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  Subjects -> PHARMACY AND PHARMACOLOGY (Total: 650 journals)
Showing 1 - 200 of 253 Journals sorted alphabetically
AAPS Journal     Hybrid Journal   (Followers: 34)
AAPS Open     Open Access   (Followers: 4)
AAPS PharmSciTech     Hybrid Journal   (Followers: 9)
AboutOpen     Open Access  
ACS Pharmacology & Translational Science     Hybrid Journal   (Followers: 4)
Acta Pharmaceutica     Open Access   (Followers: 6)
Acta Pharmaceutica Indonesia     Open Access   (Followers: 2)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 3)
Acta Pharmacologica Sinica     Hybrid Journal   (Followers: 4)
Acta Physiologica Hungarica     Full-text available via subscription   (Followers: 4)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 7)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 3)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 214)
Advanced Herbal Medicine     Open Access   (Followers: 8)
Advanced Therapeutics     Hybrid Journal   (Followers: 1)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 2)
Advances in Drug Research     Full-text available via subscription   (Followers: 27)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 21)
Advances in Pharmacoepidemiology & Drug Safety     Open Access   (Followers: 5)
Advances in Pharmacological and Pharmaceutical Sciences     Open Access   (Followers: 8)
Advances in Pharmacology     Full-text available via subscription   (Followers: 18)
Advances in Pharmacology and Pharmacy     Open Access   (Followers: 10)
Advances in Traditional Medicine     Hybrid Journal   (Followers: 8)
Adverse Drug Reaction Bulletin     Full-text available via subscription   (Followers: 6)
African Journal of Pharmacy and Pharmacology     Open Access   (Followers: 9)
AJP : The Australian Journal of Pharmacy     Full-text available via subscription   (Followers: 17)
Alternatives to Laboratory Animals     Full-text available via subscription   (Followers: 10)
American Journal of Cardiovascular Drugs     Hybrid Journal   (Followers: 21)
American Journal of Drug Discovery and Development     Open Access   (Followers: 5)
American Journal of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 13)
American Journal of Health-System Pharmacy     Full-text available via subscription   (Followers: 66)
American Journal of Pharmaceutical Education     Open Access   (Followers: 13)
American Journal of Pharmacological Sciences     Open Access   (Followers: 2)
American Journal of Pharmacology and Toxicology     Open Access   (Followers: 24)
American Journal of Therapeutics     Hybrid Journal   (Followers: 15)
Analytical Methods     Full-text available via subscription   (Followers: 13)
Annales de Toxicologie Analytique     Open Access  
Annales Pharmaceutiques Francaises     Full-text available via subscription   (Followers: 3)
Annals of Pharmacotherapy     Hybrid Journal   (Followers: 56)
Annual Review of Pharmacology and Toxicology     Full-text available via subscription   (Followers: 35)
Anti-Infective Agents     Hybrid Journal   (Followers: 6)
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry     Hybrid Journal   (Followers: 5)
Antibiotics     Open Access   (Followers: 9)
Antibiotiques     Full-text available via subscription  
Antibody Therapeutics     Open Access   (Followers: 1)
Antiviral Chemistry and Chemotherapy     Open Access   (Followers: 2)
Antiviral Research     Hybrid Journal   (Followers: 8)
Applied Clinical Research, Clinical Trials and Regulatory Affairs     Hybrid Journal   (Followers: 2)
Applied Clinical Trials     Full-text available via subscription   (Followers: 7)
Arabian Journal of Medicinal and Aromatic Plants     Open Access   (Followers: 4)
Archiv der Pharmazie     Hybrid Journal   (Followers: 3)
Archives of Drug Information     Hybrid Journal   (Followers: 5)
Archives of Pharmacal Research     Full-text available via subscription   (Followers: 1)
Archives of Pharmacy and Pharmaceutical Sciences     Open Access   (Followers: 6)
Archives of Pharmacy Practice     Open Access   (Followers: 12)
Archives of Razi Institute     Open Access  
Archivos Venezolanos de Farmacología y Terapéutica     Open Access  
Ars Pharmaceutica     Open Access   (Followers: 1)
Asian Journal of Medical and Pharmaceutical Researches     Open Access   (Followers: 2)
Asian Journal of Pharmaceutical Research and Health Care     Open Access   (Followers: 3)
Asian Journal of Pharmaceutical Sciences     Open Access   (Followers: 2)
Asian Journal of Pharmaceutics     Open Access   (Followers: 3)
Asian Journal of Research in Medical and Pharmaceutical Sciences     Open Access   (Followers: 1)
ASSAY and Drug Development Technologies     Hybrid Journal   (Followers: 4)
