Clin-Alert®Pub Date : 2021-11-01DOI: 10.1177/00694770211056889
J. Dill, T. Mcevoy
{"title":"Reporting on Adverse Clinical Events","authors":"J. Dill, T. Mcevoy","doi":"10.1177/00694770211056889","DOIUrl":"https://doi.org/10.1177/00694770211056889","url":null,"abstract":"A retrospective review of critically ill adult patients was performed to assess the association between oseltamivir and bradycardia. A total of 203 critically ill adults with presumed influenza who had received at least 2 doses of oseltamivir were included in the assessment. The primary outcome was the occurrence of bradycardia (heart rate: ≤59 beats/min) while receiving oseltamivir or a decrease of at least 20 beats/min compared with the lowest heart rate before initiating oseltamivir. Results: Less than half of the patients (43.4%) had documented bradycardia, 59 had a heart rate ≤ 59 beats/min, 19 with a heart rate decrease of at least 20 beats/min, and 10 with both. The time of onset from first dose to bradycardia was 51.4 hours. Approximately half (54.6%) of the patients received treatment for bradycardia. A multivariate logistic regression showed that bradycardia was associated with baseline heart rate, age, past medical history of neurologic issues, and positive influenza status. Based on the results of this study, the authors concluded that oseltamivir was associated with clinically relevant bradycardia in critically ill patients. They suggested that critically ill patients who receive oseltamivir should be monitored for bradycardia. Oseltamivir [Oseltamivir] MacLaren R et al (Robert MacLaren: Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, 12850 East Montview Blvd, C238, Aurora, CO 80045; e-mail: rob.maclaren@cuanschutz.edu) Oseltamivirassociated bradycardia in critically ill patients. Ann Pharmacotherapy 55:1318–1325 (Nov) 2021","PeriodicalId":102871,"journal":{"name":"Clin-Alert®","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132682671","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}
Clin-Alert®Pub Date : 2021-10-01DOI: 10.1177/00694770211051270
J. Dill, T. Mcevoy
{"title":"Reporting on Adverse Clinical Events","authors":"J. Dill, T. Mcevoy","doi":"10.1177/00694770211051270","DOIUrl":"https://doi.org/10.1177/00694770211051270","url":null,"abstract":"A 70-year-old male patient developed worsening pain and swelling of the left breast of 1 month duration. Medications at the time of medical evaluation included bicalutamide (50 mg daily for 12 months), atorvastatin (20 mg daily), allopurinol, acetylsalicylic acid, and tamsulosin. No vitamins or herbal supplements were noted on the medication history. A physical examination revealed a tender enlarged left breast without bleeding or discharge. Imaging studies indicated an enlarged left breast with normal glandular tissues and vascularity. Laboratory values were within normal limits. Treatment included the substitution of ezetimibe (10 mg daily) for atorvastatin, resulting in symptomatic improvement by 3 months without recurrence. The authors concluded that this patient developed atorvastatin-related gynecomastia based on the temporal relationship between the administration of the drug and the appearance and resolution of symptoms. According to the Naranjo causality scale, this relationship between the drug and causality was classified as probable. Atorvastatin [Atorvastatin] Famularo G et al (Giuseppe Famularo: San Camillo Hospital, Rome, Italy; e-mail: None provided) Atorvastatin-associated gynecomastia. Ann Pharmacotherapy 55(10):1300–1301 (Oct) 2021","PeriodicalId":102871,"journal":{"name":"Clin-Alert®","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132520204","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}
Clin-Alert®Pub Date : 2021-06-01DOI: 10.1177/00694770211023525
J. Dill, T. Mcevoy
{"title":"Reporting on Adverse Clinical Events","authors":"J. Dill, T. Mcevoy","doi":"10.1177/00694770211023525","DOIUrl":"https://doi.org/10.1177/00694770211023525","url":null,"abstract":"A prospective observational study in an academic hospital evaluated 23 patients (aged 13-40 years) with acute organophosphate ingestion for delayed neurological effects. Once the cholinergic crisis was treated and resolved, the patients were followed for an additional 6 months for neurologic toxicity. All but one patient had a normal neurological examination hospital discharge. The median hospitalization duration was 6 days. During the 6-month follow-up period, approximately 35% (n = 8) of the patients developed delayed neuropathy associated with organophosphate exposure. Three patients developed symptomatic neuropathy, including persistent foot drop, gait ataxia, and distal paresthesia. A total of 5 patients exhibited subclinical peripheral nerve involvement as assessed in nerve conduction studies. None of the baseline characteristics in this group were predictive of delayed neurological effects. Based on a small observational study, the authors concluded that delayed nerve involvement may occur after recovery from a cholinergic crisis in patients exposed to organophosphate poisoning. Organophosphates [Organophosphates] Pannu AK et al (A Bhalla, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, 4th Floor, F Block, Nehru Hospital, PGIMER, Chandigarh 160012, India; e-mail: bhalla.chd@gmail.com) Organophosphate induced delayed neuropathy after an acute cholinergic crisis in self-poisoning. Clin Toxicol (Phila) 59:488–492 (Jun) 2021","PeriodicalId":102871,"journal":{"name":"Clin-Alert®","volume":"155 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122919884","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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