Mirtazapine-Induced Pancreatitis—A Case Report

2018 ◽  
Vol 32 (5) ◽  
pp. 586-588 ◽  
Author(s):  
Riley D. Bowers ◽  
Sara M. Valanejad ◽  
Ashley A. Holombo
Keyword(s):  
Emergency Department ◽  
Adverse Drug Reaction ◽  
Acute Pancreatitis ◽  
Drug Reaction ◽  
Insulin Infusion ◽  
Serum Triglyceride ◽  
African American Female ◽  
Converting Enzyme ◽  
Probability Scale ◽  
Recent Alcohol Use

Acute pancreatitis has numerous etiologies, with the most common including gallstones, alcohol abuse, and medications such as angiotensin-converting enzyme (ACE) inhibitors, statins, and diuretics. Mirtazapine has been associated with increased serum cholesterol and serum triglyceride levels. However, few studies have reported dangerously elevated triglyceride levels resulting in acute pancreatitis. This report discusses a case of mirtazapine-induced pancreatitis in a 46-year-old African American female. The patient presented to the emergency department with pancreatitis, presumably alcohol-induced as with a prior admission, but she denied any recent alcohol use. Mirtazapine then became the suspected cause of her hypertriglyceridemia-induced pancreatitis and was discontinued. After discontinuing mirtazapine, and utilizing an insulin infusion, her triglyceride levels normalized and symptoms of pancreatitis resolved. Using the Naranjo Adverse Drug Reaction Probability Scale, a total score of 5 was calculated indicating a probable adverse drug reaction of acute pancreatitis from mirtazapine.

Severe Tachycardia Following Low-Dose Clozapine Treatment

2005 ◽  
Vol 13 (1) ◽  
pp. 80-82 ◽  
Author(s):  
Hans Stampfer ◽  
Peter Swanepoel
Keyword(s):  
Heart Rate ◽  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Case Report ◽  
Low Dose ◽  
Reaction Probability ◽  
Probability Scale ◽  
Clozapine Treatment ◽  
Probable Relationship ◽  
Clinical Detection

Objective: To reporta case of severe and sustained tachycardia that developed asymptomatically on a low dose of clozapine (ISO mg daily). Method: Case report. Results: Serially monitored 24 h heart rate after the introduction of clozapine showed an increase in the 24 h mean from 87 to 126 bpm, a reduction of pulse variability and anomalies in sleep-wake regulation. Cessation of clozapine was followed by a rapid return to preclozapine activity. Application of the Naranjo Adverse Drug Reaction Probability Scale indicated a probable relationship between clozapine and the sustained tachycardia. Conclusions: Severe and sustained tachycardia can develop asymptomatically with a relatively low dose of clozapine and a slow titration rate. The severity of the tachycardia may not be revealed in isolated pulse measurements and may escape clinical detection without closer monitoring of heart rate.

Delayed Onset of Central Diabetes Insipidus With Ketamine Sedation: A Report of 2 Cases

2019 ◽  
pp. 089719001988226 ◽  
Author(s):  
Leah B. Herity ◽  
Cassandra Baker ◽  
Christin Kim ◽  
Denise K. Lowe ◽  
William D. Cahoon
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Adverse Effects ◽  
Diabetes Insipidus ◽  
Drug Effect ◽  
Laboratory Data ◽  
Multimodal Analgesia ◽  
Central Diabetes Insipidus ◽  
Probability Scale ◽  
Delayed Onset

Ketamine is being prescribed with greater frequency due to an emphasis on multimodal analgesia. With increasing use, uncommon adverse effects associated with ketamine are likely to surface. Limited reports of transient central diabetes insipidus (DI) occurring early after initiation (ie, within 10 hours) of ketamine have been reported. We present 2 cases of delayed onset (32 hours or more after initiation), ketamine-induced, transient central DI in patients cannulated for venovenous extracorporeal membranous oxygenation. No other causes of central DI were determined based upon physical examination or laboratory data, and both patients responded to treatment with desmopressin/vasopressin. The Naranjo adverse drug reaction probability scale noted a probable causation for each case. These cases demonstrate the possibility of a rare but serious complication of ketamine. Improvement after discontinuation of ketamine and administration of desmopressin/vasopressin appear to support a drug–effect association.

scholarly journals Medication Allergy and Adverse Drug Reaction Documentation Discrepancies in an Urban, Academic Emergency Department

2018 ◽  
Vol 14 (4) ◽  
pp. 272-277 ◽  
Author(s):  
Eric S. Kiechle ◽  
Colleen M. McKenna ◽  
Hannah Carter ◽  
Alexander Zeymo ◽  
Bradley W. Gelfand ◽  
...  
Keyword(s):  
Emergency Department ◽  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Medication Allergy

scholarly journals Incident reporting of adverse drug reaction to intravenous ranitidine in an emergency department

2018 ◽  
Vol 12 (2) ◽  
pp. 605 ◽  
Author(s):  
Saurabh Sud ◽  
Deepak Dwivedi ◽  
Manish Paul ◽  
SanasamUshakiran Singh
Keyword(s):  
Emergency Department ◽  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Incident Reporting

Evaluation of the Reproducibility of the Naranjo Adverse Drug Reaction Probability Scale Score in Published Case Reports

