RESUMEN
Dapsone is a sulfone antimicrobial and is used widely as an antileprotic medication. The commonly encountered cutaneous adverse drug reactions [ADR] due to dapsone are exfoliative dermatitis, toxic 'erythema, erythema multiforme, morbilliform and scarlatiniform eruptions, urticaria, erythema nodusum and toxic epidermal necrolysis [TEN]. We hereby report a case of toxic epidermal necrolysis caused due to dapsone. The causality, severity and preventability assessments were carried out. The patient was treated with systemic hydrocortisone, antibiotics and other symptomatic drugs. The reaction was severe and the patient expired on the second day of hospital admission in spite of the treatment. Since TEN is a life threatening cutaneous ADR and dapsone is a commonly used drug, this reaction needs monitoring
Asunto(s)
Humanos , Masculino , Síndrome de Stevens-Johnson/diagnóstico , Síndrome de Stevens-Johnson/tratamiento farmacológico , Lepra/tratamiento farmacológico , Lepra/complicaciones , Dapsona , Dapsona/efectos adversos , Hidrocortisona , Ranitidina , Ampicilina , Cloxacilina , Sucralfato , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Dapsona/toxicidadRESUMEN
Various quinolones have varied effects on the preservative activity of blood cells. Nalidixic acid causes hemolysis in G-6PD deficient patients where as ofloxacin has been found to possess preservative action of WBCs. The present study was undertaken to see the effect of various fluoroquinolones on RBC membrane. The effect of quinolones like ciprofloxacin, ofloxacin and norfloxacin and nalidixic acid in the dose of 5 micrograms/ml was studied on dapsone induced, in vitro hemolysis of rabbit RBC, using the osmotic fragility test. The mean corpusular fragility (MCF) with various agents were as follows: (mean +/- SE) saline; 5.23 +/- 0.21; dapsone, 6.57 +/- 0.23; ofloxacin, 3.81 +/- 0.13; ofloxacin and dapsone, 5.13 +/- 0.11; nalidixic acid, 6.28 +/- 0.16; nalidixic acid and dapsone, 6.65 +/- 0.13; ciprofloxacin, 3.52 +/- 0.22; ciprofloxacin and dapsone, 4.80 +/- 0.2; norfloxacin, 1.97 +/- 0.23; norfloxacin and dapsone, 4.27 +/- 0.20. The MCF data and shift of the osmotic fragility curves (to the left) show that dapsone induced erythrolysis is significantly protected by ciprofloxacin, ofloxacin and norfloxacin but not by nalidixic acid.
Asunto(s)
Animales , Dapsona/toxicidad , Hemólisis/efectos de los fármacos , Fragilidad Osmótica/efectos de los fármacos , Quinolonas/farmacología , ConejosRESUMEN
Effect of DDS was studied using the mouse model. It was observed that DDS did not have any neurotoxic effect. On the contrary it showed a protective action towards the nerve, when administered in the early stages following definite establishment of nerve lesions.