Australian Journal of Herbal Medicine     Full-text available via subscription   (Followers: 5)
Australian Pharmacist     Full-text available via subscription   (Followers: 6)
Autonomic & Autacoid Pharmacology     Hybrid Journal  
Avicenna Journal of Phytomedicine     Open Access   (Followers: 1)
Bangladesh Journal of Pharmacology     Open Access  
Bangladesh Journal of Physiology and Pharmacology     Open Access  
Bangladesh Pharmaceutical Journal     Full-text available via subscription   (Followers: 3)
Basic & Clinical Pharmacology & Toxicology     Hybrid Journal   (Followers: 13)
Behavioural Pharmacology     Hybrid Journal   (Followers: 3)
Bioanalysis     Full-text available via subscription   (Followers: 12)
Biochemical Pharmacology     Hybrid Journal   (Followers: 11)
Biochemistry & Pharmacology : Open Access     Open Access   (Followers: 5)
BioDrugs     Full-text available via subscription   (Followers: 10)
Biological & Pharmaceutical Bulletin     Full-text available via subscription   (Followers: 6)
Biomedical and Environmental Sciences     Full-text available via subscription   (Followers: 3)
Biomedicine & Pharmacotherapy     Full-text available via subscription   (Followers: 3)
Biometrical Journal     Hybrid Journal   (Followers: 10)
Biopharm International     Full-text available via subscription   (Followers: 19)
Biopharmaceutics and Drug Disposition     Hybrid Journal   (Followers: 11)
Biotemas     Open Access  
BMC Pharmacology     Open Access   (Followers: 3)
BMC Pharmacology & Toxicology     Open Access   (Followers: 7)
Botanics : Targets and Therapy     Open Access   (Followers: 6)
Brazilian Journal of Pharmaceutical Sciences     Open Access   (Followers: 2)
British Journal of Clinical Pharmacology     Hybrid Journal   (Followers: 33)
British Journal of Pharmacology     Hybrid Journal   (Followers: 20)
British Journal of Pharmacy (BJPharm)     Open Access   (Followers: 6)
Bulletin of Faculty of Pharmacy, Cairo University     Open Access   (Followers: 8)
CADTH Technology Overviews     Free  
Canadian Journal of Pain     Open Access   (Followers: 2)
Canadian Journal of Physiology and Pharmacology     Hybrid Journal   (Followers: 2)
Canadian Pharmacists Journal / Revue des Pharmaciens du Canada     Hybrid Journal   (Followers: 3)
Cancer Biotherapy & Radiopharmaceuticals     Hybrid Journal   (Followers: 1)
Cancer Chemotherapy and Pharmacology     Hybrid Journal   (Followers: 7)
Cardiovascular Drugs and Therapy     Hybrid Journal   (Followers: 16)
Cardiovascular Therapeutics     Open Access   (Followers: 2)
Cephalalgia Reports     Open Access   (Followers: 4)
Chemical and Pharmaceutical Bulletin     Full-text available via subscription   (Followers: 3)
Chemical Research in Toxicology     Hybrid Journal   (Followers: 25)
ChemMedChem     Hybrid Journal   (Followers: 11)
Chemotherapy     Full-text available via subscription   (Followers: 3)
Chinese Herbal Medicines     Full-text available via subscription   (Followers: 1)
Chinese Journal of Pharmaceutical Analysis     Full-text available via subscription  
Ciencia e Investigación     Open Access  
Ciência Equatorial     Open Access   (Followers: 1)
Clinical and Experimental Pharmacology and Physiology     Hybrid Journal   (Followers: 8)
Clinical and Translational Science     Open Access   (Followers: 5)
Clinical Cancer Drugs     Hybrid Journal   (Followers: 2)
Clinical Drug Investigation     Full-text available via subscription   (Followers: 8)
Clinical Immunology, Endocrine & Metabolic Drugs     Hybrid Journal  
Clinical Medicine Insights : Therapeutics     Open Access   (Followers: 1)
Clinical Neuropharmacology     Hybrid Journal   (Followers: 4)
Clinical Pharmacist     Partially Free   (Followers: 11)
Clinical Pharmacokinetics     Full-text available via subscription   (Followers: 30)
Clinical Pharmacology & Therapeutics     Hybrid Journal   (Followers: 48)
Clinical Pharmacology in Drug Development     Hybrid Journal   (Followers: 6)
Clinical Pharmacology: Advances and Applications     Open Access   (Followers: 6)
Clinical Research and Regulatory Affairs     Hybrid Journal   (Followers: 17)
Clinical Therapeutics     Hybrid Journal   (Followers: 34)
Clinical Toxicology     Hybrid Journal   (Followers: 21)
Clinical Trials     Hybrid Journal   (Followers: 21)
CNS & Neurological Disorders - Drug Targets     Hybrid Journal   (Followers: 3)
CNS Drug Reviews     Open Access   (Followers: 5)
CNS Drugs     Full-text available via subscription   (Followers: 8)
Combination Products in Therapy     Open Access  
Consultant Pharmacist     Full-text available via subscription   (Followers: 3)
Consumer Drugs     Full-text available via subscription  
