RESUMO
En el presente artículo, en base a una revisión de la literatura y su experiencia personal, un equipo multidisciplinar de 14 profesionales sanitarios (incluyendo dermatólogos, reumatólogos, neurólogos, gastroenterólogos, farmacéuticos y enfermeras) ha elaborado una serie de recomendaciones generales y específicas (basadas en la fisiopatología) para el manejo de los efectos adversos secundarios a apremilast que con mayor frecuencia conducen a la suspensión del tratamiento (diarrea, náuseas y cefalea). Se aportan algoritmos sencillos de manejo que incluyen aspectos clínicos de evaluación y sugerencias de tratamiento farmacológico. Los efectos adversos de apremilast pueden ser abordados desde un punto de vista multidisciplinar y la optimización en su manejo pretende proporcionar un beneficio clínico a los pacientes que los sufren
We present a series of general and specific recommendations based on pathophysiologic considerations for managing the most common adverse effects of apremilast that lead to treatment discontinuation: diarrhea, nausea, and headache. The recommendations are based on a review of the literature and the experience of a multidisciplinary team of 14 experts including dermatologists, rheumatologists, neurologists, gastroenterologists, pharmacists, and nurses. We propose a series of simple algorithms that include clinical actions and suggestions for pharmacologic treatment. The adverse effects of apremilast can be managed from a multidisciplinary approach. The purpose of optimizing management is to bring clinical benefits to patients
Assuntos
Humanos , Guias de Prática Clínica como Assunto , Talidomida/análogos & derivados , Inibidores da Fosfodiesterase 4/efeitos adversos , Cefaleia/terapia , Diarreia/terapia , Náusea/terapia , Gerenciamento Clínico , Cefaleia/induzido quimicamente , Diarreia/induzido quimicamente , Náusea/induzido quimicamente , Algoritmos , Equipe de Assistência ao PacienteRESUMO
We present a series of general and specific recommendations based on pathophysiologic considerations for managing the most common adverse effects of apremilast that lead to treatment discontinuation: diarrhea, nausea, and headache. The recommendations are based on a review of the literature and the experience of a multidisciplinary team of 14 experts including dermatologists, rheumatologists, neurologists, gastroenterologists, pharmacists, and nurses. We propose a series of simple algorithms that include clinical actions and suggestions for pharmacologic treatment. The adverse effects of apremilast can be managed from a multidisciplinary approach. The purpose of optimizing management is to bring clinical benefits to patients.
Assuntos
Diarreia/induzido quimicamente , Cefaleia/induzido quimicamente , Náusea/induzido quimicamente , Inibidores da Fosfodiesterase 4/efeitos adversos , Talidomida/análogos & derivados , Terapia Combinada , Diarreia/dietoterapia , Diarreia/tratamento farmacológico , Diarreia/fisiopatologia , Gerenciamento Clínico , Cefaleia/tratamento farmacológico , Cefaleia/fisiopatologia , Cefaleia/prevenção & controle , Humanos , Náusea/dietoterapia , Náusea/tratamento farmacológico , Náusea/fisiopatologia , Equipe de Assistência ao Paciente , Inibidores da Fosfodiesterase 4/uso terapêutico , Guias de Prática Clínica como Assunto , Psoríase/tratamento farmacológico , Talidomida/efeitos adversos , Talidomida/uso terapêuticoRESUMO
No disponible
Assuntos
Humanos , Aquaporinas/fisiologia , Canais Iônicos/fisiologia , Osteoartrite/fisiopatologia , Fenômenos BiomecânicosRESUMO
No disponible
Assuntos
Humanos , Reumatologia/métodos , Encaminhamento e Consulta/estatística & dados numéricos , Consultores , Fatores de TempoRESUMO
We report two cases of pseudogout after parathyroidectomy by primary hyperparathyroidism. The pseudogout in each instance developed within 48 hours after parathyroid adenoma resection. Calcium supplement therapy, nonsteroidal anti-inflammatory drugs and colchicine (1 mg/day) suppressed the acute attack. The chondrocalcinosis is often asymptomatic or undiagnosed, for that, preoperative radiological studies of the knees, wrists and pelvis are recommended to screen for chondrocalcinosis. We advocate also, therapy with colchicine (1 mg/day, oral) in the prophylaxis of postoperative pseudogout.
