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Adverse Drug Reactions & Drug Side Effects

Welcome to the adverse drug reactions and drug side effects category for physicians and pharmacists. This category features links to clinical practice resources on reporting, identifying and managing adverse drug reactions and drug side effects.

Drug Analysis Prints : Medicines and Healthcare Products Regulatory Agency

The Drug Analysis Prints provided on this website give a complete listing of all UK spontaneous suspected adverse drug reactions (ADRs) reported through the Yellow Card Scheme to the MHRA and the Government’s independent scientific committee on medicines safety, the Commission on Human Medicines (CHM).

Each Drug Analysis Print lists the suspected reactions reported for a particular medicine. Medicines are listed by the name of the active ingredient, and not by the brand name.

Source: gov.uk/mhra
Clinical Resource: Drug Analysis Prints
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Last Checked: 23/04/15 Link Error: Report It

 

European database of suspected adverse drug reaction reports

On this website you can view data on suspected side-effects also known as suspected adverse drug reactions for authorised medicines in the European Economic Area (EEA).

Source: adrreports.eu
Clinical Resource: Reports
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Last Checked: 05/05/15 Link Error: Report It

 

Canada Vigilance Adverse Reaction Online Database

The Canada Vigilance Adverse Reaction Online Database contains information about suspected adverse reactions (also known as side effects) to health products.

Reports are submitted by:

  • consumers and health professionals, who submit reports voluntarily
  • manufacturers and distributors (also known as market authorization holders), who are required to submit reports according to the Next link will take you to another Web site Food and Drug Regulations.
Source: hc-sc.gc.ca
Clinical Resource: Database
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Last Checked: 05/05/15 Link Error: Report It

 

Yellow Card Scheme - MHRA

The Yellow Card Scheme is vital in helping the MHRA monitor the safety of all healthcare products in the UK to ensure they are acceptably safe for patients and those that use them. Reports can be made for all medicines including vaccines, blood factors and immunoglobulins, herbal medicines and homeopathic remedies, and all medical devices available on the UK market.

The Scheme collects information on suspected problems or incidents involving

  1. side effects (also known as adverse drug reactions or ADRs)
  2. medical device adverse incidents
  3. defective medicines (those that are not of an acceptable quality)
  4. counterfeit or fake medicines or medical devices
Source: yellowcard.mhra.gov.uk
Clinical Resource: Online Reporting
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Last Checked: 23/04/15 Link Error: Report It

 

Drug Safety Update

Drug Safety Update is the monthly electronic bulletin from the MHRA and Commission on Human Medicines.

Drug Safety Update is essential reading for all healthcare professionals, bringing you the very latest information and advice to support the safer use of medicines.

Source: gov.uk/mhra
Clinical Resource: Electronic Bulletins
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Last Checked: 23/04/15 Link Error: Report It

 

MedWatch: The FDA Safety Information and Adverse Event Reporting Program

Your FDA gateway for finding clinically important safety information and reporting serious problems with human medical products.

Source: fda.gov
Clinical Resource: Various
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Last Checked: 05/05/15 Link Error: Report It

 

MedEffect Canada - Health Product InfoWatch

The Health Product InfoWatch is a monthly publication intended primarily for healthcare professionals. It provides clinically relevant safety information on pharmaceuticals, biologics, medical devices and natural health products.

Source: hc-sc.gc.ca
Clinical Resource: Newsletters
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Last Checked: 05/05/15 Link Error: Report It

 

Australian Adverse Drug Reactions Bulletin

The Australian Adverse Drug Reactions Bulletin was produced six times a year by the Adverse Drug Reactions Advisory Committee (ACSOM), which was replaced by the Advisory Committee on the Safety of Medicines (ACSOM) in January 2010.

Medicines Safety Update

Medicines Safety Update provides practical information and advice on drug safety and information about emerging safety issues. It replaced the Australian Adverse Drug Reactions Bulletin in 2010.

Source: tga.gov.au
Clinical Resource: Bulletins and Updates
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Last Checked: 05/05/15 Link Error: Report It

 

Adverse Drug Reactions (ADRs) – immune-mediated versus pharmacological

The Drug Information Service at Christchurch Hospital answers over fifty questions each month from health professionals asking about adverse drug reactions (ADRs). Frequently, the enquirer is interested in the potential risks of causing a similar adverse reaction if they prescribe an agent from the same or similar class. This decision is influenced largely by whether the ADR was immune-mediated or pharmacologically-mediated.

Source: druginformation.co.nz
Clinical Resource: Drug Information Service Bulletin
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Last Checked: 05/05/15 Link Error: Report It

 

Adverse Drug Reactions: Types and Treatment Options

The terms “drug allergy,” “drug hypersensitivity,” and “drug reaction”are often used interchangeably. Drug reactions encompass all adverse events related to drug administration, regardless of etiology. Drug hypersensitivity is defined as an immune-mediated response to a drug agent in a sensitized patient. Drug allergy is restricted specifically to a reaction mediated by IgE.

Source: aafp.org
Clinical Resource: Journal Article
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Last Checked: 30/07/13 Link Error: Report It

 

Polypharmacy Guidance March 2015
Scottish Government Model of Care Polypharmacy Working Group

We are delighted to present the Polypharmacy Guidance 2015, which builds on and refines the previous guidance from 2012. The ‘7-steps’ is a clear structure for the medicines review process, which is centred around the individual adult patient, and presented in a number of forms to facilitate its use across a range of healthcare settings.

