RESUMO
In an effort to improve patient safety, Hassan II hospital in Fez introduced a pharmacovigilance system for notification of adverse drug reactions as a priority objective. The implementation of pharmacovigilance activities actually began in June 2007 but it was in 2009 after the inauguration of the new complex that the system became properly operational. This report outlines the activities carried out to develop and implement this system, including informing and training the health professionals, and the results obtained after its introduction. From 2007 to 2009, fewer than 100 cases of adverse drug reactions were reported. Up to June 2011, however, 520 reports of adverse drug reactions were recorded. The classes of drugs most implicated in adverse events were: cancer drugs (26%), anti-inflammatory drugs and antibiotics (each 15%), analgesics (12%), iodinated contrast agents (6%), and anticoagulants and corticosteroids (5%). The main adverse events were dermatological and 27% of reports came from the internal medicine department, followed by hepatogastroenterology (25%). Of the 520 cases reported, 46% were severe.
Assuntos
Hospitais Universitários , Farmacovigilância , Sistemas de Notificação de Reações Adversas a Medicamentos , Humanos , MarrocosRESUMO
Cushing paraneoplasic syndrome is a rare cause of hypercorticism. We report a case of 35 year-old man presenting with Cushing's syndrome characterized by severe signs of hypercorticism and hypokalemia. Endocrine investigations were suggestive of an hypercortisolism linked to an ectopic adrenocorticotropic (ACTH) secretion, both at baseline (mean ACTH levels=275 pg/ml, urinary free cortisol excretion=3.898 mmol/24 h) and after pharmacodynamic testing (lack of inhibition of ACTH by dexamethasone). Thoracic tomodensitometric examination revealed a 15 mm tumor corresponding to a neuroendocrine pulmonary carcinoid with positive immunostaining for chromogranin A. Postoperative ACTH measurement was undetectable, plasma cortisol and free urinary cortisol were also decreased after tumor resection suggesting complete tumor removal. This case report illustrates the characteristics of paraneoplasic Cushing syndrome due to ACTH secreting pulmonary neuroendocrine carcinoid.
Assuntos
Tumor Carcinoide/complicações , Síndrome de Cushing/etiologia , Neoplasias Pulmonares/complicações , Hormônio Adrenocorticotrópico/sangue , Adulto , Cromogranina A , Cromograninas/metabolismo , Humanos , Hidrocortisona/sangue , Hidrocortisona/urina , Imuno-Histoquímica , Imageamento por Ressonância Magnética , MasculinoRESUMO
In an effort to improve patient safety, Hassan II hospital in Fez introduced a pharmacovigilance system for notification of adverse drug reactions as a priority objective. The implementation of pharmacovigilance activities actually began in June 2007 but it was in 2009 after the inauguration of the new complex that the system became properly operational. This report outlines the activities carried out to develop and implement this system, including informing and training the health professionals, and the results obtained after its introduction. From 2007 to 2009, fewer than 100 cases of adverse drug reactions were reported. Up to June 2011, however, 520 reports of adverse drug reactions were recorded. The classes of drugs most implicated in adverse events were: cancer drugs [26%], anti-inflammatory drugs and antibiotics [each 15%], analgesics [12%], iodinated contrast agents [6%], and anticoagulants and corticosteroids [5%]. The main adverse events were dermatological and 27% of reports came from the internal medicine department, followed by hepatogastroenterology [25%]. Of the 520 cases reported, 46% were severe