Cutaneous Drug Reactions and Drug-Induced Pruritus
1
Citation
183
Reference
10
Related Paper
Citation Trend
Keywords:
Discontinuation
Drug withdrawal
Drug reaction
Drug Administration
Adverse drug reaction
Background
Patients with Systemic Lupus Erythematosus (SLE) are often treated with prolonged maintenance therapy with immunosuppressants (ISs) after remission achievement, with the aim of avoiding disease flares and subsequent organ damage. Data on the risk of flare after IS discontinuation and the effect of IS discontinuation on damage accrual are scanty.Objectives
Our aims were to analyze damage progression in remitted SLE patients who did or did not discontinued ISs, to assess flare rate after IS withdrawal and to compare damage accrual in patients who did or did not flare after IS discontinuation.Methods
We considered all SLE patients included in our lupus database, diagnosed between 1990 and 2018 (ACR criteria), treated with immunosuppressants over their disease course, who discontinued IS due to remission. IS discontinuation was defined as complete withdrawal of any immunosuppressive drug, and remission as clinical SLE Disease Activity Index (SLEDAI)-2K=0. Flares were defined according to SLEDAI Flare Index, and damage according to SLICC damage Index (SDI).Results
Eligible patients ever treated with ISs were 319 out of 456 (69.9%) currently in follow-up. Remission lasting at least 6 months was achieved by 206 patients treated with IS (64.6%) (Table 1); among them 105 (51%) discontinued ISs during the follow-up. Mean±SD follow-up after IS withdrawal was 91±71 months (range 6-372). No difference in damage accrual between remitted patients who discontinued or did not discontinue ISs was observed at the end of follow-up, after adjusting for disease duration: median (range) SDI 1 (0-6) and 0 (0-4), respectively. Accordingly, the proportion of remitted patients who accrued damage during the follow-up was similar between those who did or did not discontinue ISs (55% vs. 48%). Among patients who discontinued ISs, 26 (24.7%) experienced a flare after a median (range) of 57 (6-264) months from IS discontinuation. Flares were severe in 50% of cases (Table 2). No difference in damage progression between patients who flared and did not flare after IS withdrawal was found at the end of follow-up: median (range) SDI 1 (0-5) and 1 (0-6), respectively. Moreover, the proportion of patients with damage accrual was similar among patients with and without flare after IS discontinuation (56% vs. 54%).Conclusion
In our SLE cohort, the withdrawal of IS therapy in remitted patients did not seem to influence damage progression in the medium-term.Disclosure of Interests:
None declaredDiscontinuation
Drug withdrawal
Cite
Citations (0)
This study was designed to assess the Adverse drug reactions (ADRs) reported to tertiary care teaching hospital. A total of 174 ADRs, reported during 1 year period among which Dermatology department reported maximum 131 (75%). Most common ADRs reported were acneiform eruptions [n=61, 35.05%]. Among the total ADRs, topical steroids [n=60, (34.48%)] were responsible for most of the reactions followed by antimicrobial drugs and NSAIDs [n=20, (20.69%)] each. The causality of maximum ADRs were probable 148 (85.05%) with the suspected reaction. This study strongly suggests that there is a greater need for streamlining of hospital based ADR reporting and monitoring system to create awareness so that majority of ADRs can be prevented.
Drug reaction
Adverse drug reaction
Tertiary care
Cite
Citations (0)
AIM To analyze adverse drug reactions(ADRs) of traditional Chinese medicine(TCM).METHODS Using EXCEL and SPSS sofewares we analyzed 5 277 ADR cases from Shanghai Center for Adverse Drug Reactions Monitoring during the period from 2006 to 2008.Furthermore,we calculated proportional reporting ratios(PRRs) for every kind of drug and ADRs.RESULTS ADRs of TCM mainly included skin appendix damage,allergic reaction and gastrointestinal hurt.The rate of serious ADRs was 2.8%.The method of PRRs identified 91 signals which were required further evaluation.CONCLUSION Most ADRs of TCM are mild,while significant ADRs are less.The value of PPRs is conveniently calculated for monitoring the signal of ADRs.
Drug reaction
Adverse drug reaction
Allergic reaction
Cite
Citations (1)
Objective To promote the pharmaovigilance in China. Methods Compare the concept ofpharmacovigilance and adverse drug reaction monitoring , and analysis their differences and relations.Conclusions Pharmacovigilance is related closely with adverse drug reaction monitoring. It is thetendency to launch pharmacovigilance. Our government should pay attention to the pharmacovigilance.
Adverse drug reaction
Drug reaction
Cite
Citations (0)
Objective To explore the characteristics of adverse drug reaction in clinic and emergency,to decrease the number of adverse drug reaction.To promoting the reasonable administration.Method CollectED 117 cases of drug adverse reaction from Oct 2008 to Dec 2009 and analyzed the conditions.Results The common conditions were skin allergies and digestive symptoms of ADR,and anti-infectives account at most,nearly about 60%,the second reactions were neurological symptoms and cardiovascular symptoms.Conclusion According to analysis of adverse drug reaction in clinic and emergency,We should get experience of using drugs,and ensure the drugs are in right way.