Source: scot.nhs.uk
Clinical Resource: Guidance
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Last Checked: 05/05/15 Link Error: Report It

 

Gender Differences in Responses to Medication and Side Effects of Medication

In recent years, there has been growing interest and increasing recognition that sex and gender may play a significant role in a person’s response to medication and should be an important part of individual prescribing.

Source: iasp-pain.org
Clinical Resource: Newsletter
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Last Checked: 07/05/15 Link Error: Report It

 

“Pharmacogenetics & ADRs”

The objectives of this lesson are such that upon completion the participant will be able to:

  1. Discuss the pharmacogenetic variables that cause adverse drug reactions.
  2. Describe the pharmacogenetic variants that cause pharmacokinetic changes in medications and increased risk of adverse drug reactions.
  3. Describe the risk of hypersensitivity reactions associated with various HLA-alleles.
Source: wfprofessional.com
Clinical Resource: CE / CPD / Learning
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Last Checked: 17/02/14 Link Error: Report It

 

Medications With Significant Anticholinergic Properties

Source: health.state.mn.us
Clinical Resource: Table
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Last Checked: 29/03/16 Link Error: Report It

 

Neuroleptic Malignant Syndrome Information Service

NMSIS serves as an international resource center for knowledge on neuroleptic malignant syndrome in addition to other heat-related disorders and drug side effects by:

  1. developing educational support programs
  2. supporting clinical and new product research and development
  3. implementing updated web-based and published materials
  4. providing evidence-based informational and consultative services
Source: nmsis.org
Clinical Resource: Various
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Last Checked: 07/05/15 Link Error: Report It

 

The American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults (2012)

Source: americangeriatrics.org
Clinical Resource: Guideline
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Last Checked: 05/05/15 Link Error: Report It

 

Medications and Falls in Older People

Falls are a major cause of morbidity in older people. Although in most cases falls are multifactorial in aetiology, medications are one of the most easily reversible risk factors that need to be considered in the falls assessment process. There is strong evidence that sedatives, particularly benzodiazepines (short-acting and long-acting), are associated with falls with odds ratios in the range of 1.3 to 1.5.

Source: shpa.org.au
Clinical Resource: Journal Article
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Last Checked: 07/05/15 Link Error: Report It

 

Medication & The Risk of Falls in the Older Person

Lists some important facts on the connection between medication and the risk of falls and fractures. Also provides information on the degree of risk associated with specific drugs.

Source: bhps.org.uk
Clinical Resource: Information Sheet
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Last Checked: 30/07/13 Link Error: Report It

 

Drug-Induced Movement Disorders

Significant proportion of drug-induced movement disorders is related to antipsychotic medications and neuroleptics are the commonest.

Source: fmshk.org
Clinical Resource: Bulletin
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Last Checked: 16/05/13 Link Error: Report It

 

Drug-Induced Acute Renal Failure

Acute renal failure (ARF) is defined as a rapid loss of renal function due to damage to the kidneys. This results in electrolyte and acid-base abnormalities and retention of nitrogenous waste products, such as urea and creatinine.

Source: uspharmacist.com
Clinical Resource: Journal Article
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Last Checked: 16/03/13 Link Error: Report It

 

Toxic Nephropathies: Core Curriculum 2010

Toxic nephropathies are an important and relatively common category of kidney damage. Although they generally are reversible when detected early, they may be permanent, leading to chronic kidney disease (CKD). Toxic nephropathies are defined primarily as kidney injury caused by any number of medications, diagnostic agents, alternative products, herbal adulterants, or other toxin exposures, which includes environmental agents and chemicals.

Source: ajkd.org
Clinical Resource: Journal Article
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Last Checked: 05/05/15 Link Error: Report It

 

How to prevent, recognize, and treat drug-induced nephrotoxicity

In this review, we discuss the common nephrotoxic renal syndromes, the mechanisms of nephrotoxicity of specific commonly used drugs, the associated risk factors for renal injury, and strategies for preventing renal injury.

Source: mdedge.com
Clinical Resource: Journal Article
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Last Checked: 19/06/17 Link Error: Report It

 

Drug-Induced Kidney Injury

It is important to appreciate that a single drug renal toxicity can involve multiple pathophysiologic pathways and that predisposing factors are common to virtually all causative agents mediating kidney injury. Dehydration, hypotension, preexisting kidney disease, advanced age, diabetes and simultaneous use of multiple nephrotoxic drugs all greatly increase risk for any nephrotoxic drug to exert its nephrotoxic effect.

Source: ifcc.org
Clinical Resource: Journal Article
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Last Checked: 16/03/13 Link Error: Report It

 

LiverTox

LIVERTOX is a freely available website that provides up-to-date, comprehensive and unbiased information about drug induced liver injury caused by prescription and nonprescription drugs, herbals and dietary supplements.

LiverTox is a joint effort of the Liver Disease Research Branch of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the Division of Specialized Information Services of the National Library of Medicine (NLM), National Institutes of Health.

Source: nih.gov
Clinical Resource: Database
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Last Checked: 17/02/14 Link Error: Report It

 

Drug-induced liver injury: Is it somehow foreseeable?

The classic view on the pathogenesis of drug-induced liver injury is that the so-called parent compounds are made hepatotoxic by metabolism (formation of neo-substances that react abnormally), mainly by cytochromes P-450 (CYP), with further pathways, such as mitochondrial dysfunction and apoptosis, also playing a role. Risk factors for drug-induced liver injury include concomitant hepatic diseases, age and genetic polymorphisms of CYP.

