RESUMEN
We report a case of clonidine poisoning in a breastfed newborn. At 2 days of life, this boy presented a consciousness deficit with drowsiness, hypotonia, and suspected generalized seizures. There were no cardiorespiratory problems outside of progressive central apneas beginning the 5th day. Further initial investigations were normal (extensive biological exams, cranial ultrasonography and transfontanellar Doppler, electroencephalography, and brain MRI study), excluding the main causes of neonatal hypotonia (encephalitis, infection, metabolic disorder). However, new medical questioning revealed maternal daily intake of 0.15 mg clonidine for hypertension during and after pregnancy. Since it was impossible to quantify clonidine quantification in newborn serum and breast milk, a weaning test was performed the 9th day. Twenty-four hours after cessation of breastfeeding, complete regression of symptoms was obtained. Poisoning by clonidine after fetal and neonatal exposure through breast milk is rare but severe enough to simulate a neurological disease. Diagnosis is based on the search for drug use and the cessation of breastfeeding if doubt persists. Recovery of normal examination results is then rapid and complete.
Asunto(s)
Clonidina/farmacocinética , Clonidina/envenenamiento , Trastornos de la Conciencia/inducido químicamente , Hipertensión Inducida en el Embarazo/sangre , Hipertensión Inducida en el Embarazo/tratamiento farmacológico , Intercambio Materno-Fetal/fisiología , Leche Humana/metabolismo , Hipotonía Muscular/inducido químicamente , Fases del Sueño/efectos de los fármacos , Clonidina/uso terapéutico , Trastornos de la Conciencia/sangre , Diagnóstico Diferencial , Femenino , Humanos , Recién Nacido , Masculino , Embarazo , Convulsiones/sangre , Convulsiones/inducido químicamente , Apnea Central del Sueño/sangre , Apnea Central del Sueño/inducido químicamenteRESUMEN
BACKGROUND: Percutalgine(®) (dexamethasone acetate, salicylamide and hydroxyethyl salicylate) is a topical drug marketed for treatment of benign joint conditions such as mild tendinitis, small joint arthritis and sprains. The aim of the study was to describe the cutaneous side effects of Percutalgine(®) in terms of clinical signs, seriousness and causal relationship of the different components. METHODS: We extracted from the French Pharmacovigilance database all cases of adverse skin reactions occurring after application of Percutalgine(®) and reported for the period between 1st January 2000 and 31st October 2010. The only files selected were those in which Percutalgine(®) was the sole suspected drug and/or allergological tests were positive for Percutalgine(®) or its components. RESULTS: Fifty-three cases were ultimately retained and analysed. The main cutaneous side effect of Percutalgine(®) (n=41) was contact dermatitis with secondary extension in 15 cases. Onset was immediate in 12 cases, delayed in 32 cases and unspecified in eight cases. Twelve patients were hospitalized for inefficiency of the symptomatic treatment, extended lesions or generalized associated signs. Allergological tests were described in 14 cases and were positive for Percutalgine(®) (eight cases), hydroxyethyl salicylate (seven cases), salicylamide (six cases), dexamethasone (three cases), and propylene glycol (two cases). CONCLUSION: Cutaneous side effects with Percutalgine(®) appear to be rare or infrequently reported. They consist chiefly of contact allergy. The component responsible for the reaction can be determined using allergological patch tests.
Asunto(s)
Sistemas de Registro de Reacción Adversa a Medicamentos , Dexametasona/análogos & derivados , Erupciones por Medicamentos/etiología , Farmacovigilancia , Salicilamidas/efectos adversos , Salicilatos/efectos adversos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Bases de Datos Factuales , Dexametasona/efectos adversos , Combinación de Medicamentos , Femenino , Francia , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
We report 4 cases of hepatic injury in patients treated with a dextropropoxyphene-paracetamol combination in which the causal relationship with dextropropoxyphene can be suspected. These four cases show similarities with the 29 cases found in international publications. Hepatotoxicity occurs more frequently among old patients and women. Clinically, this condition can mimic a biliary tract disease with sometimes few or no symptoms. Biochemical criteria can show cholestatic, mixed or cytolytic hepatitis. Intrahepatic cholestasis may be found in liver biopsies sometimes suggesting cholangitis. Outcome is favourable on withdrawal of the drug. The mechanism of action of dextropropoxyphene is discussed.
Asunto(s)
Analgésicos Opioides/efectos adversos , Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Dextropropoxifeno/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , HumanosRESUMEN
The aim of the present work was to study anxiety among school age students suffering from asthma. The study was conducted on a total number of 146 asthmatic preparatory school students, attending the asthma clinic in Sporting Students' Hospital in Alexandria Governorate. The study was performed during the period from June to September 1997. A matching control of 223 non-asthmatic students from the preparatory school in the East educational zone in Alexandria Governorate were also included in the study. The study was carried out through a cross-sectional approach. A structured self-administered questionnaire was used to collect data about, the general characteristics of the sample, interpersonal and inter-parental relationships, school performance and the attitude and behavior of mothers towards their asthmatic children. The Arabic version of State-Trait Anxiety Inventory (STAI) was used to identify children with anxiety state. The present result revealed that 24.7% of the asthmatic students were anxious, with a higher preponderance among boys than girls (26.6%, 21.2%, respectively). Bad interpersonal and inter-parental relationships had increased the risk of occurrence of anxiety state among asthmatic children. Also, poor scholastic achievement was more encountered among asthmatics who had anxiety. The development of asthma education programs to increase parents', children's and teachers' awareness of asthma symptoms and asthma trigger events was recommended.
Asunto(s)
Ansiedad/etiología , Asma/complicaciones , Asma/psicología , Adolescente , Factores de Edad , Niño , Estudios Transversales , Femenino , Humanos , Relaciones Interpersonales , Masculino , Relaciones Padres-Hijo , Factores SexualesRESUMEN
A good immediate ocular tolerance of eye-drops is paramount for the patient's compliance, and therefore for the therapeutic success. The tolerance of a new formula of NAAXIA, an anti-allergic eye-drop, whose sole modification was the replacement of the Mg++ ion by the Na+ ion, was compared with the previous formula. One drop of each preparation was instilled in one eye so as to make an intraindividual comparison. Just after instillation, each subject was asked to express what he felt, and which eye-drop he preferred. The answers, reported on a sequential analysis graph, clearly show that in all three groups (healthy adults, red-eyed adults, red-eyed children) the slight alteration of the formula led to a marked improvement in immediate tolerance.