[Imatinib plasma levels in the management of cutaneous side effects induced by imatinib (Glivec®): 2 case reports]. / Place du dosage plasmatique de l'imatinib (Glivec®) dans la prise en charge des effets indésirables cutanés à l'imatinib : étude de deux cas.

Imatinib, an antineoplastic drug used to treat certain cancers, has many side effects such as hematologic, neurologic or cutaneous toxicity. These toxicities seem to be due to a high imatinib plasmatic concentration and are frequently controlled by a discontinuation or a dosage reduction of the drug. We report here in 2 cases of cutaneous side effects induced by imatinib in order to demonstrate the necessity of drug monitoring in such cases. In our cases, imatinib is responsible in the occurrence of these side effects. Monitoring plasma levels of imatinib allowed us to judge if levels were toxic or not and to avoid discontinuation of imatinib in some cases.

Serious adverse drug reactions in older adults notified to pharmacovigilance.

PURPOSE: To report the serious adverse drug reactions (ADRs) in older adults notified to pharmacovigilance, to identify the incriminated drugs and to search for risk factors of occurrence. METHODS: A retrospective study including 106 serious adverse drug reactions notified to pharmacovigilance in patients aged of 65 years and more, over a period of 16 years. Imputation was established according to the French method and seriousness according to the World Health Organisation (WHO) criteria. RESULTS: Adverse drug reactions were essentially systemic. Incriminated drugs were mainly antibiotics, allopurinol and cardio-vascular drugs. Gender, age and number of administered drugs did not seem to be risk factors of serious ADRs occurrence. Among older adults, 4% died further to a serious ADRs. CONCLUSION: Systemic notification to pharmacovigilance will allow a better analysis of risk factors of serious ADRs occurrence and to insure safety and health to the older adults.

Adverse drug reactions in older adults: a retrospective study from pharmacovigilance.

PURPOSE: To assess the adverse drug reactions notified in older adults to pharmacovigilance and to identify the incriminated drugs in their genesis. METHODS: A retrospective study including 688 notifications of adverse drug reactions to pharmacovigilance in patients aged of 65 years and more, over a period of 16 years and where the responsibility of one drug or more was incriminated in the genesis of the adverse reaction. Imputation was established according to the French method and seriousness according to the World Health Organization (WHO) criteria. RESULTS: Sex-ratio W/M was 1.2. Average age was 71.3 years. The average number of administered drugs was 3.64 and polymedication was noted in 30% of cases. Adverse drug reactions were essentially cutaneous and systemic. Incriminated drugs were mainly antibiotics and cardio-vascular drugs. Serious adverse drug reactions were noted in 26%. CONCLUSION: In older adults, adverse drug reactions' notification to pharmacovigilance is necessary and allows assessing large scale epidemiologic studies to identify iatrogenic risk factors.

[Allergic reactions to paracetamol]. / Réactions de type allergique au paracétamol.

BACKGROUND: Paracetamol is an extensively used analgesic and antipyretic. Allergy to this drug is occasionally reported and is usually moderate. MATERIALS AND METHODS: We led a retrospective study of 119 cases of allergic reactions to paracetamol notified to the Tunisian centre of pharmacovigilance, between September 1990 and September 2000. These cases were validated according to the method of imputability of Bégaud et al. RESULTS: Our population comprised 64 women and 55 men, aged 1 month to 70 years. Antecedents of allergy or atopy were found in many cases, including 10 cases of allergy to paracetamol and 6 to salicylates. Paracetamol was self-administered in 50% of cases and taken with other drugs in 68% of cases. The type of lesions varied, the most frequent being urticaria (34.4%), macular and pustular eruption (30.2%) and fixed drug eruption (12.6%). Some reactions were serious, such as Lyell syndrome or anaphylactic shock. Resolution was favourable in all cases and paracetamol was definitively contraindicated for patients with scores of high or mild imputability. CONCLUSION: Allergy to paracetamol seems to be rare but not exceptional. Several risk factors seem to be important in triggering this side effect, particularly antecedents of allergy to this drug or to aspirin.