Contract Pharma     Full-text available via subscription  
Cosmetics     Open Access   (Followers: 5)
CPT : Pharmacometrics & Systems Pharmacology     Open Access   (Followers: 9)
Critical Reviews in Clinical Laboratory Sciences     Hybrid Journal   (Followers: 19)
Critical Reviews in Therapeutic Drug Carrier Systems     Full-text available via subscription   (Followers: 5)
Critical Reviews in Toxicology     Hybrid Journal   (Followers: 25)
Current Bioactive Compounds     Hybrid Journal  
Current Cancer Therapy Reviews     Hybrid Journal   (Followers: 6)
Current Clinical Pharmacology     Hybrid Journal   (Followers: 4)
Current Computer-Aided Drug Design     Hybrid Journal   (Followers: 1)
Current Drug Delivery     Hybrid Journal   (Followers: 9)
Current Drug Discovery Technologies     Hybrid Journal   (Followers: 6)
Current Drug Metabolism     Hybrid Journal   (Followers: 5)
Current Drug Safety     Hybrid Journal   (Followers: 9)
Current Drug Targets     Hybrid Journal   (Followers: 7)
Current Drug Therapy     Hybrid Journal   (Followers: 3)
Current Enzyme Inhibition     Hybrid Journal   (Followers: 2)
Current Issues in Pharmacy and Medical Sciences     Open Access   (Followers: 6)
Current Medical Science     Hybrid Journal   (Followers: 3)
Current Medicinal Chemistry     Hybrid Journal   (Followers: 14)
Current Metabolomics     Hybrid Journal   (Followers: 6)
Current Molecular Pharmacology     Hybrid Journal  
Current Nanomedicine     Hybrid Journal   (Followers: 1)
Current Nanoscience     Hybrid Journal  
Current Neuropharmacology     Hybrid Journal   (Followers: 2)
Current Opinion in Pharmacology     Hybrid Journal   (Followers: 10)
Current Pharmaceutical Analysis     Hybrid Journal   (Followers: 3)
Current Pharmaceutical Biotechnology     Hybrid Journal   (Followers: 11)
Current Pharmaceutical Design     Hybrid Journal   (Followers: 13)
Current Pharmacogenomics and Personalized Medicine     Hybrid Journal   (Followers: 3)
Current Pharmacology Reports     Hybrid Journal   (Followers: 1)
Current Protocols in Pharmacology     Hybrid Journal  
Current Psychopharmacology     Hybrid Journal   (Followers: 1)
Current Radiopharmaceuticals     Hybrid Journal   (Followers: 1)
Current Research in Drug Discovery     Open Access   (Followers: 1)
Current Therapeutic Research     Open Access   (Followers: 10)
Current trends in Biotechnology and Pharmacy     Open Access   (Followers: 10)
Current Vascular Pharmacology     Hybrid Journal   (Followers: 5)
DARU Journal of Pharmaceutical Sciences     Open Access   (Followers: 4)
Dhaka University Journal of Pharmaceutical Sciences     Open Access   (Followers: 4)
Die Pharmazie - An International Journal of Pharmaceutical Sciences     Full-text available via subscription   (Followers: 10)
Discovery Phytomedicine     Open Access   (Followers: 4)
Dose-Response     Open Access  
Drug Analytical Research     Open Access  
Drug and Chemical Toxicology     Hybrid Journal   (Followers: 16)
Drug and Therapeutics Bulletin     Hybrid Journal   (Followers: 9)
Drug Delivery     Open Access   (Followers: 12)
Drug Delivery and Translational Research     Hybrid Journal   (Followers: 2)
Drug Delivery Letters     Hybrid Journal  
Drug Design, Development and Therapy     Open Access   (Followers: 4)
Drug Development and Industrial Pharmacy     Hybrid Journal   (Followers: 34)
Drug Development Research     Hybrid Journal   (Followers: 19)
Drug Discovery Today     Full-text available via subscription   (Followers: 192)
Drug Discovery Today: Disease Mechanisms     Full-text available via subscription   (Followers: 8)
Drug Discovery Today: Disease Models     Full-text available via subscription   (Followers: 10)
Drug Discovery Today: Technologies     Full-text available via subscription   (Followers: 13)
Drug Discovery Today: Therapeutic Strategies     Full-text available via subscription   (Followers: 12)
Drug Metabolism and Disposition     Hybrid Journal   (Followers: 17)
Drug Metabolism and Personalized Therapy     Hybrid Journal   (Followers: 3)
Drug Metabolism and Pharmacokinetics     Full-text available via subscription   (Followers: 6)
Drug Metabolism Letters     Hybrid Journal   (Followers: 4)
Drug Metabolism Reviews     Hybrid Journal   (Followers: 10)
Drug Research     Hybrid Journal   (Followers: 3)
Drug Resistance Updates     Hybrid Journal   (Followers: 3)
Drug Safety     Full-text available via subscription   (Followers: 192)
Drug Safety - Case Reports     Open Access   (Followers: 3)
Drug Target Insights     Open Access  
Drug, Healthcare and Patient Safety     Open Access   (Followers: 12)
Drugs     Full-text available via subscription   (Followers: 235)

