndrome Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare, potentially life-threatening, drug-induced hypersensitivity reaction that includes rash, hematologic abnormalities, lymphadenopathy, and internal organ involvement. The pathogenesis of DRESS syndrome is partially understood. Various medications have been described as the cause of DRESS syndrome. Phenytoin and allopurinol are the most

2017 Central-European Journal of Immunology

144. Practical approach to the patient with acute neuromuscular weakness Full Text available with Trip Pro

and prognosis. Respiratory failure caused by neuromuscular weakness is considered as more critical than lung disease because its development may be insidious or subtle until sudden decompensation leads to life threatening hypoxia. Also, the arterial blood gas finding of severe hypoxemia, hypercapnia, and acidosis may not be apparent until respiratory failure is profound. Hence, the requirement for respiratory assistance should also be intensively and promptly investigated in all patients with neuromuscular (...) and drug induced neuromuscular weakness which may arise as a consequence of sepsis, multi-organ failure, and exposure to certain medications like intravenous corticosteroids and neuromuscular blocking agents.

2017 World journal of clinical cases

145. Drug Reaction with Eosinophilia and Systemic Symptoms: Retrospective Analysis of 104 Cases over One Decade Full Text available with Trip Pro

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

2017 Chinese medical journal

146. A Multiple-dose Study of ASP8374, an Immune Checkpoint Inhibitor, as a Single Agent and in Combination With Pembrolizumab in Subjects With Advanced Solid Tumors

treatment period (Up to a maximum of 60 weeks) ] Initial and re-treatment. Adverse event (AE) is considered "serious" if the investigator or sponsor view any of the following outcomes: Death, life-threatening, persistent or significant disability/incapacity, congenital anomaly or birth defect, hospitalization, or medically important event Number of participants with laboratory value abnormalities and/or adverse events related to treatment [ Time Frame: Up to 30 days from last dose in safety follow up (...) Immunodeficiency Virus. Subject with positive for Hepatitis B virus (HBV) antibodies and surface antigen (including acute HBV or chronic HBV) or Hepatitis C ([HCV]; ribonucleic acid [RNA] detected by qualitative assay). Hepatitis C RNA testing is not required in subjects with negative Hepatitis C antibody testing. Subject has received a live vaccine against infectious diseases within 28 days prior to initiation of study treatment. Subject has a history of drug-induced pneumonitis (interstitial lung disease

2017 Clinical Trials

147. Adverse Drug Reaction

the actions of one or both drugs. The drugs might not work, or you could get side effects. Side effects are unwanted effects caused by the drugs. Most are mild, such as a stomach aches or drowsiness, and go away after you stop taking the drug. Others can be more serious. Drug allergies are another type of reaction. They can be mild or life-threatening. Skin reactions, such as hives and rashes, are the most common type. When you start a new prescription or over-the-counter medication, make sure you (...) Reaction Aka: Adverse Drug Reaction , Medication Hypersensitivity , Drug Reaction From Related Chapters II. Types: Medication-induced Hypersensitivity Reaction See III. Differential Diagnosis: Non-immune mediated Drug Reaction (examples) Medication intolerance Significant gastrointestinal upset with Sensitization See Idiosyncratic reaction (examples) Pseudoallergic reaction (direct mast cell activation) anaphylactoid reaction s See Example: (examples) Medication toxicity (examples) s s Medication

2018 FP Notebook

148. Parvovirus B19

infection Improves in most patients by 2 weeks Treated with s for analgesia Self limited course in 90% of patients Prolonged in 10% may last up to 10 years Morning stiffness Associated conditions VIII. Differential Diagnosis Atypical Drug-induced rashes Other IX. Labs: Adults with persistent Polyarthritis Anti-B19 IgM : 89% : 99% Elevated for 2-3 months after acute infection Parvovirus DNA by PCR testing Similar sensitivity to IgM testing Indicated in aplastic crisis or if immunocompromised Persistence (...) . Complications: General XII. Complications: Parvovirus associated erythrocyte aplasia ral May be life threatening Monitor closely for possible transfusion Transient aplastic crisis in chronic Acute Chronic suppression in immunocompromised Malignancy Transplant recipient Course Typical full recovery within 2 weeks XIII. References Klippel (1997) Primer Rheumatic Diseases, p. 201 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Parvovirus