Source: nih.gov
Clinical Resource: Journal Article
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Last Checked: 30/07/13 Link Error: Report It

 

Drug-Induced Hepatotoxicity

Drugs are an important cause of liver injury. More than 900 drugs, toxins, and herbs have been reported to cause liver injury, and drugs account for 20-40% of all instances of fulminant hepatic failure.

Source: medscape.com
Clinical Resource: Article
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Last Checked: 30/07/13 Link Error: Report It

 

Drug-induced Liver Disease

Twenty to thirty percent of all acute liver failure is drug-induced. It ranges from reversible changes in liver enzyme function tests (LFTs) to fatal hepatic necrosis.

Source: adr.org.uk
Clinical Resource: Factsheet
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Last Checked: 30/07/13 Link Error: Report It

 

An Official American Thoracic Society Statement: Hepatotoxicity of Antituberculosis Therapy

Source: thoracic.org
Clinical Resource: Statement
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Last Checked: 11/05/15 Link Error: Report It

 

Antituberculosis Drugs and Hepatotoxicity

The three key anti-tuberculosis drugs, viz isoniazid, pyrazinamide and rifampicin, are potentially hepatotoxic. Deaths due to fulminant liver necrosis have been reported, albeit rare in occurrence. With the changing demographics and clinical characteristics of tuberculosis patients in many parts of the world, hepatotoxicity is of increasing concern in the treatment of this disease.

Source: fmshk.org
Clinical Resource: Bulletin
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Last Checked: 29/04/13 Link Error: Report It

 

Assessing and Managing the Risk of Liver Disease in the Treatment of LTBI

Source: heartlandntbc.org
Clinical Resource: Flow Diagram
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Last Checked: 19/08/15 Link Error: Report It

 

Pneumotox On Line
The Drug-Induced Lung Disease Website

Pneumotox is an aid to the diagnosis of drug-induced & iatrogenic respiratory disease

The place to go for continuously updated information about DIRD

You may access it by generic drug names (alphabetical order) or patterns grouped by families

Source: pneumotox.com
Clinical Resource: Database
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Last Checked: 29/04/13 Link Error: Report It

 

Drug-Induced Pulmonary Toxicities

This article explores the relationship between pharmacotherapy and pulmonary adverse effects from frequently prescribed agents used to treat common chronic diseases.

Source: uspharmacist.com
Clinical Resource: Journal Article
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Last Checked: 29/04/13 Link Error: Report It

 

Therapeutic Update on Drug-Induced Pulmonary Disorders

This review will provide an update regarding medications and their potential for pulmonary side effects. A summary of drugs known to cause pulmonary disorders, although not all inclusive, is provided in TABLE 1.

Source: uspharmacist.com
Clinical Resource: Journal Article
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Last Checked: 29/04/13 Link Error: Report It

 

Drug-induced respiratory disease

Drug-induced lung disease is a relatively common condition caused by an adverse reaction to medication and it is often impossible to predict who will develop lung disease resulting from a drug.

Source: mcppnet.org
Clinical Resource: Journal Article
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Last Checked: 29/04/13 Link Error: Report It

 

Composite List of All QTDrugs and the List of Drugs to Avoid for Patients with Congenital LQTS

QT Drugs Lists: This portal includes QTdrugs.org, a list of drugs categorized by their potential to cause QT prolongation and/or torsades de pointes (TdP).

The lists can be exported as PDF or Excel files, printed and can be searched and sorted by: Generic Name, Brand Name, Risk Category, Pharmacologic Class, and Therapeutic Use.

Source: crediblemeds.org
Clinical Resource: Lists
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Last Checked: 22/11/13 Link Error: Report It

 

Drug-Induced QT Prolongation

Drug-induced prolongation of the QT interval has been known to occur after administration of antiarrhythmics formore than 20 years. Recently, drug-induced long QT syndrome (LQTS) has been observed after administration of non-antiarrhythmic medications. The additional attention paid to the mechanisms of hereditary QT prolongation has led to numerous advances in our understanding of how drugs produce QT prolongation.

Source: utah.edu
Clinical Resource: Poison Control Centre Newsletter
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Last Checked: 21/08/15 Link Error: Report It

 

QT Prolongation, Torsades de Pointes, and Drug Safety

The term torsades de pointes(TdP) is used to describe a polymorphic ventricular arrhythmia that occurs only in the presence of a prolonged QT interval.

Source: uwyo.edu
Clinical Resource: Newsletter
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Last Checked: 22/04/13 Link Error: Report It

 

Oral Adverse Drug Reactions to Cardiovascular Drugs

This review focuses on those cardiovascular drugs reported to induce oral drug reactions. In addition, it will provide data on specific drugs or drug classes, and outline and discuss recent research on possible mechanisms linking ADRs to drug metabolism patterns.

Source: sagepub.com
Clinical Resource: Journal Article
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Last Checked: 25/03/13 Link Error: Report It

 

Does Calcium Supplementation Increase the Risk of MI?

Clinical Question: Does calcium (Ca+) supplementation contribute to increased risk of myocardial infarction (MI) and other cardiovascular disease (CVD)?

Source: acfp.ca
Clinical Resource: Article
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Last Checked: 21/08/15 Link Error: Report It

 

European Society of Hypertension Newsletter
Cyclosporin-induced Hypertension

Source: eshonline.org
Clinical Resource: Newsletter
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Last Checked: 19/08/15 Link Error: Report It

 

Oral Manifestations of Drug Reactions

An estimated 2-4% of hospital admissions are related to adverse drug reactions. Mucocutaneous eruptions are often central to these untoward reactions, and an ever-expanding list of medications is linked to pathologic reactions in the oral and perioral region. These adverse drug reactions have a broad spectrum of clinical manifestations that can mimic those of other disease states, including both local and systemic conditions.