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Similar Journals
Journal Cover
Drug Safety - Case Reports
Journal Prestige (SJR): 0.216
Number of Followers: 3  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2199-1162 - ISSN (Online) 2198-977X
Published by Springer-Verlag Homepage  [2626 journals]
  • Anaphylactic Reaction to Tc-99m Macrosalb

    • Abstract: Abstract A 49-year-old woman developed an anaphylactic reaction to Tc-99m macrosalb used for pulmonary scintigraphy. The patient received an intravenous injection of Tc-99m macrosalb 120 MBq, containing macroaggregates of human albumin 0.14 mg. Within 1 min she developed itching all over her body, an itching throat and dyspnoea. This was followed by urticaria and facial oedema. She was diagnosed with an anaphylactic shock. The patient received clemastine and prednisone, and fully recovered after release from the hospital. According to the Naranjo assessment algorithm, the relationship between the allergic reaction and the administration of Tc-99m macrosalb should be considered as ‘probable’.
      PubDate: 2019-03-05
  • Ibrutinib Caused Mediastinal Emphysema and Pneumothorax in the Treatment
           of a Patient with Mantle Cell Lymphoma

    • Abstract: Abstract A 70-year-old Japanese man with mantle cell lymphoma underwent extensive chemotherapy and radiation because of the relapse of mantle cell lymphoma. He developed mediastinal emphysema and a pneumothorax 14 days after treatment with 560 mg of ibrutinib. The mediastinal emphysema and the right pneumothorax disappeared after the ibrutinib treatment was tapered off. The patient developed interstitial pneumonia without any infection and new lesions of mantle cell lymphoma in the lungs after restarting treatment with 560 mg of ibrutinib. In this case, the patient developed pneumonia after retreatment with ibrutinib, suggesting the small lung fibrosis that penetrated the mediastinum might have caused the emphysema and pneumothorax.
      PubDate: 2019-02-21
  • Acute Exacerbation of Fever Following Administration of Tropicamide and
           Phenylephrine Ophthalmic Solution: A Case Report

    • Abstract: Abstract A 24-year-old woman with atopic dermatitis and persistent fever (axillary temperature of 37–38 °C for 6 months) received combination ophthalmic drops containing tropicamide and phenylephrine (Mydrin®-P), which exacerbated her fever within 15 min after instillation. Her axillary fever reached 40.1 °C but resolved the following day. No new dermatological symptoms developed. Although the patient’s fever may have been caused by either tropicamide or phenylephrine, neither of which have been reported to induce fever in topical formulations, atopic dermatitis and tropicamide’s inhibitory effect on perspiration under hot and humid conditions may have been the more probable cause. While drug-induced fever has been reported for other ophthalmic anticholinergic agents, this is the first reported case of possible fever exacerbation by an ophthalmic formulation of tropicamide, if the causative agent is assumed to be tropicamide.
      PubDate: 2019-02-12
  • Desmopressin-Induced Severe Hyponatremia with Central Pontine
           Myelinolysis: A Case Report

    • Authors: Tanzib Hossain; Marya Ghazipura; Vineet Reddy; Pedro J. Rivera; Vikramjit Mukherjee
      Abstract: Abstract Desmopressin, a synthetic vasopressin analog, is used to treat central diabetes insipidus, hemostatic disorders such as von Willebrand’s disease, and nocturnal enuresis. We present the case of a 69-year-old man who developed severe hyponatremia during treatment with intranasal desmopressin at 10 µg twice daily for chronic polyuria and nocturia thought to be due to central diabetes insipidus. After 5 months of therapy, the patient noticed progressive fatigue, anorexia, dizziness, weakness, light-headedness, decreased concentration, and new-onset falls. At 6 months of therapy, the patient was brought to the emergency department for altered mental status and was found to be severely hyponatremic with a serum sodium level of 96 mmol/L, down from a value of 134 mmol/L at the initiation of therapy. The intranasal desmopressin was discontinued and the patient was admitted to the intensive care unit where the hyponatremia was slowly corrected over the next week to 132 mmol/L, never increasing by more than 8 mmol/L a day, with careful fluid management. This included infusion of over 11 L of 5% dextrose to account for a high urine output, which peaked at 7.4 L in 1 day. However, while the recommended rate for sodium correction was followed, the patient’s magnetic resonance imaging of the brain obtained after discharge displayed evidence of central pontine myelinolysis. Despite this finding, the patient eventually returned to his baseline mental status with no permanent neurologic deficits.
      PubDate: 2018-04-25
      DOI: 10.1007/s40800-018-0084-1
      Issue No: Vol. 5, No. 1 (2018)
  • Severe Adverse Reactions Following Ketoconazole, Fluconazole, and
           Environmental Exposures: A Case Report