2014 ◽  
Vol 34 (11) ◽  
pp. 1159-1166 ◽  
Author(s):  
Ruby Liang ◽  
Bjug Borgundvaag ◽  
Mark McIntyre ◽  
Crystal Thwaites ◽  
Kelsey Ragan ◽  
...  
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Scale Score ◽  
Case Reports ◽  
Reaction Probability ◽  
Probability Scale

scholarly journals Trifluoperazine-Induced Angioedema

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Mugtaba Osman ◽  
Daniel Edwards ◽  
Mona Kilduff
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Allergic Reaction ◽  
Mental Health Professionals ◽  
Schizoaffective Disorder ◽  
Health Professionals ◽  
Lower Limb ◽  
Bilateral Lower Limb

Angioedema is a serious adverse drug reaction that can rarely be associated with trifluoperazine treatment. We present the case of a 44-year-old male with an established diagnosis of schizoaffective disorder, for which trifluoperazine therapy was considered. He presented to the emergency department with bilateral lower limb oedematous painful erythematous swelling that eased off completely when trifluoperazine was stopped. The possibility of allergic reaction, such as angioedema, should always be kept in mind by psychiatrists and mental health professionals when prescribing trifluoperazine antipsychotic.

scholarly journals Severe L-asparaginase-induced Hypertriglyceridaemia Treated with Plasmapheresis

2021 ◽  
Author(s):  
José Silvano ◽  
Nídia Marques ◽  
Isabel Tavares ◽  
Inês Ferreira
Keyword(s):  
Acute Pancreatitis ◽  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Platelet Transfusion ◽  
Insulin Infusion ◽  
Drug Withdrawal ◽  
Removal Rate ◽  
Serum Triglyceride ◽  
Intravenous Insulin ◽  
Fatal Complications

L-asparaginase is used for the treatment of acute lymphoblastic leukaemia. Hypertriglyceridaemia is a side effect and associated with potentially fatal complications, including acute pancreatitis. Plasmapheresis may have a role in treatment when triglycerides are >2000 mg/dl. We report the case of a 39-year-old woman treated with L-asparaginase for acute lymphoblastic leukaemia, who developed severe hypertriglyceridaemia (6560 mg/dl) and acute pancreatitis. Intravenous insulin infusion was started, along with fenofibrate and atorvastatin administration, and platelet transfusion. Plasmapheresis was carried out leading to a frank decline in serum triglyceride levels (366 mg/dl), a decrease in pancreatic enzymes and clinical improvement. The diagnosis of pancreatitis secondary to L-asparaginase should lead to immediate drug withdrawal, and plasmapheresis should be considered when serum triglyceride values exceed 2000 mg/dl. In our case, there was a 95% triglyceride removal rate. This response illustrates the strong effectiveness of early treatment with plasmapheresis in severe and symptomatic hypertriglyceridaemia associated with L-asparaginase.

scholarly journals Epileptic Convulsions Probably Induced by Desloratadine, a Second-Generation H1-Antihistamine

2020 ◽  
Author(s):  
Xiaonian Han ◽  
Xin Zan ◽  
Fengmei Xiong ◽  
Xiaojing Nie ◽  
Lirong Peng
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Drug Therapy ◽  
Side Effects ◽  
Second Generation ◽  
Healthy Children ◽  
Probability Scale ◽  
H1 Antihistamines ◽  
History Of ◽  
History Of Epilepsy

Second-generation H1-antihistamines are generally considered to be safe. Here we describe a healthy boy who developed left-arm convulsions after repeated exposure to a dry suspension of desloratadine combined with Huatengzi granules. The boy had no family or disease history of epilepsy, convulsions, or any other drug therapy. The Naranjo Adverse Drug Reaction Probability Scale was used to determine that the convulsions were probably related to desloratadine. Our findings suggest that desloratadine (a second-generation H1-antihistamine) can cause epileptic convulsions in healthy children, and so clinicians should be vigilant of the possibility of central side effects.

Lisinopril-Induced Alopecia: A Case Report

2016 ◽  
Vol 30 (5) ◽  
pp. 562-566 ◽  
Author(s):  
Vivek Kataria ◽  
Hueyyoung Wang ◽  
Joyce W. Wald ◽  
Yvonne L. Phan
Keyword(s):  
Heart Failure ◽  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Ace Inhibitors ◽  
American Heart ◽  
Causality Assessment ◽  
Heart Association ◽  
Probability Scale ◽  
Heart Failure Clinic ◽  
New Onset

The American College of Cardiology Foundation/American Heart Association (ACCF/AHA) guidelines consider angiotensin-converting enzyme (ACE) inhibitors as one of the mainstay therapies in the management of heart failure. The widespread use of ACE inhibitors has been associated with several notable adverse effects such as hyperkalemia and an increased serum creatinine. There are no previous reports of alopecia associated with lisinopril use; however, a few previous cases of alopecia associated with other ACE inhibitors exist. This report discusses a case of lisinopril-induced alopecia of a 53-year-old male presenting to our outpatient heart failure clinic with a chief complaint of a new onset of alopecia. Upon evaluation, it was suspected that the patient’s alopecia was likely medication induced by lisinopril; therefore, lisinopril was discontinued and switched to an angiotensin receptor blocker (ARB), losartan potassium. Alopecia resolved in 4 weeks after the therapeutic intervention. Our report suggests that the patient likely experienced a medication-induced alopecia, which was successfully resolved through proper identification and removal of the causative agent. Causality assessment between lisinopril and alopecia was determined using the Naranjo Adverse Drug Reaction Probability Scale—a total score of 6 was achieved and thus identified the adverse drug reaction as probable. Clinicians should be aware of the possibility that lisinopril may be an offending agent in a patient with unexplained alopecia.

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