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Showing 3 results for Drug Reaction

Heidari B, Noroozi Z,
Volume 59, Issue 1 (4-2001)
Abstract

To determine the complications of gold sodium thiomalate therapy in rheumatoid arthritis (RA), 32 patients with active RA (27 female, 5 male) treated for a mean period of 28 ? 14 weeks were studied. From these patients, 62.5 (46-79) percent showed at least one drug reaction. Pruritus was the most common complication occurred in 59 (42-76) percents, and was accompanied by skin rush in 37 (15-57) percents of cases. Renal, mucosal and post-injection complication developed, each in 16 (3-29) and percents of patients. Hematologic and pulmonary reaction occurred in 12.5 (1-24) and 9 (1-19) percents of cases respectively. Drug reaction resulted to discontinuation of gold therapy in 19 (5-32) percents of patients. Majority of drug reactions occurred during the first 15 weeks of therapy. In comparison to reports coming from other studies, drug reactions in Iranian patients were more frequent but less severe.
Mohagheghi M A, Nahvi Jou A, Sedighi Z,
Volume 61, Issue 2 (5-2003)
Abstract

Opioids are increasingly being recognized as the primary treatment for cancer pain management. Optimal treatment of cancer pain involves assessing its characteristics, considering different management strategies, evaluating side effects and adverse drug reactions and establishing the most appropriate therapeutic regimen. This study was designed to review the current status of pain management for advanced cancer cases using opioid analgesics.
Materials and Methods: A questionnaire was used to collect data on demographics, disease characteristics, and opioids use indicators in 700 cases of advanced cancer patients.
Results: A total of 700 cancer cases, 42 percent females and 58 percent males, between 17-80 years age range (Mean age of 57.25) were studied retrospectively. Cancers of breast (21 percent), colorectal (12 percent), lung (7 percent), stomach (7 percent) and bone either primary or metastatic (6 percent ) in women and stomach (17 percent), lung (12 percent), colorectal (11 percent), prostate (9 percent ), and bone (8 percent ) in men were the most common causes of opioids prescription in study group respectively. Advanced primary cancer (in 52 percent), bone metastasis (in 32 percent), and treatment complications (in 7 percent ) were considered as physical basis for pain in patients. Morphine (by injection), Opium (by oral intake) and methadone (injection and/or oral) were the most common opioids prescribed. Using equianalgesic conversion chart, the daily dosages and therapeutics schedules of morphine administration were as follows:
43 percent received 21-30 mg. in 2-4 divided doses
27 percent received >30 mg. in 3-5 divided doses
21 percent received 11-20 mg. in 2-3 divided doses
9 percent received 5-10 mg. in 1-2 divided doses
Conclusion: Pain management of cancer patients is not adequate and opioid use is not rational. New educational and managerial strategies are needed to optimize cancer pain treatment in routine medical practice. To overcome current barriers, WHO stepwise model for cancer pain control and palliative care is recommended. Publishing Standard Treatment Guidelines for different levels of health care system is another recommended approach to optimize cancer pain.

 


Toktam Etezadi Jam, Robabeh Mousavi Nejad , Majid Sezavar Dukht Farooqi , Rahele Rahimi, Seyedeh Maryam Mousavi,
Volume 79, Issue 7 (10-2021)
Abstract

Background: Nicolau syndrome is a rare condition that happens after intramuscular injection. All the intramuscular injections may have mild to moderate complications such as pain, focal abscess, nerve complication and anaphylactic reactions. Among these complications, wide necrosis of the skin like Nicolau syndrome happens very rarely. In this condition, Patients typically report acute, intense pain, immediately after drug injection and it is followed by an erythematous macular evolving after 24 hours into a livedoid violaceous patch with dendritic extensions. The study has been reported a case report of a 6-month-old infant who suffered from Nicolau syndrome after the injection of pentavalent vaccine.
Methods: A 6-month-old girl infant without a history of any disease was referred to the emergency department with the signs of erythema, edema and purple like discoloration in the vaccine injection site at the left tight, after vaccination. One hour after admission, in the lower limb severe edema along with an extension of a dark red to purple discoloration happened on different parts of foot and after 5 days they turned necrotic. The infant suffered from Nicolau syndrome after the injection of the pentavalent vaccine.
Conclusion: Although Nicolau syndrome is a very rare complication with no definitive treatment but can be prevented and not be aggravated by doing proper method of intramuscular injection and no application of cold compress (aspiration the needle for 5–10 seconds before injecting to make sure not to hit a blood vessel, the proper method of z-track, holding injection immediately if the patient complains excruciating pain on injection site, appropriate length of the needle to reach muscle, and different sites for multiple injections). However, due to lack of supporting evidence, needle aspiration is not recommended because no major vessel runs through the normal vaccination zone and that faster method is less painful. So, the vaccination must be done in right place with an appropriate length of the needle.


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