    • Authors: Allan Lieberman; Luke Curtis
      Abstract: Abstract In this case report, we describe a 66-year-old man who developed multiple adverse reactions beginning at age 56 after exposure to several azole antifungal drugs including ketoconazole and fluconazole. He also had a history of more than 40 years exposure to chemicals including pesticides, wood preservatives, fertilizers, and welding chemicals. His reactions involved dehydration (requiring several liters of intravenous fluids in less than an hour to alleviate this condition), angioedema, nausea, tinnitus, hypotension, and difficulty breathing. His acute adverse reactions were triggered by a wide range of chemicals including gasoline, diesel fuel, pesticides, chlorine, topical isopropyl alcohol, and paper mill emissions. His acute reactions were also triggered by a wide range of foods such as bananas, apples, milk, white potatoes, and processed sweets. A number of mechanisms could be responsible for his increased sensitivity to chemicals following exposure to fluconazole/ketoconazole, including inhibition of P450 and other detoxification enzymes, acetaldehyde buildup, and neurogenic sensitization.
      PubDate: 2018-04-18
      DOI: 10.1007/s40800-018-0083-2
      Issue No: Vol. 5, No. 1 (2018)
  • Nephrotoxicity of Ciprofloxacin: Five Cases and a Review of the Literature

    • Authors: Meriam Hajji; Hela Jebali; Aymen Mrad; Yassine Blel; Nozha Brahmi; Rania Kheder; Soumaya Beji; Lilia Ben Fatma; Wided Smaoui; Madiha Krid; Fethi Ben Hmida; Lamia Rais; Mohammed Karim Zouaghi
      Abstract: Abstract Fluoroquinolones are usually well tolerated with a minimum of serious adverse effects; renal toxicity is uncommon. Apart from the renal side effects of ciprofloxacin, we aimed to highlight the renal impact of a ciprofloxacin overdose, and thus conducted a prospective study in the Department of Nephrology at La Rabta Hospital between 2010 and 2015. The cohort database was continually updated until the inclusion of five patients who were subjected to an overdose and who were initially admitted to the medical intensive care unit and then transferred to our department for acute renal failure (ARF) due to ciprofloxacin ingestion requiring urgent hemodialysis. All patients developed ARF after 12–36 h of ingestion. Renal ultrasound was normal in all cases. Twenty-four-hour proteinuria was present but not significant in one case, while microscopic hematuria was present in one case. Treatment consisted of supportive therapy and extrarenal purification by conventional intermittent hemodialysis. Four patients recovered normal renal function within 3 weeks and the remaining patient eventually had chronic kidney failure.
      PubDate: 2018-04-18
      DOI: 10.1007/s40800-018-0073-4
      Issue No: Vol. 5, No. 1 (2018)
  • Cefazolin-Related Acute Interstitial Nephritis with Associated
           Nephrotic-Range Proteinuria: A Case Report

    • Authors: Ang Xu; David Hyman; Lee Bach Lu
      Abstract: Abstract A 67-year-old male with history of well controlled type 2 diabetes mellitus and hypertension developed acute interstitial nephritis (AIN) with nephrotic-range proteinuria during treatment with cefazolin for methicillin-sensitive Staphylococcus aureus and Group B Streptococcus (GBS) bacteremia. The patient received intravenous cefazolin 2 g every 8 h for 4 weeks prior to presentation to the emergency department with abdominal distension, nausea, and vomiting. Investigations revealed a serum ascites albumin gradient of 1.0 with total protein of 1.8 g/dL suggestive of nephrotic syndrome, which was confirmed with a spot urine protein/creatinine ratio that estimated 7.95 g of protein per day. Serum creatinine was elevated compared with baseline. Urine studies showed sterile pyuria with 3+ protein and eosinophiluria. The patient was diagnosed with AIN with nephrotic-range proteinuria associated with cefazolin use. Cefazolin was discontinued and, within a couple of days, the patient’s creatinine stabilized. He was discharged with prednisone 60 mg once a day for 10 days with a taper over 2 weeks for his AIN. The patient’s creatinine and proteinuria slowly decreased over the next couple of weeks, however, did not recover to baseline. A Naranjo assessment score of 6 was obtained, indicating a probable relationship between the patient’s AIN with nephrotic-range proteinuria and his use of cefazolin.
      PubDate: 2018-04-09
      DOI: 10.1007/s40800-018-0080-5
      Issue No: Vol. 5, No. 1 (2018)
  • Acquired Methemoglobinemia Associated with Topical Lidocaine
           Administration: A Case Report

    • Authors: Hawkins C. Gay; Ansel Philip Amaral
      Abstract: Abstract A 55-year-old male was admitted to the hospital with pneumonia. During an intubation procedure, the patient received an application of endobronchial lidocaine (4% gel). Within 2 h of intubation, the patient developed worsening hypoxia, and investigation of arterial blood gasses revealed a pH of 7.21, carbon dioxide partial pressure (PaCO2) of 3.3 kPa, oxygen partial pressure (PaO2) of 55.1 kPa, and measured oxygen saturation of 49%. Co-oximetry of this sample returned a methemoglobin level of 53%. Intravenous methylthioninium chloride (1% solution at 1 mg/kg) was delivered, and subsequent arterial blood gasses, at 30 min and 1 h post administration, showed methemoglobin levels of 12 and 9%, respectively, with return of oxygen saturation to > 90%.
      PubDate: 2018-04-07
      DOI: 10.1007/s40800-018-0081-4
      Issue No: Vol. 5, No. 1 (2018)
  • Investigation of the Pharmaceutical Care in One Elderly Parkinson’s
           Disease Patient with Psychotic Symptoms

