Hira Bhalla, Abhishek Gupta, Tejas Patel
Xylometazoline, a sympathomimetic agent, is considered safe in hypertensive patients as a relief measure for nasal congestion with intranasal application. In the present case, a 58-year old male patient, having ischemic heart disease, controlled hypertension on telmisartan and bisoprolol, experienced hypertensive urgency in a span of two hours of intranasal administration of the paediatric formulation of xylometazoline. The interaction with bisoprolol should be kept in mind while using xylometazoline.
January 13, 2021: Current Drug Safety
Joseph M Pappachan
Diabetes mellitus (DM) has already affected one in every eleven person in the global population, and the disease prevalence continues to increase because of the obesity pandemic. Even with the availability of a multitude of antidiabetic medications for optimal glycaemic control, cardiovascular morbidity and mortality were not largely altered until recently when newer antidiabetic drugs such as glucagon-like peptide-1 receptor analogues (GLP-1RAs) and sodiumglucose cotransporter-2 (SGLT2) inhibitors were introduced...
January 12, 2021: Current Drug Safety
Ranjith K Rajgopal, Rupinder S Kochhar
Metformin has been the cornerstone of medical management of type 2 diabetes mellitus (T2DM) for over 6 decades now since its first ever discovery. Although there were initial concerns about its efficacy and safety, increasing evidence over the years proved it to be very effective and safe. It has stood the test of time, proving to be much safer than other drugs in the same class and garnering robust evidence in cardiovascular safety. In patients with T2DM, metformin lowers mean glycated haemoglobin (HbA1c) levels by 1...
January 6, 2021: Current Drug Safety
Elif Bayar, Mehtap Cevik, Selen Caker, Penbe Cagatay, Belgin Susleyici
BACKGROUND: Clopidogrel has been commonly prescribed as a selective P2Y12 receptor antagonist to reduce heart attack and stroke risk. Nearly 10 % of absorbed clopidogrel is metabolized by cytochrome P450 (CYP) enzymes in the liver to active forms and 90 % to inactive clopidogrel carboxylate by esterases. OBJECTIVE: Since different forms of clopidogrel have cytotoxic potential, our aim was to determinate the effect of clopidogrel (7.5, 40 and 75µM) over DNA damage in adipocyte and hepatocytes...
January 6, 2021: Current Drug Safety
Naci Senkal, Ozum Atasoy, Emine Bilge Caparali, Mumin Alper Erdogan, Oytun Erbas
BACKGROUND: Colistin utilization has gradually increased worldwide with the arising of multidrug-resistant (MDR) gram-negative bacilli despite its nephrotoxicity. Lipid emulsion (LE) is widely used for the toxic overdose treatment of various drugs. OBJECTIVE: The aim of the present study is to evaluate the effect of lipid emulsion on improvement of renal damage in colistin-induced nephrotoxicity with experimental Sprague Dawley rat model. METHODS: Twenty-four male Sprague Dawley rats were initially assigned at random into 2 groups...
December 28, 2020: Current Drug Safety
Thitaree Yuyaem, Patcharaporn Sudchada, Chutika Srisuttiyakorn, Jirapan Juntawong, Naruemon Khanngern, Natwara Watcharapokin, Pitchayakorn Chansangiam
BACKGROUND: A rare type of cutaneous adverse drug reaction (CADR), lichenoid drug eruption (LDE), can be associated with ethambutol. CASE REPORT: A 60-year-old woman with spinal tuberculosis received multiple anti-TB medications and developed rashes after 3 months of the treatments. A skin biopsy from the posterior auricular area confirmed lichenoid dermatitis and the Naranjo causality assessment indicated ethambutol as a probable cause of LDE in the patient. The rashes slowly improved after discontinuation of ethambutol ...
December 16, 2020: Current Drug Safety
Nizam Ud Din Khwaja, Ganesan Arunagirinathan
Alpha Glucosidase Inhibitors (AGIs) are a group of drugs which acts on the gastrointestinal tract and helps in reducing fasting and postprandial hyperglycemia by reducing the absorption of carbohydrates. This group comprises of Acarbose, Miglitol and Voglibose. They are available in the market for almost three decades now. When used as monotherapy Glycated Haemoglobin (HBA1c) reduction can be as high as 0.77% which is predominantly noted in Eastern Asian population and those on high carbohydrate diet. There is more pronounced reduction in HbA1c in those who present with higher baseline values...
