ABSTRACT
No abstract available.
Subject(s)
Humans , Male , Middle Aged , Acute Disease , Anticonvulsants/poisoning , Diagnosis, Differential , Drug Overdose , Phenytoin/poisoning , Predictive Value of Tests , Respiratory Insufficiency/chemically induced , Suicide, Attempted , Tomography, X-Ray ComputedABSTRACT
El Síndrome de Stevens Johnson (SSJ), el Síndrome de Superposición (SSJ/ NET) y la Necrólisis Epidérmica Tóxica (NET) son formas clínicas cutáneo-mucosas graves, desencadenadas por fármacos y muy frecuentemente por anticonvulsivantes. Comunicamos el caso de una paciente medicada por su epilepsia, quién presentó un cuadro incipiente de SSJ empeorando rápidamente hasta derivar en la NET. A pesar de la gravedad, la paciente respondió satisfactoriamente a altas dosis de corticoides sistémicos desde el comienzo y por las medidas de soporte del equipo médico multidisciplinario del hospital.
The Stevens Johnson Syndrome, the Overlape Syndrome (SSJ / NET), and the Toxic Epidermal Necrolysis are clinical cutaneous mucouse forms due to drugs administration and most frequently due caused by antiepileptic. We communicate the case of a patient treated with lamotrigina for epilepsy, who presented an incipient case of Stevens Johnson Syndrome, worsened rapidly causing a Toxic Epidermal Necrolysis. Nevertheless, the patient gained a satisfactory answer due to high doses of corticoids, which were given from the beginning as well as the measures and the support of the whole medical team of the hospital.
Subject(s)
Humans , Female , Adult , Anticonvulsants/poisoning , Anticonvulsants/adverse effects , Drug-Related Side Effects and Adverse Reactions/complications , Stevens-Johnson Syndrome/diagnosis , Stevens-Johnson Syndrome/drug therapyABSTRACT
This case report describes a rare interaction between therapeutic doses of phenytoin and acenocoumarol resulting in both acute phenytoin toxicity and increased international normalized ratio (INR). Interactions between these drugs are due to the pharmacokinetics and the common metabolising pathway by hepatic cytochrome P450 isoenzyme-CYP2C9. Our patient was detected to be homozygous for CYP2C9*3 by PCR-RFLP analysis resulting in markedly decreased metabolism of both the drugs. Given that these two drugs are often given concomitantly in the medical out patient department, and that CYP2C9 polymorphisms are not uncommon, clinicians should be aware of this interaction and suspect this in patients with toxicity to these drugs.
Subject(s)
Acenocoumarol/adverse effects , Adult , Anticoagulants/adverse effects , Anticonvulsants/poisoning , Aryl Hydrocarbon Hydroxylases/genetics , Drug Interactions , Female , Humans , Mutation , Pharmacogenetics , Phenytoin/poisoning , Polymorphism, Genetic , Pregnancy , Pregnancy Complications/drug therapy , Pregnancy Complications, Hematologic/prevention & control , Seizures/drug therapyABSTRACT
El síndrome de hipersensibilidad a drogas o síndrome DRESS es una reacción rara y potencialmente fatal; se caracteriza por presentar la tríada de fiebre, rash y compromiso de órganos internos. Fenitoína, fenobarbital y carbamazepina son los anticonvulsivantes aromáticos que con más frecuencia causan esta reacción. Dicho síndrome ocurre entre la 1ra y 8va semanas después de la exposición al fármaco. La eliminación inmediata de la droga es esencial para el manejo de estos pacientes. Presentamos una paciente de sexo femenino, de 62 años, medicada con carbamazepina durante un mes, que consulta por fiebre, mal estado general y rash máculopapuloso que se generalizó hasta abarcar el 90% de la superficie cutánea.
Anticonvulsivant hypersensitivity syndrome (AHS) is a rare and potentially fatal reaction characterized by the appearance of fever, skin rash and internal organ involvement. Phenytoin, phenobarbital and carbamazepine are the most frequent aromatic anticonvulsivant causing the reaction. This syndrome occurs 1-8 weeks after the initial drug exposure.
Subject(s)
Humans , Female , Middle Aged , Carbamazepine/adverse effects , Drug Hypersensitivity Syndrome/diagnosis , Anticonvulsants/poisoning , Skin ManifestationsABSTRACT
To study the accidental drug poisoning. A retrospective study. Prince Rashid Ben Al- Hassan Hospital- Northern Jordan. Children with accidental drug poisoning, who were admitted to Prince Rashid Hospital from January 2001 to January 2005. Fifty-nine children have been enrolled in the study; thirty-six [61%] were male. Thirty-two [54%] of children belong to the age group of 1- 4 years. Twenty-nine [49%] children had ingested miscellaneous drugs, 15 [26%] anticonvulsant drugs, 5 [8%] antipsychotic drugs, and 6 [10%] children had ingested drugs for local use and 4 [7%] unknown. In 5 [8%] children the drug had been ingested due to unidentified identity. In 2 [3%] the drug was given by mistake to the child. Eighty-eight percent of drug ingestion took place at homes. Lack of supervision at the time of ingestion was noted in 52 [89%] of cases. Drowsiness was the most common presenting features [24%]. Gastric lavage was done in 27 [46%] children. Drug poisoning is still a major health problem in our community. Family should be aware of the problem and health professionals should participate in preventive measures. This study emphasizes the need for establishment of poison control centers all over the country