    • Authors: Chun-Ping Gu; Yue-Liang Xie; Yin-Juan Liao; Cui-Fang Wu; Sheng-Feng Wang; Yu-Lu Zhou; Su-Jie Jia
      Abstract: Abstract A 66-year-old male patient with a 10-year course of Parkinson’s disease (PD) was admitted for hallucination lasting a half a month. After treatment with levodopa/carbidopa, selegiline, and piribedil, the patient’s motor symptoms were improved while no significant effects were observed on psychotic symptoms. A clinical pharmacist analyzed the pharmacologic and pharmacokinetic characteristics of selegiline and piribedil, summarized the scheme of PD with psychotic symptoms in the literature, and discovered that selegiline might potentiate psychotic side effects of piribedil, while the use of levodopa/carbidopa cannot be ruled out either. Finally, the clinical pharmacist proposed to reduce the dosage of levodopa/carbidopa, increase the dosage of selegiline and quetiapine, and discontinue piribedil. The clinician accepted this suggestion. After the adjustment of medication, the patient’s motor symptoms were absolutely improved and the psychotic symptoms were notably improved. This case study suggests that long-term treatment with levodopa/carbidopa and piribedil, along with the progression of the disease itself, could contribute to the emergence of psychotic symptoms in PD. Additionally, selegiline could potentiate psychotic side effects of piribedil. Neurology clinical pharmacists should work alongside neurology clinicians at the bedside to optimize pharmacotherapy, improve patient safety, and contribute to scholarly efforts.
      PubDate: 2018-04-06
      DOI: 10.1007/s40800-018-0082-3
      Issue No: Vol. 5, No. 1 (2018)
  • Intravenous Lipid Emulsion Overdose in Infancy: A Case Report and Overview
           of Opportunities, Challenges and Prevention

    • Authors: Wasim Khasawneh; Salar Bani Hani
      Abstract: Abstract Medication errors remain among the major problems seen in hospitals. Such errors can relate to the prescription, dispensation, or administration of drugs. Human factors account for most of these mistakes, but other factors such as infusion pump programming defects should always be considered. Worldwide, medication errors have been reported to affect 2–30% of patients, depending on the institution. Intravenous lipid emulsion (ILE) infusion is frequently used as part of total parenteral nutrition in patients of all ages with feeding and gastrointestinal issues. ILE overdose has been previously reported, with variable clinical outcomes. We report a case of accidental ILE (Intralipid) overdose in a 3-month-old male infant who fully recovered after single-volume blood exchange transfusion. We also review reported cases and summarize potential solutions for ILE overdose. Our review indicates that ILE infusion is a high-risk medication, and opportunities for errors remain even in the best hospital set-ups. Attention should be directed towards proper prescription, dosing, dispensation, and administration. Most of the cases indicate the safety breach was at the nursing drug-administration level, with improper pump use or programming, together with other fluid infusion rate switching, being the main possible defects. Strategies targeting the areas of weakness in the drug-delivery pathway are needed. Special attention should be paid towards nursing duties and working hours. In addition, nursing staff should receive frequent education sessions and should be required to pass competency modules regularly. An error-prevention plan should be established and implemented. This plan needs full collaboration between physicians, pharmacists, and nursing staff.
      PubDate: 2018-03-19
      DOI: 10.1007/s40800-018-0079-y
      Issue No: Vol. 5, No. 1 (2018)
  • An Interesting Case of Carbamazepine-Induced Stevens–Johnson

    • Abstract: Abstract A 29-year-old Black female patient was admitted to a psychiatric ward with symptoms of major depressive disorder with psychosis. The patient was started on amitriptyline 50 mg/day and haloperidol 10 mg/day. On day 4 post-admission, the preferred first-line antidepressant, fluoxetine, became available and the patient was switched from amitriptyline to fluoxetine 20 mg/day. On the same day, the dose of haloperidol was reduced to 5 mg/day. Thirteen days post-initiation of these medications the patient became talkative, associated with emotional lability, an expansive mood, irritability and restlessness. The working diagnosis was changed to bipolar affective disorder in the manic phase. Fluoxetine was discontinued and carbamazepine 600 mg/day was added to the patient’s treatment regimen. Her manic symptoms started to resolve; however, 14 days post-initiation of carbamazepine, the patient had a fever; itchy, discharging eyes; respiratory distress; generalised symmetrical erythematosus rash; buccal ulceration; and conjunctival injection with difficulty opening her eyes. Carbamazepine was immediately discontinued and the patient received intravenous fluid resuscitation. The patient recovered considerably after 12 days of symptomatic and supportive management, and was transferred back to the psychiatric ward for the continuation of bipolar disorder management. Lithium therapy was instituted and the patient was subsequently discharged. Using the Algorithm of Drug causality for Epidermal Necrolysis (ALDEN) Stevens–Johnson Syndrome/toxic epidermal necrolysis (SJS/TEN) drug causality scoring system, carbamazepine and fluoxetine were evaluated as ‘very probable’ and ‘possible’ causes of SJS, respectively, in this patient. Fluoxetine-induced SJS was considered on account of previous case reports, however no evidence of causality was found in this patient. Consecutive administration with a potential increase in carbamazepine due to inhibition of cytochrome P450 (CYP) 3A4 metabolism by fluoxetine was also not ruled out. A diagnosis of carbamazepine-induced SJS was made and was considered an idiosyncratic adverse drug reaction.
      PubDate: 2018-12-10
  • Neutropenia and Thrombocytopenia Induced by Proton Pump Inhibitors: A Case