Source: medscape.com
Clinical Resource: Article
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Last Checked: 25/03/13 Link Error: Report It

 

Ototoxicity

Any drug with the potential to cause toxic reactions to structures of the inner ear, including the cochlea, vestibule, semicircular canals, and otoliths, is considered ototoxic. Drug-induced damage to these structures of the auditory and balance system can result in hearing loss, tinnitus, and dysequilibrium or dizziness.

Source: medscape.com
Clinical Resource: Article
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Last Checked: 25/03/13 Link Error: Report It

 

Drug-Induced Glaucoma

Several different drugs have the potential to cause the elevation of intraocular pressure (IOP), which can occur via an open-angle mechanism or a closed-angle mechanism.

Source: medscape.com
Clinical Resource: Article
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Last Checked: 19/05/14 Link Error: Report It

 

Update on Steroid-Induced Glaucoma

Recently, advances in molecular biology and genetics have generated considerable interest in the mechanisms and management of corticosteroid-induced ocular hypertension and glaucoma. This article reviews the literature on the subject and offers some advice on prevention and management.

Source: bmctoday.com
Clinical Resource: Publication
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Last Checked: 19/05/14 Link Error: Report It

 

Ocular & Visual Side Effects of Systemic Drugs

This article deals briefly with the mechanisms and reasons that account for the effects that systemic drugs can exert on the visual system. The remainder of the paper will cover major drug classes and serve as a guide to familiarize clinicians with important ocular and visual implications.

Source: oepf.org
Clinical Resource: Journal Article
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Last Checked: 19/05/14 Link Error: Report It

 

Side effects of glaucoma medications

The safety profile of the different glaucoma medications is an important issue when initiating therapy in glaucomatous patients. The decision on which medication to prescribe depends not only on the type of glaucoma, but also on the patient’s medical history and needs a detailed knowledge of the potential side-effects of each medication. Medications side effects may be an important cause of non adherence for the individual patient

Source: ophthalmologia.be
Clinical Resource: Publication
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Last Checked: 19/05/14 Link Error: Report It

 

Potential Ocular Side Effects of Select Systemic Drugs

The purpose of this poster is to serve as a handy reference for current and future eye care providers. It summarizes the ocular side effects that are potentially seen in patients who are on select systemic medications.

Source: commons.pacificu.edu
Clinical Resource: Poster
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Last Checked: 19/05/14 Link Error: Report It

 

Prevention and management of drug-induced ocular disorders

This article describes the principal ocular adverse effects and the drugs most often implicated.

Source: eu.wiley.com
Clinical Resource: Journal Article
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Last Checked: 19/05/14 Link Error: Report It

 

The Ocular Side-Effects of Vigabatrin (Sabril)

Source: rcophth.ac.uk
Clinical Resource: Guideline
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Last Checked: 21/08/15 Link Error: Report It

 

Hydroxychloroquine and Ocular Toxicity Recommendations on Screening

Source: rcophth.ac.uk
Clinical Resource: Guideline
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Last Checked: 21/08/15 Link Error: Report It

 

Ocular Side Effects of Topiramate - Frequently Asked Questions

Source: rcophth.ac.uk
Clinical Resource: Frequently Asked Questions
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Last Checked: 21/08/15 Link Error: Report It

 

Causes and management of drug-induced angioedema

This article considers the recommended management of angioedema and the drugs commonly implicated.

Source: eu.wiley.com
Clinical Resource: Journal Article
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Last Checked: 11/05/15 Link Error: Report It

 

Drug-induced angioedema

Angioedema is a potentially life-threatening adverse effect of many drugs.

Major drugs and drug classes involved include ACE-inhibitors, bupropion, NSAIDs and antidepressants

Source: adr.org.uk
Clinical Resource: Factsheet
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Last Checked: 30/07/13 Link Error: Report It

 

Cutaneous Drug Reactions

In this review, we assess the current knowledge of four categories of cutaneous drug reactions: immediate-type immune-mediated reactions, delayed-type immune-mediated reactions, photosensitivity reactions, and autoimmune syndromes. Moreover, we describe evidence that viral infection is an important predisposing factor for the development of cutaneous drug reactions upon drug administration. Finally, we review the current knowledge of the type and mechanisms of cutaneous drug reactions to several categories of drugs.

Source: pharmrev.aspetjournals.org
Clinical Resource: Journal Article
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Last Checked: 13/05/14 Link Error: Report It

 

Acute Cutaneous Adverse Drug Reactions

Cutaneous adverse drug reactions (CADR) are a common form of adverse drug reaction, affecting upto 3% of hospital patients. Almost any drug can cause a CADR and the effects can range from mild to life-threatening. When investigating a possible CADR it is important to include in the history all current/recent drugs, topical, over the counter (OTC), alternative medicines, vaccines and contrast media.

Source: druginformation.co.nz
Clinical Resource: Drug Information Service Bulletin
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Last Checked: 13/05/14 Link Error: Report It

 

Drug Eruptions

Drug eruptions can mimic a wide range of dermatoses. The morphologies are myriad and include morbilliform, urticarial, papulosquamous, pustular, and bullous. Medications can also cause pruritus and dysesthesia without an obvious eruption.

