ABSTRACT
Total radical prostatectomy for advanced prostate cancer may lead to sexual impotence, since it is associated with severe erectile dysfunction. A widely recommended treatment for this disabling condition is intracavernous penile injection of a mixture of prostaglandin E1, papaverine, and phentolamine. To our knowledge, we present the first case of anaphylaxis associated with intracavernous penile injection of prostaglandin E1 in combination with papaverine and phentolamine.
A prostatectomia radical total para câncer de próstata avançado pode levar à impotência sexual, associada a uma disfunção erétil grave. Um tratamento amplamente recomendado para esta condição incapacitante é a injeção intracavernosa no pênis de uma mistura de prostaglandina E1, papaverina e fentolamina. Até onde sabemos, estamos apresentando o primeiro caso de anafilaxia associada à injeção intracavernosa peniana de prostaglandina E1 em combinação com papaverina e fentolamina.
Subject(s)
Humans , Male , Middle AgedABSTRACT
Objective@#To investigate the occurrence and characteristics of adverse reactions of penicillin combined with chloramphenicol and tetracycline, so as to provide a reliable basis for the rational clinical application of penicillin, chloramphenicol and tetracycline antibiotics.@*Methods@#From January 2017 to July 2018, 200 cases with adverse reactions of combined use of penicillin, chloramphenicol, tetracycline in Yiwu Central Hospital were chosen.The clinical data of 200 cases of drug adverse reactions report were retrospectively analyzed.The gender distribution, age distribution, dosage, clinical manifestation, adverse reactions involving system, time, unreasonable drug adverse reactions happen were analyzed.@*Results@#Among the 200 adverse reactions, 51.50% cases were male and 48.50% were female, and the difference was not statistically significant(χ2=0.360, P>0.05). The age distribution of 200 cases of adverse reactions was concentrated in people aged less than 14 and more than 60, accounting for 36.50% and 41.00%, respectively.The main routes of administration of 200 adverse reactions were intravenous injection, intramuscular injection and oral administration, accounting for 38.00%, 32.50% and 29.50%, respectively.The clinical manifestations of adverse reactions in 200 cases were mainly anaphylactic shock, bone marrow suppression and dizziness, accounting for 20.00%, 18.50% and 11.50%, respectively.The adverse reactions of 200 cases mainly involved hematopoietic system, nervous system, systemic damage and skin system, accounting for 36.00%, 24.50%, 20.00% and 18.00%, respectively.The adverse reactions of 200 cases occurred within 30 min after medication, accounting for 69.50%.The unreasonable medication of 200 cases of adverse reactions mainly included unreasonable course of medication, unreasonable timing of administration, unreasonable solvent selection, unreasonable dosage and repeated medication.@*Conclusion@#Penicillin, chloramphenicol, tetracycline class of antimicrobial agents combined application has more adverse reactions, the adverse reaction throughout children and the elderly, many involving the hematopoietic system, nervous system, clinical need according to penicillin, chloramphenicol, tetracycline class of antimicrobial agents combined use of the laws and characteristics of adverse reactions in the aftermath of the targeted pharmaceutical intervention, so as to promote clinical rational drug use.
ABSTRACT
Objective To investigate the occurrence and characteristics of adverse reactions of penicillin combined with chloramphenicol and tetracycline ,so as to provide a reliable basis for the rational clinical application of penicillin,chloramphenicol and tetracycline antibiotics.Methods From January 2017 to July 2018,200 cases with adverse reactions of combined use of penicillin ,chloramphenicol,tetracycline in Yiwu Central Hospital were chosen. The clinical data of 200 cases of drug adverse reactions report were retrospectively analyzed.The gender distribution, age distribution,dosage,clinical manifestation,adverse reactions involving system , time, unreasonable drug adverse reactions happen were analyzed.Results Among the 200 adverse reactions ,51.50% cases were male and 48.50%were female,and the difference was not statistically significant (χ2 ＝0.360,P＞0.05).The age distribution of 200 cases of adverse reactions was concentrated in people aged less than 14 and more than 60,accounting for 36.50%and 41.00%, respectively.The main routes of administration of 200 adverse reactions were intravenous injection , intramuscular injection and oral administration,accounting for 38.00%,32.50%and 29.50%,respectively.The clinical manifestations of adverse reactions in 200 cases were mainly anaphylactic shock ,bone marrow suppression and dizziness ,accounting for 20.00%,18.50% and 11.50%, respectively.The adverse reactions of 200 cases mainly involved hematopoietic system,nervous system,systemic damage and skin system ,accounting for 36.00%,24.50%,20.00% and 18.00%, respectively.The adverse reactions of 200 cases occurred within 30 min after medication,accounting for 69.50%.The unreasonable medication of 200 cases of adverse reactions mainly included unreasonable course of medication , unreasonable timing of administration,unreasonable solvent selection ,unreasonable dosage and repeated medication. Conclusion Penicillin,chloramphenicol ,tetracycline class of antimicrobial agents combined application has more adverse reactions,the adverse reaction throughout children and the elderly ,many involving the hematopoietic system , nervous system, clinical need according to penicillin , chloramphenicol, tetracycline class of antimicrobial agents combined use of the laws and characteristics of adverse reactions in the aftermath of the targeted pharmaceutical intervention,so as to promote clinical rational drug use.