December 16, 2020: Current Drug Safety
Anoop Mohamed Iqbal, Nasvin Imamudeen, Amjad Basheer, Sukrita Menon, Gisha Mohan, Tesil Nedumkallel Sani, Nisha Nigil Haroon
Glucagon like peptide- 1 receptor analogs (GLP-1RAs) are incretin mimetics with potent glucose-dependent insulinotropic action that translates to glycemic control in people with type-2 diabetes mellitus (T2DM). These agents potentially have the ability to stimulate proliferation or prevent apoptosis of pancreatic β-cells, induce weight-loss and provide vascular benefits in patients with T2DM. Newer GLP-1RA, semaglutide has shown robust reduction in HbA1c up to 1.5 - 1.8%. However individual differences do exist between the different GLP-1RAs, in terms of efficacy, pharmacokinetics, tolerability, and vascular protection...
December 8, 2020: Current Drug Safety
Cornelius James Fernandez, Raveendran Arkiath Veettil, Nyi Htwe
There is universal agreement that when lifestyle modifications are inadequate to control the hyperglycemia, metformin should be considered as the first line pharmacological therapy. However, when metformin monotherapy fails, there is no consensus as to which drug should be added. Many new classes of drugs that are currently available including DPP-4 inhibitors, GLP-1 agonists and SGLT-2 inhibitors have undergone cardiovascular outcome trials which had been made mandatory by the regulatory authority and thereby established their cardiovascular safety or at least neutrality...
November 25, 2020: Current Drug Safety
Cornelius James Fernandez, Chandni Radhakrishnan
Insulin is a lifesaving drug in patients with type 1 diabetes mellitus. Many type 2 diabetes mellitus patients will eventually require insulin. The rapid-acting and long-acting insulin analogues (RAIAs and LAIAs) have a pharmacological profile that closely mimic normal human physiology when compared to Neutral Protamine Hagedorn (NPH) insulin and regular human insulin, respectively. Glucagon-like peptide 1 receptor agonists (GLP-1RAs) were found to have a proven cardiovascular safety. They are preferred over insulin in many recent guidelines...
November 5, 2020: Current Drug Safety
Rithika Mary Koshy, Cornelius James Fernandez, Koshy Jacob
A large proportion of persons with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) do not reach the glycosylated haemoglobin (HbA1c) target of < 7% (53 mmol/mol) with an increasing proportion of them being overweight or obese. In both T1DM and T2DM, there is accelerated gastric emptying and postprandial hyperglucagonemia. Furthermore, insulin therapy itself is associated with risk of hypoglycemia and weight-gain both of which are barriers to achieving good control. Medications which can achieve significant HbA1c and weight reduction associated with an ability to delay gastric emptying and suppress the glucagon secretion with minimal/no hypoglycemia are of particular interest as an adjuvant to insulin...
November 5, 2020: Current Drug Safety
Manan Shah, Charmy Kothari
BACKGROUND: Gallstone disease (GSD) is one of the most common gastroenterological disorders. It is known that Drospirenone causes small increased risk of gallbladder diseases. But the risk may varies among different adverse drug reaction database. OBJECTIVE: To examine the safety and risk association between hormonal contraceptive Drospirenone and gallbladder diseases using adverse drug reaction database of USFDA's Federal Adverse Events Reporting System (FAERS), Europ's Eudravigilance (EV) and Canada's Canada Vigilance Adverse Reaction Online Database (CVARD)...
October 27, 2020: Current Drug Safety
Shiva Shanker Reddy Mukku, Preeti Sinha, Palanimuthu Thangaraju Sivakumar, Mathew Varghese
BACKGROUND: Drugs with anticholinergic properties are known to be associated with deleterious effects on cognition in older adults. There is a paucity of literature in this aspect in older adults with psychiatric disorders. OBJECTIVE: To examine the anticholinergic cognitive burden and its predictors in hospitalised older adults having psychiatric disorders. METHODS: Case records of older adults who sought inpatient care under the Geriatric Psychiatry Unit from January, 2019 to June, 2019 were reviewed...