A drug-induced reaction should be considered in any patient who is taking medications and who suddenly develops a symmetric cutaneous eruption. Medications that are known for causing cutaneous reactions include antimicrobial agents, nonsteroidal anti-inflammatory drugs (NSAIDs), cytokines, chemotherapeutic agents, anticonvulsants, and psychotropic agents.

Source: medscape.com
Clinical Resource: Article
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Last Checked: 13/05/14 Link Error: Report It

 

European Dermatology Forum Evidence-Based Guidelines for the Classification and Management of Drug-Induced Phototoxicity

Source: euroderm.org
Clinical Resource: Guideline
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Last Checked: 20/08/15 Link Error: Report It

 

Photosensitivity: Light, sun and pharmacy

Educational aims

  • To provide an overview of different types of drug-induced photosensitivity reactions
  • To provide an overview of treatment options and prevention strategies
  • To provide an practical help as regards the use of sunscreen
Source: mcppnet.org
Clinical Resource: Journal Article
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Last Checked: 13/05/14 Link Error: Report It

 

Drug-Induced Photosensitivity

Drug-induced photosensitivity refers to the development of cutaneous disease as a result of the combined effects of a chemical and light. Exposure to either the chemical or the light alone is not sufficient to induce the disease; however, when photoactivation of the chemical occurs, one or more cutaneous manifestations may arise. These include phototoxic and photoallergic reactions, a planus lichenoides reaction, pseudoporphyria, and subacute cutaneous lupus erythematosus. Photosensitivity reactions may result from systemic medications and topically applied compounds.

Source: medscape.com
Clinical Resource: Article
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Last Checked: 19/03/13 Link Error: Report It

 

Drug-induced photosensitivity reaction

Drug induced photosensitivity reactions are a relatively common side effect associated with many medications. These reactions occur via activation of a chemical by ultra-violet or visible light. Many commonly used drugs are implicated (both systemic and topical use), and include amiodarone, NSAIDs, phenothiazines, retinoids, quinolones, sulfonamides, tetracyclines, and thiazides.

Source: auspharmlist.net.au
Clinical Resource: Pharmacy E-Bulletin
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Last Checked: 13/05/14 Link Error: Report It

 

Q: What are the differences between chemically-induced phototoxic and photoallergic reactions

A: Phototoxicity and photoallergy are two classifications of a chemically-induced reaction more commonly referred to as photosensitivity. This dermatologic reaction results from exposure to the sun after administration of select drugs and is characterized by erythema, edema, vesicles, and the formation of papules.

Source: duq.edu
Clinical Resource: Pharmaceutical Information Centre Publication
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Last Checked: 13/05/14 Link Error: Report It

 

Topical Corticosteroids: Face Facts

The use of topical corticosteroids on the face can result in harmful skin effects such as atrophy, telangiectasia and periorificial dermatitis. These adverse reactions are greater with the more potent steroids but can be minimised by limiting use on the face. The risks of facial use should be communicated to patients, along with clear directions about where to apply the topical steroid and for how long to continue treatment.

Source: medsafe.govt.nz
Clinical Resource: Prescriber Update Article
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Last Checked: 13/05/14 Link Error: Report It

 

Drug-induced muscle and joint pain

Drug-induced muscle and joint pains are severe adverse reactions.

Major drugs and drug classes associated with myalgia include suxamethonium, statins, fibrates, amiodarone, ciclosporin, colchicine, diuretics and danazol.

Source: adr.org.uk
Clinical Resource: Factsheet
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Last Checked: 19/07/13 Link Error: Report It

 

Update on Drug-Induced Osteoporosis (DIO)

Many commonly prescribed drugs are known to cause bone loss. The aim of this newsletter is to review drugs associated with osteoporosis (OP), the frequency of occurrence, prevention and management.

Source: usask.ca
Clinical Resource: Drug Information Service Newsletter
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Last Checked: 11/05/15 Link Error: Report It

 

Position statement of the Society for Endocrinology on the endocrine effects of inhaled corticosteroids in respiratory disease

This position statement highlights the suppressive effects of inhaled corticosteroids on the endogenous hypothalamo-pituitary-adrenal axis.

Source: endocrinology.org
Clinical Resource: Position Statement
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Last Checked: 29/04/13 Link Error: Report It

 

Psychiatric Adverse Effects of Corticosteroids

This review offers an approach to identifying and managing corticosteroid-induced psychiatric syndromes based on the type of symptoms and anticipated duration of corticosteroid treatment.

Source: mayoclinicproceedings.org
Clinical Resource: Journal Article
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Last Checked: 08/05/13 Link Error: Report It

 

Is it safe to use beta-blockers for cardiac disease in people with COPD?

Cardioselective beta-blockers such as metoprolol and atenolol are usually safe and effective in patients with well controlled COPD with or without a reversible obstructive component. Carvedilol (a combined non-selective beta-blocker and alpha-blocker) also appears to be safe to use in COPD patients without reversible airways obstruction.

Source: bpac.org.nz
Clinical Resource: Journal Article
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Last Checked: 22/04/13 Link Error: Report It

 

Beta-blocker selectivity and airways obstruction

In this Drug Points article the author describes a case of unrecognised airways disease where prescribing timolol resulted in shortness of breath and comments on the issues it raises

Source: eu.wiley.com
Clinical Resource: Journal Article
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Last Checked: 22/04/13 Link Error: Report It

 

Society for Endocrinology position statement on the use of synthetic ACTH (Synacthen) in patients with a history of asthma

This statement is issued to coincide with the publication of BNF62 that contains (in section 6.5.1) an amendment to cautions and contraindications in the use of Tetracosactide (Tetracosactrin).

