General adverse effects

In the treatment of schistosomiasis adverse effects were seen in 80 of inpatients and 33 of outpatients. Gastrointestinal effects were the most common, with vomiting in 50 of cases. Neurotoxic and psychiatric effects, convulsions, and cardiac effects are less common, except in patients with liver disease. Insomnia, somnolence, vertigo, nightmares, headache, weakness, jaundice, and muscle pains have all been reported (SEDA-12, 244). Toxic reactions are seen more often in Schistosoma man-soni...

Drug overdose

Overdosage of amphetamines can cause restlessness, dizziness, tremor, increased reflexes, talkativeness, tenseness, irritability, and insomnia less common effects include euphoria, confusion, anxiety, delirium, hallucinations, panic states, suicidal and homicidal tendencies, excessive sweating, dry mouth, metallic taste, anorexia, nausea, vomiting, diarrhea, and abdominal cramps. Fatal poisoning is usually associated with hyperpyrexia, convulsions, coma, or cerebral hemorrhage. In addition,...

General Information

Pizotifen is a 5-HT receptor antagonist chemically related to the tricyclic antidepressants, with a five-membered third ring containing a sulfur atom. It has been suggested that pizotifen has effects and adverse effects resembling those of amitriptyline (1). However, it is pharmacologically similar to the antihistamine cyproheptadine and shares its adverse effects, including drowsiness and increased appetite. When used in migraine it causes increased weight conversely, when it is used to...

Comparative studies

The efficacy and safety of oral granisetron (2 mg od) and oral ondansetron (8 mg tds for 3 days and bd on day 4) in the prophylaxis of nausea and vomiting have been studied in 34 patients receiving hyperfractionated total body irradiation in a randomized, double-blind trial (12). A historical group of 90 patients who received a similar irradiation regimen but no 5HT3 receptor antagonists acted as a control group. Both drugs were safe and effective in preventing nausea and vomiting resulting...

Piper methysticum

The rhizome of Piper methysticum (kava kava) has been used for hundreds of years in the South Pacific islands as a recreational drug, the main constituents of which are non-alkaloidal pyrone derivatives. These compounds cause sedation and centrally induced muscle relaxation. Kava has also been marketed in the West as a herbal pharmaceutical for use in the treatment of anxiety, for which it seems to be effective (1). However, the formulation used indigenously is an aqueous extract, while the...

Methylcobalamin Vertigo

The frequency of aminoglycoside-associated hearing loss is 2-45 . Since gentamicin-induced ototoxicity in most cases only involves vestibular function, the symptoms are easily overlooked in severely ill patients who are unable to sit. If diagnosed early, the vestibular damage is usually reversible. In some cases, severe long-term disability has been described (6). Six patients presented with unilateral vestibulotoxicity after systemic gentamicin therapy (7). All had ataxia and oscillopsia, but...

Placebocontrolled studies

In a randomized, double-blind, placebo-controlled, multicenter study, 289 patients took nateglinide in doses of 30 mg (n 51), 60 mg (n 58), 120 mg (n 63), and 180 mg (n 57), or placebo (n 60) before main meals (23). Meal-time insulin increased rapidly and meal-time glucose excursions were reduced. HbA1c concentrations were significantly reduced after 12 weeks in those taking 60 mg and more. Fasting plasma glucose was only significantly reduced in those taking 120 mg. The drug was withdrawn in...

Lorazepam

See also Benzodiazepines General Information Lorazepam is a benzodiazepine with CNS, depressant, anxiolytic, and sedative properties, used as a hypnotic, sedative, and anxiolytic drug. In a multicenter, randomized, double-blind comparison of diazepam (0.15 mg kg followed by phenytoin 18 mg kg), lorazepam (0.1 mg kg), phenobarbital (15 mg kg), and phe-nytoin (18 mg kg) in 518 patients with generalized convulsive status epilepticus, lorazepam was more effective than phenytoin and at least as...