October 26, 2020: Current Drug Safety
Jim Philip, Cornelius James Fernandez
Meglitinides are a group of oral hypoglycemic medications currently approved for the treatment of type 2 diabetes mellitus (T2DM). Two meglitinide molecules, Repaglinide and Nateglinide,are presently in use. Repaglinide is preferred because of its superior glycemic efficacy.They have modest efficacy with a mean decrement of glycosylated haemoglobin (HbA1c) ranging between -0.2 to -1.50% with individual therapy. Additional HbA1c reduction can occur with combination therapy with other oral hypoglycemics. This class of drugs is effective in controlling postprandial hyperglycemia with minimal risk of hypoglycemia...
October 26, 2020: Current Drug Safety
Raveendran Arkiath Veettil, Cornelius James Fernandez, Koshy Jacob
Type 2 diabetes mellitus (T2DM) is characterized by a progressive beta cell dysfunction in the setting of peripheral insulin resistance. Insulin resistance in subjects with type 2 diabetes and metabolic syndrome is primarily caused by an ectopic fat accumulation in liver and skeletal muscle. Insulin sensitizers are particularly important in the management of T2DM. Though, thiazolidinediones (TZDs) are principally insulin sensitizers, they possess an ability to preserve pancreatic β-cell function and thereby exhibit durable glycemic control...
October 26, 2020: Current Drug Safety
Ajeet Singh, Ritul Choudhary, Namrata Chhabra, Satyaki Ganguly, Vinay Rathore
Methotrexate is an antimetabolite anticancer drug frequently used in the treatment of extensive chronic plaque psoriasis. Psoriatic plaque erosion is a rare toxic side effect of single-dose methotrexate and is described as a sign of the impending pancytopenia. Here, we report a case of a 48-year-old male, presented with multiple oral and genital erosions, fissuring over palm and soles for 5 days. His laboratory tests revealed severe pancytopenia and nephropathy. He had a history of chronic plaque psoriasis for which he took a single dose of 15 mg methotrexate...
October 26, 2020: Current Drug Safety
Ausama Jaccob, Sheima Kadhim, Amal Hassan, Ali Mohsin, Salah Muslim
BACKGROUND: With the recent widespread use of over- the- counter drugs, there has been a noticeable increase in the occurrence of gastrointestinal discomfort and peptic ulcer disease. However, peptic ulcer is a highly complex disorder resulting from an imbalance between gstricdestructive and protective factors. OBJECTIVES: To identifyrisk factors of peptic ulcer disease. METHODS: This study was organized at Al-Basra teaching hospital and Al Sader teaching hospital in Basrah city, Iraq...
October 13, 2020: Current Drug Safety
Anangamanjari Pedapudi, Jonathan Stewart, Ankita Patel
Quinacrine is an older antimalarial drug that remains in use for a variety of illnesses including treatment resistant giardiasis. We report a patient with no prior psychiatric history who developed mild, prodromal psychiatric symptoms when treated with quinacrine for treatment resistant giardiasis. Symptoms resolved when the drug was stopped, recurred with greater severity (requiring involuntary psychiatric hospitalization) when restarted and promptly resolved again when finally stopped. Although quinacrine remains in use today, providers may be unaware of its potential for serious neuropsychiatric toxicity...
October 4, 2020: Current Drug Safety
Manan Shah, Charmy Kothari
BACKGROUND: Several studies have been published which stated that there is some connection between severe psychiatric disorders and contraceptive drug "desogestrel". However, nothing in the summary of product characteristics (SmPC) or patient information leaflets of desogestrel about anxiety, more severe anxiety leading to panic attacks, or about risks of severe depression leading to suicidal thoughts or suicide attempts. OBJECTIVE: To examine the safety and risk association between hormonal contraceptive desogestrel among women with psychiatric disorders using adverse drug reaction database of FDA Adverse Events Reporting System (FAERS) and Eudravigilance (EV)...
October 4, 2020: Current Drug Safety
Syed Wasif Gillani, Shabaz Mohiuddin Gulam, Dixon Thomas, Fithawit Bahran Gebreigziabher, Jumana Al-Salloum, Rizah Anwar Assadi, Kishore Gnana Sam
OBJECTIVE: This systematic review aims to investigate the role and responsibilities of pharmacists in prevention of medication errors. Also to evaluate pharmacist-centered strategies that has an impact in medication error reduction and prevention. METHOD: A search was conducted through the following databases PubMed Central, Scopus, Trip, Prospero, Medline and Google Scholar using terms related to "medication errors prevention" or "pharmacist-related errors"...
October 2, 2020: Current Drug Safety
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