Adverse drug reaction
Drug reaction
Cite
Citations (0)
Objective To understand the basic conditions of a hospital′s adverse drug reactions(ADR) so as to improve the importance and reported rate of ADR in the future. Methods Adopt a retrospective research methods and analyze a hospital collected 57 cases of ADR reports,report the number and resource of cases each year respectively and besides,the don′t reported cases of ADR and its cause,types of drugs,involved organs or clinical manifestations and so on,and then do statistical analysis of them. Results Among 57 cases of ADR reports,the ADR reporting rate in 2007 is the highest(38.6%),the physicians reported number is the largest(79.0%),mostly involving drugs to anti-infection(accounting for 75.4%),ADR accumulated clinical manifestations are involved in the skin and its annexes damage for the most(43.9%). Conclusion The drug-induced adverse reactions can not be ignored,we should take effective measures to improve the reporting rate.
Drug reaction
Adverse drug reaction
Cite
Citations (0)
Discontinuation
Drug withdrawal
Withdrawal syndrome
Cite
Citations (57)
Discontinuation
Drug withdrawal
Cite
Citations (5)
Discontinuation
Drug withdrawal
Withdrawal syndrome
Antiepileptic drug
Cite
Citations (38)
INTRODUCTION:
WHO characterizes adverse drug reaction (ADR) as any reaction to a medication which is harmful and unintended, and which happens at measurements typically utilized as a part of man for prophylaxis, analysis or treatment of illness or for the alteration of physiological capacity. Antagonistic medication responses are negative outcomes of medication treatment. They are one of the main sources of grimness and mortality. It has been assessed that around 2.9-5.6% of all clinic affirmations are because of ADRs and upwards of 35% of hospitalized patients encounter an ADR amid their hospitalization. An unconstrained revealing of ADRs has remained the foundation of pharmacovigilance and is imperative in keeping up tolerant wellbeing. In India, all social insurance experts including specialists, medical caretakers, and drug specialists can report an ADR by filling an ADR type of the Central Drugs Standard Control Organization. The dynamic interest of social insurance experts in the pharmacovigilance program can enhance the ADR revealing.
AIM OF THE STUDY:
To assess the knowledge, attitude and practice of pharmacovigilance and adverse drug reaction reporting among nursing staffs.
OBJECTIVES:
1. To assess the knowledge of pharmacovigilance towards adverse drug reaction reporting.
2. To assess the attitude and practice towards adverse drug reaction reporting.
3. To determine the factors that encourages the study subjects to report adverse drug reaction.
4. To evaluate the factors that discourages the study subjects not to report adverse drug reaction.
NEED OF THE STUDY:
The most serious ADRs lead to hospitalization, and hospital stays can lead to further ADRs. Hence, HCPs and hospitals can play a significant role in minimizing ADR-related morbidity and mortality. HCPs can play multiple roles by carefully reviewing the full patient history, particularly the drug allergy and drug-drug interaction history, to avoid any unwanted ADRs. In addition, reporting ADRs to the
responsible office at their hospital or the regulatory authority is a pharmacovigilance approach that can be used to minimize ADRs because reporting ADRs can increase HCPs’ awareness of reactions, which could result in the avoidance of particular drugs, thus reducing the harm associated with reactions to particular drugs.
Several drugs have been withdrawn from the market as a result of HCPs reporting ADRs. However, understanding the knowledge and practice of health care professionals regarding ADR reporting is very important for enhancing the reporting of ADRs.
Therefore, the present study is undertaken to determine the current status of ADR reporting and also to investigate knowledge and attitude of particularly nursing
staffs towards pharmacovigilance and ADR reporting.
METHODOLOGY:
The study was conducted in 3 different multi-speciality hospitals, at Chennai.
Study design: Cross sectional, questionnaire based study
Study setting:
This study was conducted from December 2017 to August 2018 for a period of 10 months.
Study sample:
The study sample size was 300.
Inclusion criteria:
Nurses,
Any age group.
Exclusion criteria:
Other health care professionals,
Study participants with unwillingness are excluded.
CONCLUSION:
The study discloses that nursing staffs have poor knowledge and poor practice but good in attitude towards ADR reporting. Even though they have reported more number of severe ADRs, they didn’t perform any further interventions to prevent it. The major factor which discourages them from reporting ADR is a patient confidentiality issue and managing patient was more important. Seriousness of reaction, unusualness of reaction, involvement of new drug, confidence in diagnosis of ADR was the factors that encourage nursing staffs to report ADR.
Based on the outcomes of the present study following recommendations are concluded. ADR reporting forms should be freely available in all hospitals as it can improve the reporting rates of ADR in the country. ADR reporting should be mandatory for all healthcare professionals. Each hospital should have a database on ADR which should be considered by healthcare professionals. The nursing syllabus curriculum needs to be revised to include ADR and pharmacovigilance. Continuous education programme and workshop want to be conducted regularly relate to how and where to report ADR.
Adverse drug reaction
Drug reaction
Cite
Citations (0)