Source: endocrinology.org
Clinical Resource: Position Statement
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Last Checked: 29/04/13 Link Error: Report It

 

Drugs & Gastrointestinal Bleeding

This bulletin summarises the current evidence regarding some drugs less well known to increase the risk of GI bleeding including clopidogrel, selective serotonin reuptake inhibitors (SSRI’s), tricyclic antidepressants & calcium channel blockers.

Source: druginformation.co.nz
Clinical Resource: Drug Information Service Bulletin
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Last Checked: 30/07/13 Link Error: Report It

 

Management of NSAID-Associated Upper GI Disorders

To describe risk factors and review appropriate management strategies for patients who experience nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) adverse events.

Source: amcp.org
Clinical Resource: Supplement
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Last Checked: 30/07/13 Link Error: Report It

 

Indigestion and non-steroidal anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs (NSAIDs) are usually thought to pose a dilemma for doctors wishing to prescribe them. Their anti-inflammatory and analgesic properties have led to their widespread use for rheumatoid and (much more commonly) other conditions often regarded as more trivial.

Source: europepmc.org
Clinical Resource: Journal Article
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Last Checked: 07/04/14 Link Error: Report It

 

Cardiovascular and gastrointestinal safety of NSAIDs

This article summarises current evidence of relative CV and GI risks for non-aspirin NSAIDs and highly selective COX-2 inhibitors (coxibs), and provides prescribing advice which is consistent with previous advice from the Commission on Human Medicines.

Source: webarchive.org.uk
Clinical Resource: National Prescribing Centre Publication
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Last Checked: 24/04/15 Link Error: Report It

 

SSRIs and bleeding disorders

The selective serotonin re-uptake inhibitors (SSRIs) (e.g. fluoxetine, paroxetine, citalopram) have been associated with a variety of bleeding disorders and these started to be reported soon after their introduction. Reported reactions have ranged from mild spontaneous bleeding such as bruising or epistaxis to serious conditions including GI haemorrhage, genitourinary bleeding, intracranial haemorrhage and increased bleeding during surgery.

Source: bpac.org.nz
Clinical Resource: Journal Article
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Last Checked: 20/06/13 Link Error: Report It

 

Drug-induced acute pancreatitis

Reports of drug-induced acute pancreatitis (AP) have been published since the 1950s, and each year the list of drugs associated with AP increases. There are many etiological risk factors for AP, including a history of alcohol abuse, gallstones, endoscopic retrograde cholangiopancreatography and manometry, trauma or surgical procedures near the pancreas, certain medications, hyperlipidemia, infection, and chronic hypercalcemia. Knowledge of the true incidence of drug-induced AP is dependent on clinicians excluding other possible causes and reporting the event.

Source: baylorhealth.edu
Clinical Resource: Journal Article
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Last Checked: 30/07/13 Link Error: Report It

 

Management of Adverse Opioid Reactions

Source: paineducation.vcu.edu
Clinical Resource: Table
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Last Checked: 24/04/14 Link Error: Report It

 

Opioid Complications and Side Effects

Common side effects of opioid administration include sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance, and respiratory depression. Physical dependence and addiction are clinical concerns that may prevent proper prescribing and in turn inadequate pain management.

Source: painphysicianjournal.com
Clinical Resource: Journal Article
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Last Checked: 19/10/15 Link Error: Report It

 

Medication Induced Constipation and Diarrhea

This article discusses the most common medications associated with constipation and diarrhea as well as diagnosis, treatment and prevention of the disorder; the diagnosis is especially important when the offending medication cannot be discontinued.

Source: practicalgastro.com
Clinical Resource: Journal Article
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Last Checked: 30/07/13 Link Error: Report It

 

Drug-Associated Diarrhoea and Constipation in Older People
1. Diarrhoea

The first part of this review explains the mechanisms involved in drug-induced diarrhoea and gives examples of drugs commonly involved.

Drug-Associated Diarrhoea and Constipation in Older People
2. Constipation

This second part of the review explains the mechanisms of drug-induced constipation and presents examples of drugs commonly associated with this abnormality of bowel function.

Source: shpa.org.au
Clinical Resource: Journal Articles
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Last Checked: 30/07/13 Link Error: Report It

 

Antibiotic-Associated Diarrhoea

Antibiotic-associated diarrhoea (AAD) is a common side effect. The incidence varies between antibiotics, and has been estimated to occur in 15% of patients taking beta-lactams (although up to 25% of those taking amoxicillin/clavulanate), 2 to 5% of those taking cephalosporins, fluoroquinolones or macrolides. Rates with intravenous administration (particularly if a drug undergoes enterohepatic circulation) are similar to those with oral administration.

Source: druginformation.co.nz
Clinical Resource: Drug Information Service Bulletin
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Last Checked: 30/07/13 Link Error: Report It

 

Drug-induced fluid and electrolyte disorders

Water and electrolyte homeostasis may be disrupted by the presence of drugs, in both acute and chronic settings, affecting patient’s morbidity and mortality. Early recognition and appropriate monitoring of drug-induced fluid and electrolyte imbalances is crucial, especially in those receiving TPN therapy.

Source: eahp.eu
Clinical Resource: Journal Article
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Last Checked: 30/07/13 Link Error: Report It

 

Medications that have an effect on the anion and osmolal gaps

Medications implicated in high anion gap acidosis have usually been taken in excess or as a result of overdose.

The most common cause of an osmolal gap is ethanol intoxication.

