Adverse drug reactions in the elderly: case studies.

ADRs in the elderly may present in an atypical manner. Atypical reactions are uncommon and usually cannot be anticipated from the chemical or pharmacologic properties of the drug. In many cases, you may find a careful and thorough drug history and knowledge of drug-related reactions more helpful than an array of laboratory data.

Effect of diisopropyl 1,3-dithiolan-2-ylidenemalonate on experimental fatty livers in chicks.

The effect of diisopropyl 1,3-dithiolan-2-ylidenemalonate (NKK-100) on experimental fatty livers was investigated in chicks administered an antithyroid agent plus synthetic estrogen or in estrogenized, starved-refed chicks. NKK-100 was added at levels of 250, 500, 1000, and 1500 mg/kg diet. Liver weight was significantly decreased by administration of NKK-100 at 1500 mg/kg diet in the estrogen-administered chicks. Liver lipid content and liver lipid deposition were significantly and inversely decreased with increasing NKK-100 concentration in the diet in the estrogen administered chicks. Plasma transaminase activity, which was elevated by the estrogen administration, was reduced by the administration of NKK-100. These results suggest that NKK-100 may be of value in preventing fatty livers in poultry.

[Blastomogenesis in rats induced by transplacental introduction of estrogens]. / Blastomogenez u krys pri transplatsentarnom vvedenii éstrogenov.

The increased frequency of tumors of the uterus and testis was observed in old noninbred rats after the transplacental treatment with estrogens. Eleven tumors of the uterus (6.7 +/- 1.9%) were detected in 165 noninbred rats, supplied by the animal farm of the USSR Academy of Medical Sciences, 18 months or longer after pre- and neonatal treatment with diethylstilbestrol, synestrol and sigetin. Those neoplasms included 4 squamous-cell carcinomas of cervix uteri and vagina. 4 myomas, 2 papillomas of the vagina and one endometrial adenocarcinoma. An ovarian adenocarcinoma and an angiosarcoma of the oviduct were found in two animals. These findings were matched by 2 endometrial adenocarcinomas (1.6 +/- 1.1%) and 3 benign ovarian tumors (in two animals) detected in 124 control female rats aged more than two years. The transplacental treatment with sigetin was followed by an increased frequency of interstitial cell tumors of the testis (up to 16.4 +/- 5.0% as compared with 2.2 +/- 1.6% in control) which developed at an earlier stage, too.

The influence of environmental temperature, thyroid status and a synthetic oestrogen on the induction of fatty livers in chicks.

1. Hepatic lipid content, lipogenic enzyme activity and plasma lipid concentration were measured in chicks reared at 21 degrees or 34 degrees C and after thyroxine (T4), thiouracil (TU), propylthiouracil (PTU), dienestrol diacetate (DD) or PTU with DD had been given for 14 d. 2. At 34 degrees C there was a significant increase in the total liver lipid and triglyceride content. 3. Injections of T4 decreased liver lipid content whereas it was increased by feeding PTU or DD. The effects of PTU were more pronounced at 21 degrees C while those of DD were more pronounced at 34 degrees C. 4. There were significant interactions between temperature, thyroid status and synthetic oestrogen treatments on total lipid and triglyceride content of the liver. Fatty liver with marked steatosis could be produced through synergic actions of PTU and DD in chicks maintained at 21 degrees C.

Vaginal medications as a cause for varied widespread dermatitides.

Widespread dermatitis developed in three women after use of vaginal preparations. Besides allergic contact dermatitis, these cases involved erythema multiforme and a photosensitive eruption. Antigen absorption into the general circulation through the vaginal wall, and its deposition at distant skin sites, appeared to account for the spread of the eruption. This type of eruption is akin to the systemic, eczematous, contact-type dermatitis mediated by a systemically given drug in a primarily cutaneously sensitized person.