ABSTRACT
INTRODUCTION: Fluoroquinolones are most widely used for empirical treatment of gastrointestinal disease due to emergence of drug resistant strains to other antimicrobials. They are also indulged in cutaneous adverse drug reactions with varying form of severity. CASE PRESENTATION: A 43 year old male patient developed fixed drug eruptions after administration of tablet norfloxacin and metronidazole for treatment of colicky abdominal pain with diarrhoea. Erythematous rashes involved whole body including buccal mucosa. Causative drugs were stopped and patient was managed by local as well as systemic therapy and was recovered after 20 days. CONCLUSION: Awareness among healthcare professionals regarding FDEs and its management is essential to prevent mortality and morbidity and counsel patient regarding future use of drugs causing reactions with physician's advice.
ABSTRACT
PURPOSE: The study aimed to measure the percentage of preventable adverse drug reactions that lead to the hospitalization (PADRAd) and to explore the heterogeneity in its estimation through subgroup analysis of study characteristics. METHODS: Two investigators independently searched in electronic databases and related bibliography for prospective studies involving PADRAd. We excluded studies investigating medication errors and spontaneous and retrospective reporting. The primary outcome was PADRAd percentage. To explore the heterogeneity, we performed subgroup analysis based on study region, wards, age groups, adverse drug reaction (ADR) definitions, preventability assessment, ADR identification methods, study duration and sample size. We explored fatal PADRAd and causative drugs as a secondary outcome. We used the generic inverse variance method with random effect model to compute meta-analytic summary. RESULTS: Of the 68 full-text articles assessed, we included 22 studies. The mean PADRAd percentage was 45.11 % (95 % CI = 33.06-57.15; I 2 = 99 %). Studies including elderly (63.31 %) and all age groups (49.03 %) showed higher percentages than paediatric population (16.40 %). Studies examining all hospital populations showed higher percentages than specific wards. We observed high percentages in studies using Edwards and Aronson as an ADR definition and Hallas et al. as a preventability assessment tool. After age group adjustment, ADR detection methods did not show significant difference. The fatal PADRAd percentage was 1.58 % (95 % CI = -0.60 to 3.76; I 2 = 47 %). Paediatric and elderly studies showed a different causative drug pattern. CONCLUSION: Variation in PADRAd across the studies can be explained by difference in study populations and data collection methods. Extrapolation of preventable reactions should be carried out considering all these factors with caution.
Subject(s)
Drug-Related Side Effects and Adverse Reactions , HospitalizationABSTRACT
A stability-indicating reverse phase high performance liquid chromatography method was developed and validated for cefixime and linezolid. The wavelength selected for quantitation was 276 nm. The method has been validated for linearity, accuracy, precision, robustness, limit of detection and limit of quantitation. Linearity was observed in the concentration range of 2-12 µg/ml for cefixime and 6-36 µg/ml for linezolid. For RP-HPLC, the separation was achieved by Phenomenex Luna C18 (250×4.6 mm) 5 µm column using phosphate buffer (pH 7):methanol (60:40 v/v) as mobile phase with flow rate 1 ml/min. The retention time of cefixime and linezolid were found to be 3.127 min and 11.986 min, respectively. During force degradation, drug product was exposed to hydrolysis (acid and base hydrolysis), H2O2, thermal degradation and photo degradation. The % degradation was found to be 10 to 20% for both cefixime and linezolid in the given condition. The method specifically estimates both the drugs in presence of all the degradants generated during forced degradation study. The developed methods were simple, specific and economic, which can be used for simultaneous estimation of cefixime and linezolid in tablet dosage form.
ABSTRACT
Drug-eluting stents (DESs) prevail in the treatment of carotid artery diseases in the interventional cardiology world owing to their efficacy for significant reduction of restenosis. A current successful DES requires a polymer coating for drug delivery. Clinical trials examining several pharmaceutical agents have demonstrated marked reduction in restenosis following stenting. The development of DES is one of the major revolutions in the field of interventional cardiology. The ideal drug to prevent restenosis must have an anti-proliferative and anti-migratory effect on smooth muscle cells but, on the other hand, it must also enhance re-endothelialization in order to prevent late thrombosis. Additionally, it should effectively inhibit the anti-inflammatory response after balloon induced arterial injury. Although DES have significantly reduced the angiographic restenosis rate and have improved clinical outcomes, late thrombosis and restenosis remain an important subject of ongoing research.