Source: journals.lww.com
Clinical Resource: Journal Article
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Last Checked: 17/05/13 Link Error: Report It

 

Medication-Induced Hypokalemia: A Common Problem

This issue of Elder Care will review the most common hypokalemia-causing drugs. These and other medications are listed in Table 2. In addition to medication, hypokalemia can also be caused by the ingestion of large quantities of caffeine or licorice.

Source: aging.arizona.edu
Clinical Resource: Factsheet
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Last Checked: 26/10/15 Link Error: Report It

 

Drug-Induced Thrombocytopenia

Drug-induced thrombocytopenia presents several diagnostic and management challenges. First, it can be difficult to definitively prove that a decrease in platelet count is drug-related, especially in the absence of sufficiently frequent platelet counts to allow for a clearly defined temporal relationship between drug administration and thrombocytopenia.

Source: archivesofpathology.org
Clinical Resource: Journal Article
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Last Checked: 02/07/14 Link Error: Report It

 

American Society of Hematology 2013 Clinical Practice Guideline on the Evaluation and Management of Adults with Suspected Heparin-Induced Thrombocytopenia (HIT)

Source: hematology.org
Clinical Resource: Guideline
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Last Checked: 10/12/13 Link Error: Report It

 

British Society for Haematology Guidelines on the Diagnosis and Management of Heparin Induced Thrombocytopenia: Second Edition

Source: b-s-h.org.uk
Clinical Resource: Guideline
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Last Checked: 16/11/16 Link Error: Report It

 

Heparin-Induced Thrombocytopenia (HIT)
Frequently Asked Questions

What is HIT? What causes HIT? What is the clinical significance of HIT? How is HIT diagnosed? What are the laboratory features of Type I HIT? What are the laboratory features of Type II HIT? How is HIT treated?

Source: pathology.vcu.edu
Clinical Resource: Frequently Asked Questions
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Last Checked: 02/07/14 Link Error: Report It

 

Heparin-Induced thrombocytopenia: An Update

This article reviews the pathophysiology and provides updates presented in the recently revised American College of Chest Physicians practice guidelines with regard to management of HIT with and without thrombosis.

Source: uspharmacist.com
Clinical Resource: Journal Article
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Last Checked: 02/07/14 Link Error: Report It

 

Glaucoma Associated With therapies for Psychiatric disorders

The most common psychiatric conditions in the elderly are anxiety, severe cognitive impairment, and mood disorders (depression or bipolar disorder). Unfortunately, some psychiatric treatments, both medical and electroconvulsive therapy (ECT), can cause glaucoma, and glaucoma therapy such as timolol, brimonidine, and pilocarpine can cause psychiatric symptoms. This article provides an overview of the relationship between glaucoma and psychiatric treatments.

Source: bmctoday.com
Clinical Resource: Publication
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Last Checked: 19/05/14 Link Error: Report It

 

Drug-induced depression

Drug-induced depression can vary from minor mood changes, to more severe mood changes with sleep disturbances and loss of appetite. In its most severe form, it can include suicidal ideation.

Source: adr.org.uk
Clinical Resource: Factsheet
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Last Checked: 20/06/13 Link Error: Report It

 

Drug-induced hallucinations

Hallucinations are serious reactions.

Major drugs and drug classes associated with hallucinations include antimuscarinic agents, antiparkinsonian drugs, antidepressants, beta adrenoceptor antagonists and opiates.

Source: adr.org.uk
Clinical Resource: Factsheet
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Last Checked: 30/07/13 Link Error: Report It

 

Drug-induced sexual dysfunction in men and women

Many medical conditions and their treatments contribute to sexual dysfunction.

Commonly implicated drugs include antihypertensives, antidepressants, antipsychotics and antiandrogens.

Understanding the potential for drug-induced sexual problems and their negative impact on adherence to treatment will enable the clinician to tailor treatments for the patient and his or her partner.

Source: nps.org.au
Clinical Resource: Journal Article
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Last Checked: 08/08/16 Link Error: Report It

 

Drugs causing possible erectile dysfunction

Source: refhelp.scot.nhs.uk
Clinical Resource: Table
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Last Checked: 18/06/13 Link Error: Report It

 

Some prescribed drugs that may cause problems with sexual dysfunction

Source: sda.uk.net
Clinical Resource: List
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Last Checked: 18/06/13 Link Error: Report It

 

Sexual dysfunction & antidepressants – part one

When considering whether sexual dysfunction is a result of antidepressant therapy, other causes and or contributing factors should be taken into account.

Sexual dysfunction & antidepressants – part two

There are a number of strategies that have been suggested for managing antidepressant induced sexual dysfunction as follows.

Source: auspharmlist.net.au
Clinical Resource: Pharmacy E-Bulletins
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Last Checked: 18/06/13 Link Error: Report It

 

Antidepressant-induced sexual dysfunction

Depression and sexual dysfunction are both common in the general population. When they co-exist they have the potential to impact negatively on each other in a bidirectional manner. Medication used to treat depression may cause additional problems with the sexual response cycle; although no drug is completely innocent, serotonergic agents such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs) are most frequently implicated in antidepressant-induced sexual dysfunction.

Source: safpj.co.za
Clinical Resource: Journal Article
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Last Checked: 18/06/13 Link Error: Report It

 

Antidepressant-induced seizures

The incidence of antidepressant induced seizures ranges from 0.1–4.0%, with the greatest risk being in patients with identifiable risk factors, as listed below. The mechanisms by which antidepressants cause seizures are unclear.