    • Abstract: Abstract An 85-year-old man was admitted to our hospital because of dysphagia, and was diagnosed with benign stricture of the esophagus. He was hospitalized repeatedly for balloon dilations. Pantoprazole sodium (80 mg, twice daily, intravenously) was administered each time when he was in hospital, while esomeprazole (20 mg/day, orally) was administered intermittently when he was at home. Reductions in both white blood cells and platelets were noticed about 4 months after proton pump inhibitors were introduced. Bone marrow suppression induced by proton pump inhibitors was diagnosed as proven by bone marrow biopsy. White blood cell, neutrophil, and platelet counts went back to the normal range after proton pump inhibitors were stopped. The present case shows a rare bi-cytopenia associated with proton pump inhibitors and suggests the importance of awareness of hematological adverse events during proton pump inhibitor therapy.
      PubDate: 2018-11-23
  • Acknowledgement to Referees

    • PubDate: 2018-11-22
  • Curling of Hair in Two Female Patients Taking Alitretinoin

    • Abstract: Abstract Two female patients aged 45 and 51 years experienced curling of hair during treatment with alitretinoin (Toctino®). For one patient, the indication for use was severe chronic hand eczema, but for the second patient the indication was not reported. After 5 and 9 months, respectively, the patients developed hair texture changes and their straight hair began to curl. The dose of alitretinoin was reduced in both cases, but the patients’ hair had not straightened at the time of reporting (9 months and 2 years after onset of the event). Based on the described reports received by the Netherlands Pharmacovigilance Centre Lareb, the case reports in the literature, and the possible mechanisms, we suggest a causal relationship between curling of the hair and the use of alitretinoin. Using the World Health Organization Uppsala Monitoring Centre (WHO-UMC) system for standardized case causality assessment, the association in our cases can be assessed as likely.
      PubDate: 2018-10-16
  • Acute Myocardial Infarction Following Administration of Polyethylene
           Glycol Electrolyte Solution with Ascorbic Acid (MoviPrep ® ) at Home: A
           Case Report

    • Abstract: Abstract A male individual aged 82 years with hypertension who had a smoking history, but no history of cardiovascular events, developed acute myocardial infarction immediately after he took oral polyethylene glycol electrolyte solution with ascorbic acid as a pretreatment for a colonoscopy to examine anemia. He took polyethylene glycol electrolyte solution with ascorbic acid at twice (2 L/h) the rate recommended in the package insert and by the physician. The patient showed impaired consciousness 2 h after taking polyethylene glycol electrolyte solution with ascorbic acid and his family called the emergency medical service. Upon arrival of the emergency medical service, his systolic blood pressure was 60 mmHg and heart rate was 50 bpm. Systolic blood pressure and impaired consciousness were slightly improved, but compensatory shock remained, at arrival at the emergency outpatient service at our hospital. No dyspnea or rash was apparent. The patient had no subjective chest pain; however, ST-segment elevation was detected in the electrocardiogram at II, III, aVF, V3R, and V4R. He was diagnosed with ST-segment elevation myocardial infarction and underwent a coronary catheter intervention for total occlusion of the right coronary artery. His shock state was abolished by this intervention. The patient was pretreated with polyethylene glycol electrolyte solution with ascorbic acid under close watch in the coronary care unit 4 days later, with no relapse of symptoms. Advanced cancer was found in the ileocecum by colonoscopy; consequently, the patient underwent a colectomy and was discharged from our hospital and transferred to another hospital for rehabilitation on hospital day 74. A Naranjo assessment score of 4 was obtained, indicating a possible relationship of acute myocardial infarction with misuse of the suspect drug, polyethylene glycol electrolyte solution with ascorbic acid.
      PubDate: 2018-08-27
  • Metoclopramide: A Safe Alternative to Domperidone' A Case Report on
           Severe Cardiac Adverse Effects in an Older Patient