2018 FP Notebook

151. Icatibant (Firazyr)

of icatibant for the treatment of acute HAE attacks in adults. Reference ID: 2978223Clinical Review Brian Oscar Porter, M.D., Ph.D., M.P.H. NDA 22-150 Icatibant 11 1.2 Risk-Benefit Assessment HAE is a rare, autosomal dominant, inheritable disease caused by a quantitative or qualitative functional deficiency in C1 esterase inhibitor (C1-INH), which leads to dysregulated accumulation of the potent vasodilator bradykinin. This results in recurrent, intermittent attacks of potentially life-threatening mucosal (...) from an individual review of each of the Phase 3 efficacy trials, as well as a pooled safety analysis of all subjects receiving blinded treatment for an initial HAE attack during the randomized treatment phase of these trials, demonstrates adequate safety and tolerability, thereby supporting the approval of this agent for this rare but potentially life-threatening indication. Although the safety database is relative small, given the rarity of HAE, which is a designated orphan disease

2011 FDA - Drug Approval Package

153. Acute Coronary Syndromes (ACS) in patients presenting without persistent ST-segment elevation

. ESC Guidelines 3003 Downloaded from https://academic.oup.com/eurheartj/article-abstract/32/23/2999/477824 by guest on 02 April 2019resulting in myocardial underperfusion, form the basic pathophy- siological mechanisms in most conditions of ACS. As this may be a life-threatening state of atherothrombotic disease, criteria for risk strati?cation have been developed to allow the clinician to make timely decisions on pharmacological management as well as coronary revascularization strategies, tai (...) the epidemiology and natural history of NSTE-ACS have been presented in the previous guidelines 3 and are also covered in The ESC Textbook of Cardiovas- cular Medicine. 9 2.2 Pathophysiology ACS represents a life-threatening manifestation of atherosclerosis. It is usually precipitated by acute thrombosis induced by a ruptured or eroded atherosclerotic coronary plaque, with or without con- comitant vasoconstriction, causing a sudden and critical reduction in blood ?ow. In the complex process of plaque

2011 European Society of Cardiology

154. Jaundice in adults

Jaundice in adults Jaundice in adults - NICE CKS Share Jaundice in adults: Summary Jaundice is a clinical sign describing yellow pigmentation of the skin, sclera, and mucous membranes due to raised plasma bilirubin. It can be caused by many disorders ranging from benign to life-threatening conditions such as Gilbert's syndrome and pancreatic cancer respectively. Jaundice is the result of dysfunction in bilirubin metabolism and its causes can be categorized as pre-hepatic, hepatic, or post (...) Background information Definition Definition Jaundice (also known as icterus) describes the yellow pigmentation of the skin, sclera, and mucous membranes resulting from raised plasma bilirubin. Normal plasma bilirubin levels range between 5 to 19 micromol/L. Clinical jaundice may not become apparent until serum bilirubin is greater than 51 micromol/L. [ ; ] Pathophysiology Pathophysiology Jaundice can be caused by a wide variety of disorders which range from benign to life-threatening conditions

2016 NICE Clinical Knowledge Summaries

155. British Association of Dermatologists' guidelines for the safe and effective prescribing of azathioprine

of evidence 4) • Consider temporary withdrawal of azathioprine • Prompt use of oral antivirals (aciclovir, valaciclovir or famciclo- vir) in all patients • Intravenous antiviral therapy desirable for disseminated or oph- thalmic VZV 9.23 Hepatotoxicity Mild derangement of liver blood tests due to azathioprine is not uncommon and usually has no serious clinical implica- tions. In contrast, severe hepatotoxicity is rare. Liver injury occurs in two patterns: (i) acute idiosyncratic drug-induced liver injury (...) . Food and Drug Administration categorizes azathioprine as risk group D, indicating ‘positive evidence of fetal risk is available, but the bene?ts may outweigh the risk in life-threatening or serious disease’. However, the literature is inconclusive on any teratogenic effects. 143 Most investigators have found azathio- prine to be relatively safe in pregnancy and its use in trans- plant recipients is not associated with any increased risk of congenital defects, although this group is at increased