ABSTRACT
La diabetes mellitus se asocia con complicaciones vasculares y elevadas tasas de morbimortalidad. La terapia oportuna con insulina y su intensificación cuando es necesaria, representan estrategias apropiadas para evitar o retardar la aparición de dichas complicaciones. Sin embargo, la incidencia de hipoglucemia y las dificultades en la adherencia al tratamiento representan barreras para alcanzar el éxito terapéutico. Las nuevas combinaciones de análogos de insulina constituyen tratamientos que presentarían ventajas farmacocinéticas y farmacodinámicas, logrando beneficios clínicos tales como un mejor control metabólico, la disminución de eventos hipoglucémicos y, por su simplicidad, potencialmente una mayor adherencia al tratamiento.
Diabetes mellitus is associated with vascular complications and high rates of morbidity and mortality. Timely insulin therapy, intensified when necessary, represent appropriate measures to prevent or delay the onset of complications. However, the incidence of hypoglycemia and difficulties in treatment adherence represent barriers to achieve therapeutic success. Premixes analogs and, specially, combinations of insulin analogues are associated with pharmacokinetic and pharmacodynamic advantages, that translate into clinical benefits such as improved metabolic control, decreased hypoglycemic events and, for their simplicity, potentially greater adherence.
Subject(s)
Humans , Diabetes Mellitus, Type 2/drug therapy , Insulins/therapeutic use , Hypoglycemic Agents/therapeutic use , Risk Factors , Treatment Outcome , Diabetes Mellitus, Type 2/prevention & control , Drug Therapy, Combination , Insulins/pharmacokinetics , Glucagon-Like Peptide-1 Receptor/antagonists & inhibitors , Hypoglycemia/chemically induced , Hypoglycemia/prevention & control , Hypoglycemic Agents/pharmacokineticsABSTRACT
A Hipertensão Arterial é uma patologia de grande prevalência em nosso meio e que contribui de forma importante como o maior fator de risco independente para o desenvolvimento de Acidente Vascular Cerebral (AVC) e Doença Arterial Coronária (DAC). Atualmente, a DAC representa a maior causa de mortalidade cardiovascular em nosso país. Portanto, a busca de controle das cifras pressóricas em hipertensos com DAC ou com risco de desenvolvê-la torna-se um objetivo. Que metas devemos atingir nesse tipo de paciente? Recente estudos modificaram esses valores, que devem situar entre 130 139/85 89 mmHg. Reduções mais intensas podem aumentar o risco de eventos, com especial atenção para não reduzir a pressão arterial diastólica (PAD) abaixo de 60 mmHg. Grande benefício decorre da redução da PA per se, devendo ser fortemente implementada, em todos os pacientes, a modificação no estilo de vida associada a esquemas medicamentosos. Sabidamente, algumas classes de anti-hipertensivos têm uma indicação compulsória nessa situação, a saber, os Beta-bloqueadores (BB), os Inibidores da Enzina Conversora de Angiotensina (IECA), os Bloqueadores dos Receptores da Angiotensina (BRA) e os Bloqueadores dos Canais de Cálcio (BCC). Da mesma forma, podemos utilizar as associações desses fármacos na busca de um melhor controle da PA, sendo inclusive uma opção de início de tratamento, uma vez que estamos diante de pacientes de alto ou muito alto risco.
Hypertension is a disease of high prevalence in Brazil and contributes significantly as the largest independent risk factor for the development of stroke and coronary artery disease (CAD). Currently, CAD is the major cause of cardiovascular mortality in Brazil. Therefore, the search for the control of blood pressure levels in hypertensive patients with CAD or with risk for developing it becomes a target. What goals should we achieve in this type of patient? Recent studies have modified these values that should be in the range of 130 139/85 89 mmHg. Larger decreases may increase the risk for events, with special care to not reduce diastolic blood pressure (DBP) below 60 mmHg. Great benefit results from reduction of BP per se, and the modification in life style, associated with drug regimens, must be strongly implemented in all patients. It is known that some classes of antihypertensive drugs have a compelling indication in this situation, as Beta-blockers (BB), Angiotensin-Converting Enzyme Inhibitors (ACEI), Angiotensin Receptor Blockers (ARB) and Calcium Channel Blockers (CCB). Likewise, we can use the association of these drugs in search for a better BP control, being inclusively an option of early treatment, since we are dealing with patients at high or very high risk.