Source: auspharmlist.net.au
Clinical Resource: Pharmacy E-Bulletin
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Last Checked: 16/05/13 Link Error: Report It

 

Atypical Antipsychotics and Metabolic Abnormalities

This article will focus on the type of metabolic abnormalities that can be associated with AAPs as well as recommended monitoring and management strategies.

Source: oregonstate.edu
Clinical Resource: Newsletter
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Last Checked: 19/08/15 Link Error: Report It

 

Diabetes, Psychiatric Disorders, and the Metabolic Effects of Antipsychotic Medications

This article will review the atypical, or second-generation, antipsychotics and their current uses. The relationship between diabetes and two of the most frequent indications for the use of these medications (schizophrenia and behavioral and psychological symptoms of dementia) will be examined. Additionally, this article will explore the complex association between antipsychotic medications and obesity, hyperglycemia, and dyslipidemias.

Source: diabetesjournals.org
Clinical Resource: Journal Article
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Last Checked: 20/06/13 Link Error: Report It

 

Atypical antipsychotic-induced blood dyscrasias and other adverse effects

A summary of recent information regarding atypical antipsychotic-induced blood dyscrasias is outlined below.

Source: druginformation.co.nz
Clinical Resource: Drug Information Service Bulletin
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Last Checked: 20/06/13 Link Error: Report It

 

Q: Can you summarize the relationship of fluoroquinolones and tendon-related injury?

A: The effects of fluoroquinolones on musculoskeletal tissue have been recognized since their introduction in the early 1980s. Due to a significant number of spontaneously reported cases and an FDA re-evaluation of the problem, the agency has now issued a Black Box Warning regarding tendon damage and this class of drugs. Most reports identify the age of affected patients as between 33 and 85 years.

Source: duq.edu
Clinical Resource: Pharmaceutical Information Centre Publication
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Last Checked: 30/07/13 Link Error: Report It

 

Comprehensive Antiretroviral Table: Adult Dosing, Dosage Form Modifications, Adverse Reactions and Interaction Potential

Source: nccc.ucsf.edu
Clinical Resource: Table
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Last Checked: 25/04/15 Link Error: Report It

 

Guidelines for the Management of Adverse Drug Effects of Antimycobacterial Agents

Source: upenn.edu
Clinical Resource: Guideline
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Last Checked: 29/04/13 Link Error: Report It

 

American Association of Oral and Maxillofacial Surgeons Position Paper on Medication-Related Osteonecrosis of the Jaw—2014 Update

Source: aaoms.org
Clinical Resource: Position Paper
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Last Checked: 20/08/15 Link Error: Report It

 

Canadian Consensus Practice Guidelines for Bisphosphonate Associated Osteonecrosis of the Jaw
Canadian Association of Oral & Maxillofacial Surgeons

Source: caoms.com
Clinical Resource: Guideline
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Last Checked: 19/07/13 Link Error: Report It

 

Bisphosphonates and osteonecrosis of the jaw

On behalf of the Australian and New Zealand Bone and Mineral Society, Osteoporosis Australia, Medical Oncology Group of Australia, and the Australian Dental Association.

Source: racgp.org.au
Clinical Resource: Position Statement
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Last Checked: 19/07/13 Link Error: Report It

 

Scottish Dental Clinical Effectiveness Programme Guidance on Oral Health Management of Patients Prescribed Bisphosphonates

This guidance has been developed to inform dental practitioners about how to manage patients prescribed bisphosphonates. Prescribers and dispensers of bisphosphonates, as well as patients may also find the information in this guidance of relevance.

Source: sdcep.org.uk
Clinical Resource: Guidance
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Last Checked: 20/08/15 Link Error: Report It

 

Pharmaceutical excipients – where do we begin?

Excipients have been defined in many ways, including as inert substances used as vehicles and diluents for drugs. The problem with this definition is that in recent years excipients have proved to be anything but inert, not only possessing the ability to react with other ingredients in the formulation, but also to cause adverse and hypersensitivity reactions in patients.

Source: nps.org.au
Clinical Resource: Journal Article
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Last Checked: 08/08/16 Link Error: Report It

 

Adverse reactions to vaccines practice parameter 2012 update

These parameters were developed by the Joint Task Force on Practice Parameters (JTFPP), representing the American Academy of Allergy, Asthma & Immunology (AAAAI); the American College of Allergy, Asthma & Immunology (ACAAI); and the Joint Council of Allergy, Asthma & Immunology.

Source: allergyparameters.org
Clinical Resource: Practice Parameter
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Last Checked: 08/05/15 Link Error: Report It

 

Vaccine Adverse Event Reporting System

The Vaccine Adverse Event Reporting System (VAERS) is a national vaccine safety surveillance program co-sponsored by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). VAERS is a post-marketing safety surveillance program, collecting information about adverse events (possible side effects) that occur after the administration of vaccines licensed for use in the United States.

Source: vaers.hhs.gov
Clinical Resource: Various
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Last Checked: 22/04/14 Link Error: Report It

 

Vaccination and the Risk of Atopy and Asthma

Vaccines are of major importance in controlling the spread of infectious diseases, but use of some vaccines was linked to allergic and autoimmune phenomena in healthy and often in certain high risk populations. Immediate systemic allergic reactions after vaccination with commonly used vaccines are extremely rare to a degree were it can be argued that there is any association at all between the vaccines and the allergic reactions that were reported.

Source: worldallergy.org
Clinical Resource: Summary
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Last Checked: 22/04/14 Link Error: Report It

 

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