ABSTRACT
TITLE: Encefalopatia hiperamonemica inducida por acido valproico.
Subject(s)
Anticonvulsants/adverse effects , Brain Diseases, Metabolic/chemically induced , Coma/chemically induced , Hyperammonemia/chemically induced , Valproic Acid/adverse effects , Acetamides/therapeutic use , Anticonvulsants/administration & dosage , Brain Diseases, Metabolic/drug therapy , Carnitine/therapeutic use , Coma/diagnosis , Drug Therapy, Combination , Electroencephalography , Epilepsies, Partial/drug therapy , Female , Humans , Hyperammonemia/diagnosis , Hyperammonemia/drug therapy , Lacosamide , Lactulose/therapeutic use , Middle Aged , Models, Biological , Young AdultABSTRACT
La ceftazidima es un antibiótico perteneciente al grupo de las cefalosporinas de tercera generación, de uso frecuente en la práctica clínica por su amplio espectro antibacteriano. Presentamos el caso de un varón de 78 años que ingresó en la unidad de cuidados intensivos por una insuficiencia respiratoria secundaria a una neumonía nosocomial en el postoperatorio de una bisegmentectomía hepática laparoscópica por un hepatocarcinoma. Precisó ventilación mecánica invasiva, y se trató con ceftazidima, desarrollando un descenso progresivo en la cifra de plaquetas tras el comienzo de este fármaco y tras la reexposición al mismo, no coincidiendo temporalmente con la introducción de otros fármacos. La reacción adversa fue comunicada al Sistema Español de Farmacovigilancia y según el algoritmo de Naranjo la relación de causalidad fue probable. Puesto que no se ha encontrado descrito en la literatura ningún caso de trombocitopenia inducida por ceftazidima se considera relevante su conocimiento para que sea una reacción adversa a tener en cuenta dada su potencial gravedad, especialmente cuando no sea explicable por otras causas (AU)
Ceftazidime is an antibiotic belonging to the group of third generation cephalosporins, frequently used in clinical practice for its broad antibacterial spectrum. A case report is presented on a 78-year-old man who entered the intensive care unit due to respiratory failure secondary to nosocomial pneumonia in the postoperative period of a laparoscopic hepatic bisegmentectomy for a hepatocarcinoma. It required invasive mechanical ventilation and was treated with ceftazidime, developing a progressive decrease in platelet count after the onset of this drug and after re-exposure to it, not coinciding with the introduction of other drugs. The adverse reaction was reported to the Spanish pharmacosurveillance system and according to the Naranjo algorithm the causal relationship was probable. Since no case of ceftazidime-induced thrombocytopenia was found in the literature, we consider knowledge of it relevant as an adverse effect to be taken into account given its potential severity, especially when it cannot be explained by other causes (AU)
Subject(s)
Humans , Male , Aged , Thrombocytopenia/chemically induced , Ceftazidime/adverse effects , Carcinoma, Hepatocellular/surgery , Respiratory Insufficiency/complications , Respiration, Artificial , Platelet Count , Pneumonia/drug therapyABSTRACT
Ceftazidime is an antibiotic belonging to the group of third generation cephalosporins, frequently used in clinical practice for its broad antibacterial spectrum. A case report is presented on a 78-year-old man who entered the intensive care unit due to respiratory failure secondary to nosocomial pneumonia in the postoperative period of a laparoscopic hepatic bisegmentectomy for a hepatocarcinoma. It required invasive mechanical ventilation and was treated with ceftazidime, developing a progressive decrease in platelet count after the onset of this drug and after re-exposure to it, not coinciding with the introduction of other drugs. The adverse reaction was reported to the Spanish pharmacosurveillance system and according to the Naranjo algorithm the causal relationship was probable. Since no case of ceftazidime-induced thrombocytopenia was found in the literature, we consider knowledge of it relevant as an adverse effect to be taken into account given its potential severity, especially when it cannot be explained by other causes.