2011 British Association of Dermatologists

157. Ceftaroline fosamil for injection (Teflaro)

Phase 3 Trials Safety Population 201 Table 95. Incidence of patients with TEAEs of potential drug-induced anemia broken down by study 203 Table 96. Incidence of PCS Postbaseline Hematology Values for Phase 3 Studies. .. 204 Table 97. Incidence of TEAE Representing Potential Liver Injury Broken Down by Trials 206 Table 98. Incidence of TEAE Representing Potential Antibiotic-Associated Diarrhea Broken Down by Studies/Trials 208 Table 99. Incidence of TEAEs of Potential Antibiotic-Associated Diarrhea (...) renal impairment, direct Coombs’ test seroconversion, and drug-induced hemolytic anemia be monitored as part of post- marketing safety surveillance reporting. In summary, data presented in the NDA provide sufficient information on directions for use, the appropriate recommended dose, and the dose adjustment for renal impairment. The efficacy of ceftaroline as treatment of ABSSSI and CABP in adults (except in CABP caused by MRSA) has been established by the pivotal Phase 3 trials. Safety data

2010 FDA - Drug Approval Package

158. Antecedent Drug Exposure Aetiology and Management Protocols in Steven-Johnson Syndrome and Toxic Epidermal Necrolysis, A Hospital Based Prospective Study Full Text available with Trip Pro

%) and in no male. Drugs implicated in causing these life threatening reactions were identified as anticonvulsant agents like carbamazepine (CBZ), phenytoin (PHT) and Lamotrigine (LTG), oxicam NSAID, Sulfasalazine and levofloxacin. Despite higher reported mortality rates in SJS and TEN all patients survived with 2 patients surviving TEN suffered from long term opthalmological sequelae of the disease.Present study suggest that drug induced cutaneous eruptions are common ranging from common nuisance rashes (...) to rare life threatening diseases like SJS and TEN, SJS/TEN typically occur 1-3 weeks after initiation of therapy. Aromatic AED's, LTG, oxicam NSAID's, sulfasalazine and levofloxacin have a tremendous potential to trigger SCARS's. To ensure safe use of pharmaceutical agents and better treatment outcomes post marketing voluntary reporting of severe rare and unusual reactions remains inevitable.

2016 Journal of clinical and diagnostic research : JCDR

159. DRESS syndrome potentially induced by allopurinol and triggered by influenza vaccine Full Text available with Trip Pro

DRESS syndrome potentially induced by allopurinol and triggered by influenza vaccine Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome, also known as drug-induced hypersensitivity syndrome (DHIS), is an acute, potentially life-threatening disease that includes skin rash, fever, haematological abnormalities and multiorgan involvement. Although its aetiopathogenesis is not exactly known, it is thought that inefficient drug detoxification leading to the accumulation of drug

2016 BMJ case reports

160. Grover’s-like drug eruption in a patient with metastatic melanoma under ipilimumab therapy Full Text available with Trip Pro

Grover’s-like drug eruption in a patient with metastatic melanoma under ipilimumab therapy Dermatologic toxicity is an important adverse effect of immune checkpoint inhibitors targeting cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and programmed cell death 1 receptor (PD-1) or PD ligand 1 (PD-L1). Skin toxicity most commonly includes a maculopapular erythematous rash and pruritus. Rarely life threatening complications such as Steven's Johnson syndrome or toxic epidermal necrolysis may (...) occur.Here we report the uncommon event of a drug-induced transient acantholytic dermatosis (Grover's disease) in a 73-year-old Caucasian male treated with ipilimumab for metastatic melanoma. Five weeks after initiation of therapy, the patient developed a widespread polymorphic papulovesicular dermatosis on the trunk and proximal extremities with intense pruritus. Skin biopsy showed acantholytic dyskeratosis with interface dermatitis consistent with a Grover's-like drug eruption.These findings should

2016 Journal for immunotherapy of cancer

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