Naltrexone

See also Opioid antagonists General Information Naltrexone is an orally-active long-acting pure opioid antagonist with no significant actions of its own. It antagonizes the actions of morphine-like drugs by preferentially binding to opioid receptors in the brain and other tissues, thereby displacing any opioid present and preventing the binding of any pure opioid agonist subsequently administered. Naltrexone can be used on its own in detoxified individuals to discourage relapse. The neurotoxic...

Metabolism

In 36 Japanese patients who were relatively lean but had excess abdominal fat, glibenclamide and voglibose caused loss of weight and abdominal fat (25). The loss of abdominal fat was related to glycemic control. The ratio of subcutaneous to abdominal fat shifted toward subcutaneous fat only in those who took voglibose. Both vogli-bose and glibenclamide improved insulin sensitivity and the acute response to insulin. DoTS classification (BMJ 2003 327 1222-5) Adverse effect Hypoglycemia due to...

Pefloxacin

See also Fluoroquinolones General Information Pefloxacin is a fluoroquinolone antibiotic that inhibits Plasmodium falciparum in vitro. It is effective against Plasmodium yoelii infections in mice. In humans pefloxacin was tested in a dosage of 400 mg every 12 hours for 3 days against chloroquine-resistant P. falciparum infections in Madagascar, and proved successful in 9 out of 22 cases seven further cases responded at first but recrudescence followed. The investigators suggested that...

Amiodarone

See also Antidysrhythmic drugs General Information Amiodarone is highly effective in treating both ventricular and supraventricular dysrhythmias (1). Its pharmacology, therapeutic uses, and adverse effects and interactions have been extensively reviewed (2-14). Amiodarone prolongs the QT interval and can therefore cause dysrhythmias there have also been reports of conduction disturbances. Abnormalities of thyroid function tests can occur without thyroid dysfunction, typically increases in serum...

Gastrointestinal

In a prospective study of 556 adults using isoflurane-, halothane-, or enflurane-based anesthesia for ear, nose, throat, and eye procedures, the incidences of emesis in the various groups over the ensuing 24 hours were 36, 41, and 46 respectively (49). Other drugs given during anesthesia included midazolam, thiopental, morphine, and nitrous oxide. Antiemetic requirements were also less with isoflurane 12 of patients required an antiemetic compared with 23 with halothane and enflurane. There...

Valproate

Co-administration of valproate is one of the most important risk factors for skin reactions to lamotrigine valpro-ate co-medication was present in 74 and 64 of patients with Stevens-Johnson syndrome and toxic epidermal necrolysis respectively (44). Valproate reduced the oral clearance of lamotrigine by about 70 , but the effect was not related to the concentration of valproate (hence the rather misleading title of the paper, that is there was an effect but it did not appear to be...

Semisynthetic progestogens

Desogestrel, one of the so-called third-generation proges-togenic steroids intended for use in oral contraceptives, is metabolized to estrogen. It was developed and introduced because of its relatively favorable effect on blood lipids in experimental work this led to the hope that it might, in the long run, have a relatively favorable effect on the risk of atherogenesis. However, it is not clear that this does in fact happen, and the third-generation progestogens have been associated with an...

Susceptibility Factors

In a prospective study on the prevalence of hearing impairment in a neonatal intensive care unit population (a total of 942 neonates were screened), aminoglycoside administration did not seem to be an important risk factor for communication-related hearing impairment (148). In almost all cases, another factor was the more probable cause of the hearing loss (dysmorphism, prenatal rubella or cytomegaly, a positive family history of hearing loss, and severe perinatal and postnatal complications)....

Nervous system

Ketamine causes a significant rise in cerebrospinal fluid pressure, increased electroencephalographic activity, and possibly epileptiform discharges (17). Delayed acute intracranial hypertension has been described after ketamine anesthesia (18). Oral ketamine is an effective analgesic in patients with chronic pain. In 21 patients with central and peripheral chronic neuropathic pain treated with oral ketamine, the starting dose was ketamine 100 mg day, titrated upward by 40 mg day increments...

