Side Effects of Drugs

Address list of national centres that participate in the WHO Drug Monitoring Programme

Editor's note The details given here were correct at the time of going to press in January 2003. However, details of this sort often change, and readers should contact the WHO Monitoring Programme at Uppsala if they are unable to reach any of the agencies listed using the information given. Tel 54-1-340 0866 Fax 54-1-340 0866 E-mail snfvg anmat.gov.ar Website anmat.gov.ar Armenia ARM Dr Samvel Azatyan Deputy director Tel 374-1-584 020, 584 120 Fax 374-1-542 406 E-mail azatyan pharm.am Website...

The baclofen withdrawal syndrome

Long-term administration of baclofen is widely used in patients with muscle spasticity resulting from a variety of cerebral and spinal chord lesions. As with other GABA receptor agonists, withdrawal reactions will occur if it is stopped abruptly. Patients can present with different symptoms, not all ofwhich would be considered classical of drug withdrawal. Some interesting aspects of withdrawal symptoms after baclofen administration have been highlighted in three recent reports. Clinical...

Diethylstilbestrol stilbestrol

Diethylstilbestrol continues to be recommended in some centers as one of the agents of last resort when prostate cancer proves refractory to steroid hormones or androgen deprivation therapy has done all it can 14cr . In a Japanese study in which 16 patients were given a daily intravenous injection of 250 mg of diethylstilbestrol diphosphate for 28 days the short-term response was favorable and the drug was well-tolerated 15c . Carcinogenicity Vaginal cancer The evidence incriminating fetal...

Methylphenidate

Two reviews have addressed the diagnosis and management of attention-deficit hyperkinetic disorder (ADHD) and have summarized the effects of stimulants, including those of methylphenidate and adderal (a mixture of equal components of d-amphetamine saccharate, d,l-amphetamine aspartate, d-amphetamine sulfate, and d,l-amphetamine sulfate, which seems to be gaining popularity in the treatment of ADHD) (26r, 27r). The results of the National Institute of Mental Health Collaborative Multimodal...

Caspofungin

Caspofungin has been compared with ampho-tericin in a multicenter, double-blind, randomized trial in 128 adults with endoscopically documented symptomatic Candida esophagi-tis (64C). There was endoscopically verified clinical success in 74 and 89 of the patients who received caspofungin 50 and 70 mg day respectively, and in 63 of patients given amphotericin B deoxycholate 0.5 mg kg day. Therapy was withdrawn because of drug-related adverse events in 24 of the patients who were given...

Androgenic anabolic steroids

Nervous system An old indication for anabolic steroids, still followed in a few centers, is the treatment of aplastic anemia. A 40-year-old Korean woman who had taken oxymetholone for aplastic anemia (doses not stated) developed cerebral venous thrombosis accompanied by a tentorial subdural hematoma (99Ar). Hiccups have been classified as a neurological reaction that can be triggered by many factors. There have been a few published reports of persistent hiccups associated with oral and...

Antithyroid drugs

THYROID HORMONES (SED-14, 1485 SEDA-23, 451 SEDA-24, 484 SEDA-25, 503) Cardiovascular It is well recognized that worsening of angina, precipitation of acute my-ocardial infarction, and even death in subjects with underlying coronary artery disease can occur, albeit uncommonly, when thyroxine replacement is begun. This recognition has led to the recommendation, especially in those known to have heart disease and with severe and longstanding hypothyroidism, that thyroxine should be introduced...

Phenolic Compounds

(SED-14, 773 SEDA-23, 248 SEDA-24, 271) Phenol is a benzyl alcohol and a major oxidized metabolite of benzene. Although it can be prepared in an aqueous solution or in glycerin, it appears to be more effective when mixed in aqueous compounds. At a concentration of 0.2 it is bacteriostatic and at over 1 bacteriocidal (10R). In addition to its uses as an antiseptic and disinfectant, phenol is also used as a sclerosant, as a local anesthetic on the skin, and as an analgesic, by injection into...

Oxybuprocaine

Skin There have been two reports of patients scheduled for tonometry who developed periorbital dermatitis following the topical instillation of local anesthetic eye drops (44A). The first patient reacted strongly positive on patch testing to Thilorbin AT (oxybuprocaine, fluorescein, phenylmercuric borate, polysorbate 20, manni-tol) and also to oxybuprocaine alone. The second reacted to Conjucain EDO (oxybuprocaine, sorbitol, sodium hydroxide) and to oxybupro-caine alone. The authors believed...

Allergic reactions to rocuronium

During the last few years several allergic reactions to rocuronium have been reported. Based on data from the UK, Australia, and France, it had been suggested that the incidence of such reactions after rocuronium administration paralleled its frequency of use, as assessed by its market share, implying that rocuronium did not have unusual allergenic properties (4C-6C). Also, the incidence ofhypotension, tachycardia, or reduced oxygen saturation (which might suggest an anaphylactoid reaction) was...

Vitamin B6 pyridoxine

In India, pyridoxine hydrochloride, along with thiamine and cyanocobalamin, is often injected or given orally as a neurotonic to large numbers of people. Skin Contact hypersensitivity to pyridoxine is rare. Only three cases of allergy to pyridox-ine have been reported in hair lotion (24A), a corticosteroid cream (25A), and a skin cream (Iruxol) (26a). There have also been a few reports of photosensitivity due to pyridoxine hydrochloride (27A-29A). Occupational systemic contact dermatitis with...