RESUMEN
BACKGROUND: Acute generalized exanthematic pustulosis is a severe adverse drug reaction which occurs after taking antibiotics. Rare cases implicating psychotrops have been observed. CASE REPORT: A 71-year old women with schizophrenia was given closapine for six weeks when she developed an erythematopustular skin reaction and fever typical of acute generalized exanthematic pustulosis. The skin disease regressed one week after withdrawing clozapine. DISCUSSION: This is the first case of acute generalized exanthematic pustulosis observed after taking the neuroleptic drug, clozapine, used in severe schizophrenia.
Asunto(s)
Antipsicóticos/efectos adversos , Clozapina/efectos adversos , Exantema/inducido químicamente , Enfermedades Cutáneas Vesiculoampollosas/inducido químicamente , Enfermedad Aguda , Anciano , Antipsicóticos/uso terapéutico , Clozapina/uso terapéutico , Femenino , Humanos , Esquizofrenia/tratamiento farmacológicoRESUMEN
In order to specify the frequency and the potential consequences of drug interactions in the elderly, we retrospectively analysed 409 discharge prescriptions. The possibility of drug interactions was screened out for each prescription in the software version of the Vidal drug compendium. It appears that prescriptions are mainly adapted to the elderly with respect to posology and pharmacokinetics. Potentially dangerous drug interactions ('contraindicated' or 'unsuitable' associations) were found in 6 per cent of prescriptions; after careful assessment, this frequency decreased to less than 1 per cent. The most common orthoergic side effects were sedation (15 per cent) and hypotension (14.5 per cent). This study points out the multiplicity of criteria to be considered in order to prevent drug interactions, and the gaps in available software.
Asunto(s)
Interacciones Farmacológicas , Prescripciones de Medicamentos/estadística & datos numéricos , Servicios de Salud para Ancianos , Anciano , Anciano de 80 o más Años , Contraindicaciones , Femenino , Francia , Hospitales Especializados/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Preparaciones Farmacéuticas/clasificaciónRESUMEN
The treatment and the prevention of Pneumocystis carinii pneumonia (PCP) is based on trimethoprim-sulfamethoxazole. However, hypersensitivity reactions occur often in HIV-infected patients. In this study, clinical and biological parameters of 27 PCP-patients treated by this drug association were analyzed. We divided the drug reactions into two groups according to the severity. A drug reaction occurred in 59.2% of the patients and was note as a mild reaction in 18.5% of the cases and as a severe reaction in 40.7%. An initial high eosinophil count was noted in patients who may present future drug reaction. This difference was more significant in patients who may present severe drug reaction. No other clinical or biological factors were predictive of hypersensitivity. The immune status of HIV-disease, drug therapy, and drug mechanisms were discussed.