Prilocaine and Emla

See also Local anesthetics General Information Prilocaine is an aminoamide local anesthetic. It can be used on its own, but it is also included in Emla in a eutectic combination with lidocaine (25 mg ml each), which is widely used as a local anesthetic in topical administration for, for example, superficial surgery and vene-puncture. Emla cream causes minor local adverse effects, such as itch, burning, and localized purpura (SEDA-19, 131) (SEDA-20,127) (SEDA-22, 140). A meta-analysis of the use...

Drug administration route

Compared with conventional routes, spinal opioid administration carries potentially greater morbidity and can only be justified if it produces equal or superior pain relief compared with conventional methods, with fewer unwanted effects (SED-11, 139). Although the analgesic effect of spinal opioids is largely due to a spinal effect, the opioid can spread rostrally to the brainstem and higher centers, and can cause delayed adverse effects. Lipid solubility affects the rate at which an opioid is...

Long Term Effects Drug abuse

There are many reports of abuse of phenmetrazine. Nervousness, hyperexcitability, euphoria, and insomnia, although less frequent than with amphetamines, have been observed with average doses. Dizziness, headache, nausea, dryness of the mouth, and urticaria have also been recorded. With large doses these adverse reactions were more pronounced. Paranoid psychosis was produced in addicts, and with chronic ingestion psychotic manifestations were evident as with amphetamine. In Sweden, phenmetrazine...

Reproductive system

Poor cycle control is a problem with medroxyprogester-one acetate. Most women using the product have at first either irregular or excessive bleeding and spotting or amenorrhea linked to endometrial atrophy (27) however, only one woman in a thousand bleeds sufficiently to warrant aggressive therapy, such as curettage. As the duration of use increases, amenorrhea becomes more common. Depot medroxyprogesterone acetate is associated with greater variability in menstrual patterns than other hormonal...

Uses

In 13 British soldiers with cutaneous larva migrans after a 2-week jungle training exercise in Belize the median incubation period was 10 (range 4-38) days in 12 there were skin lesions on the calves or shins, and only two had foot or ankle lesions (2). Ten received oral thiabendazole, one oral mebendazole, one oral albendazole, and one topical thia-bendazole. All those treated with oral thiabendazole complained of unpleasant reactions, predominantly nausea, vomiting, and dizziness. The one...

Stephania species

Various species of Corydalis (fumewort, Fumariaceae) and Stephania (Jin bu huan) contain tetrahydropalmatine (1), which is the active constituent in Chinese Jin Bu Huan Anodyne'' tablets, sold on the Western market. The package insert suggested that Polygala chinensis is the source plant, but in reality this alkaloid comes from a species of Stephania. Both l-tetrahydropalmatine and its racemic dl-form are used in Chinese medicine as analgesic and hypnotic agents. Stephania has been adulterated...

Amyl nitrite

Amyl nitrite, despite its name, is also used as a nitrate. It is a yellowish liquid taken by inhalation of its vapor for angina pectoris. It has also been used to treat cyanide poisoning, but is nowadays used exclusively as a substance of abuse. Although it is a prescription-only medicine in the UK, it is sold over the counter in glass ampoules to be used as a room deodorizer'' or incense.'' It is known under numerous different nicknames and brand names, including snappers, poppers, Rush, Kix,...

Drugs With Sensory Side Effects

At high doses, and especially if serum concentrations are over 50 mg ml, furosemide can cause ototoxic reactions, such as tinnitus, vertigo, and even deafness, sometimes permanent (SED-9, 351). Subclinical, audiometrically determined, high-tone deafness has been reported to occur in 6.4 of furosemide-treated patients (2). It is generally considered advisable to use another diuretic in patients whose hearing is already impaired, and to avoid using furosemide along with other ototoxic drugs, such...

Ginseng

Ginseng is an ambiguous vernacular term, which can refer to Panax species such as Panax ginseng (Asian ginseng) and Panax quinquefolius (American ginseng), Eleutherococcus senticosus (Siberian ginseng), Pfaffia paniculata (Brazilian ginseng), or unidentified material (for example Rumanian ginseng). Asian ginseng (P. ginseng) contains a wide variety of flavonoids, saponins, steroids, sesquiterpenoids, and triter-penoids. These include ginsenolides and ginsenosides, pro-topanaxadiol, panaxadiol,...