    • Abstract: Abstract Peripheral antidopaminergic medication is frequently prescribed to treat nausea. However, domperidone is ill-famed for its severe cardiac adverse effects. Metoclopramide has been suggested as a relatively safe alternative because it has long been considered to have less significant cardiovascular adverse effects. We present an older patient who developed severe bradycardia and hypotension shortly after receiving intravenous metoclopramide. Cardiac adverse effects of metoclopramide in elderly are not frequently described in the literature, especially not in patients without a major history of cardiac disease. We recommend caution with intravenous administered metoclopramide in older patients.
      PubDate: 2018-08-07
  • Antituberculosis Drug-Induced Fixed Drug Eruption: A Case Report

    • Abstract: Abstract Fixed drug eruption (FDE) was caused by fixed-dose combination (FDC) of antituberculosis drugs in the form of tablet Forecox® (rifampicin [rifampin] 225 mg + isoniazid 150 mg + pyrazinamide 750 mg + ethambutol 400 mg) in a 40-year-old male patient with a history of drug allergy. The patient developed FDE after taking the third dose of tablet Forecox® for pulmonary tuberculosis. Tablet Forecox® was withdrawn and the patient recovered from the reaction after 15 days of treatment for FDE. As per World Health Organization–Uppsala Monitoring Centre (WHO-UMC) and Naranjo causality assessment criteria, the association between the reaction and tablet Forecox® was possible and probable, respectively. The reaction was moderately (Level 4b) severe according to the Modified Hartwig and Siegel scale. As there is an increased risk of allergic reaction in patients with a history of drug allergy, FDCs should not be used in order to avoid complexity in identifying the culprit drug.
      PubDate: 2018-05-21
  • Secondary Hypogammaglobulinemia After Rituximab for Neuromyelitis Optica:
           A Case Report

    • Abstract: Abstract A 17-year-old male with history of neuromyelitis optica and seizures presented to the pulmonology clinic for evaluation of recurrent pneumonias. He had received rituximab for the past 6 years. Over the past 2 years, he experienced four episodes of pneumonia. In between these episodes, he would improve briefly but continued to have daily cough that was productive with yellow phlegm. He also had recurrent rhinitis and sinusitis despite multiple antibiotic courses. Review of chest X-rays revealed localized right middle lobe and right lower lobe infiltrates. An extensive workup was performed, including computed tomography (CT) of the chest and bronchoscopy to rule out congenital lesions of the right lung and foreign body aspiration. Chest CT showed right lower lobe bronchiectasis. Flexible bronchoscopy with bronchoalveolar lavage showed normal anatomy with thick mucus secretions in the right lower lobe. Immunologic evaluation was performed and revealed low levels of immunoglobulin (Ig)-G, IgM, and IgA, which had declined since initiation of rituximab. Lymphocyte subset testing was remarkable for low cluster of differentiation (CD)-19. He was referred to allergy and immunology and was initiated on immunoglobulin-replacement therapy (IGRT) for acquired hypogammaglobulinemia secondary to rituximab. There was marked clinical improvement after initiation of IGRT.
      PubDate: 2018-05-11
  • Bilateral Mastectomy as Radical Treatment of Gynecomastia Secondary to
           Antiretroviral Therapy in a Low-Income Setting: A Case Report

    • Abstract: Abstract Gynecomastia is a common finding in males, with an incidence that varies widely globally. In 10–25% of cases, it is caused by drugs. Its pathophysiologic mechanism includes exposure to exogenous estrogens and medications that cause hypogonadism, antiandrogenic effects and hyperprolactinemia. Gynecomastia is associated with exposure to antiretroviral therapy (ART), particularly efavirenz. Sometimes surgery may be required as treatment. We report a case of a 46-year-old man receiving ART presenting with a marked bilateral breast enlargement who underwent bilateral mastectomy as the only successful treatment in a low-income setting.
      PubDate: 2018-05-11
  • Naloxone-Induced Non-Cardiogenic Pulmonary Edema: A Case Report

    • Abstract: Abstract A 22-year-old man was admitted for an elective right-shoulder open subacromial decompression and distal clavicle excision. He received a single intravenous dose of fentanyl 50 μg for anesthesia. His procedure was completed without intra-operative complications; however, he developed post-operative respiratory depression in the setting of narcotic administration. He was given naloxone 0.2 mg intravenously once to reverse this effect, which subsequently led to acute hypoxic respiratory failure secondary to pulmonary edema shortly after administration of naloxone. His oxygen saturation was noted to be 50% on room air, he was tachypneic with a respiratory rate of 22, and his heart rate ranged from 89 to 104 beats per minute. His blood pressure remained within normal limits at 128/62. His chest X-ray was notable for patchy bilateral perihilar infiltrates and the patient was intubated postoperatively. An EKG revealed normal sinus rhythm, and cardiac enzymes were negative. He was diagnosed with naloxone-induced non-cardiogenic pulmonary edema supported by the temporal relationship of the causal drug and no other identifiable cause of his clinical picture. He received furosemide and underwent diuresis while intubated, with subsequent improvement in his oxygen requirements. His vitals remained stable and he was extubated 6 h later. A Naranjo assessment score of 6 was obtained, indicating a probable relationship between the patient’s symptoms and the suspect drug.
      PubDate: 2018-05-10
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
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