Drug Drug Interactions

The greatest potential for serious mishap arises from interactions between calcium channel blockers (especially verapamil and related compounds) and beta-adrenoceptor antagonists (159,160). This combination can cause severe hypotension and cardiac failure, particularly in patients with poor myocardial function (161-163). The major risk appears to be associated with the intravenous administration of verapamil to patients who are already taking a beta-blocker (164), but a drug-like tiapamil,...

Pharmacokinetics

After oral administration zaleplon is well absorbed (71 ) and peak concentrations are reached in about 60 minutes. However, it undergoes presystemic elimination and has a systemic availability of about 30 . Its adverse effects include anterograde amnesia, depression, paradoxical reactions (for example restlessness, agitation), dependence, and withdrawal symptoms (related to the dose and duration of treatment). Although the data are limited, it is thought to be relatively safe in overdose,...

Organs and Systems Cardiovascular

Cardiovascular complications are not uncommon in the course of local anesthesia however, most changes are moderate, involving mild peripheral vasodilatation and reduced cardiac output with a change in heart rate. Local anesthetics reduce myocardial contractility and rate of conduction 11 . They also cause direct vasoconstriction or vasodilatation of vascular smooth muscle 12 and central stimulation of the autonomic nervous system 13 . Cardiac arrest and marked myocardial depression, in which...

Side Effects Of

Traditionally, nitrates have been first-line therapy in angina. They can be given to treat acute attacks, taken prophylactically before exertion or other stimuli known to provoke an attack, or used as continuous prophylaxis over 24 hours. Since angina is an episodic symptom, the first two methods are attractive, as continuous prophylaxis requires treatment over long periods when there are no symptoms. Tempering this argument is the realization that there may be silent myocardial ischemia,...

Zolmitriptan

The available data on zolmitriptan have been reviewed. Only safety aspects are mentioned here. Orally administered zolmitriptan appears to have been generally well tolerated in placebo-controlled studies 7 . The most commonly reported adverse events are weakness, heaviness or tightness other than in the chest , dry mouth, nausea, dizziness, somnolence, paresthesia, a sensation of warmth, and chest pain. They were mild to moderate and resolved without the need for intervention or drug...

Lobelia inflata

Lobelia inflata Indian tobacco contains lobeline and other pyridine alkaloids. It has been used as an emetic, antidepressant, respiratory stimulant, an aid to smoking cessation, and a treatment for metamfetamine abuse 1 . Lobeline has peripheral effects similar to those of nicotine, whereas its central activity may be different. It has been associated with nausea, vomiting, headache, tremors, and dizziness. Symptoms caused by overdosage include profuse sweating, paresis, tachycardia,...

Mandragora species

Mandragora mandrake species contain toxic tropane alkaloids, such as hyoscyamine and or scopolamine. The tropane alkaloids in Mandragora species are powerful anticholinergic agents and can cause peripheral symptoms for example blurred vision, dry mouth and central effects for example drowsiness, delirium 15 . They can potentiate the effects of synthetic drugs with similar pharmacological activity. In 15 patients anticholinergic effects were due to poisoning by Mandragora autumnalis intermingled...

Drug Administration Drug formulations

As with estradiol, a case has been made for using natural progesterone, rather than synthetic analogues, largely because it is assumed that as a physiological substance it will be safer. Progesterone is unsuitable for oral use unless given in a special micronized form , but it is used by other routes. These include systemic and intra-articular injection 36 , an intranasal ointment 37 , transdermal formulations 38 , and intravaginal formulations 39 . Apart from local irritation, the wanted and...

Zingiber officinale

Zingiber officinale ginger contains a variety of compounds, including diarylheptanoids and the phenol gingerol. It has been used to treat motion sickness and other forms of nausea and vomiting, and may have some efficacy 1 . Of about 1000 patients with occupational skin diseases, five had occupational allergic contact dermatitis from spices 2 . They were chefs, or workers in kitchens, coffee rooms, and restaurants. In all cases the dermatitis affected the hands. The causative spices were...