American Pharmacists Association

About: American Pharmacists Association is a other organization based out in Washington D.C., District of Columbia, United States. It is known for research contribution in the topics: Pharmacist & Pharmacy. The organization has 2413 authors who have published 1969 publications receiving 30470 citations. The organization is also known as: APhA & American Pharmaceutical Association.

Risk Factors for Nephrotoxicity Associated with Cisplatin

Abstract: Background: Cisplatin-induced nephrotoxicity occurs in about one-third of patients who receive this chemotherapy drug. In late 2012, the study institution began measuring serum creatinine on day 7 after administration of cisplatin to identify patients with acute renal failure. Objective: To evaluate the extent of nephrotoxicity associated with cisplatin and the influence of risk factors for nephrotoxicity. Methods: This retrospective study involved patients who received a first cycle of cisplatin-based chemotherapy between November 1, 2012, and November 1, 2013. Patients’ medical records were reviewed to determine the increase in creatinine level (graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events) and the influence of certain prespecified risk factors, such as age, concomitant medications, initial dose of cisplatin, and related medical conditions. Results: Among the 80 patients evaluated, 14 (17%) experienced no increase in the level of serum creatinine (grade 0), 44 (55%) experienced a grade 1 increase, 19 (24%) a grade 2 increase, and 3 (4%) a grade 3 increase; no patients experienced a grade 4 increase. Patients with the greatest risk of a grade 2 or 3 increase were those treated with hydrochlorothiazide (odds ratio [OR] 9.35, 95% confidence interval [CI] 2.49 to 35.14) or an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker (OR 5.02, 95% CI 1.76 to 14.32). After adjustment, only hydrochlorothiazide was associated with an increased risk of nephrotoxicity (OR 5.39, 95% CI 1.04 to 28.07). Among patients taking hydrochlorothiazide, the average incremental increase in serum creatinine was 59.9 μmol/L (95% CI 34.3 to 85.4 μmol/L). Conclusions: Taking hydrochlorothiazide was associated with a significant increase in serum creatinine following cisplatin therapy. On the basis of these results, patients should stop taking hydrochlorothiazide before undergoing cisplatin-based chemotherapy. RESUME Contexte : La nephrotoxicite associee au cisplatine se produit chez environ le tiers des patients qui recoivent ce medicament de chimiotherapie. A la fin de 2012, l’etablissement de sante des auteurs a commence a mesurer la creatinine serique au jour 7 apres l’administration de cisplatine afin de reperer les patients atteints d’insuffisance renale aigue. Objectif : Evaluer le degre de la nephrotoxicite associee au cisplatine et determiner si des facteurs de risque favorisent cette nephrotoxicite. Methodes : Cette etude retrospective a ete menee aupres de patients ayant subi un premier cycle de chimiotherapie a base de cisplatine entre le premier novembre 2012 et le premier novembre 2013. Les dossiers medicaux des patients ont ete examines afin de detecter les cas d’augmentation de creatinine serique (qui ont ete classes selon les criteres pour une terminologie commune des evenements indesirables du National Cancer Institute) et l’influence de facteurs de risque preetablis (âge, medicaments concomitants, dose initiale de cisplatine et pathologies associees). Resultats : Parmi les 80 patients analyses, 14 (17 %) n’affichaient aucune augmentation du taux de creatinine serique (degre 0), 44 (55 %) presentaient une augmentation de degre 1, 19 (24 %) affichaient une augmentation de degre 2 et 3 (4 %) presentaient une augmentation de degre 3; aucun ne presentait une augmentation de degre 4. Les patients qui couraient le plus grand risque de connaitre une augmentation de degre 2 ou 3 etaient ceux traites avec l’hydrochlorothiazide (risque relatif approche [RRA] de 9,35, intervalle de confiance [IC] a 95 % de 2,49 a 35,14) ou d’un inhibiteur de l’enzyme de conversion de l’angiotensine ou d’un bloqueur des recepteurs de l’angiotensine II (RRA de 5,02, IC a 95 % de 1,76 a 14,32). Apres ajustement, seul l’hydrochlorothiazide etait associe a une augmentation du risque de nephrotoxicite (RRA de 5,39, IC a 95 % de 1,04 a 28,07). Parmi les patients qui prenaient de l’hydrochlorothiazide, l’augmentation differentielle moyenne de creatinine serique etait de 59,9 μmol/L (IC a 95 % de 34,3 a 85,4 μmol/L). Conclusions : La prise concomitante d’hydrochlorothiazide a ete associee a une augmentation significative de la creatinine serique apres un traitement de cisplatine. Considerant ces resultats, les patients devraient cesser de prendre de l’hydrochlorothiazide avant de recevoir une chimiotherapie a base de cisplatine.

Lamotrigine: a review of clinical studies in bipolar disorders.

Abstract: Objectif : Cet article examine les etudes publiees sur l'utilisation de la lamotrigine dans le traitement du trouble bipolaire (TB). Methode : Nous avons effectue une recherche dans Medline afin de reperer les bases de donnees disponibles sur les essais ouverts, les essais a double insu et les series de cas portant sur l'utilisation de la lamotrigine pour traiter le TB. Resultats : Trois essais a double insu, 3 essais ouverts et 2 series de cas ont ete menes jusqu'ici (n = 401 patients). La plupart des patients ne repondaient pas ou repondaient partiellement aux autres regulateurs de l'humeur. En tout, 50% a 83% des patients repondaient a la lamotrigine, les doses des etudes variaient de 50 a 400 mg par jour. Avec une dose de 200 mg de lamotrigine, le passage a la manie etait extrement rare, et aucun effet indesirable grave n'a ete declare durant la periode des etudes. Conclusion : La lamotrigine se revele un agent efficace dans le traitement du TB et peut etre utile aux patients qui n'ont pas repondu aux autres regulateurs de l'humeur.

Adverse Dermatologic Reaction to Transdermal Nitroglycerin

Abstract: The incidence of adverse effects from transdermal nitroglycerin systems is reported to be very low. A cutaneous reaction from Transderm-Nitro is described. The patient in this case was a 63-year-old male with a history of chronic obstructive lung disease, adult onset diabetes mellitus, peptic ulcer disease, congestive heart failure, and angina pectoris.Seven weeks after having used a Transderm-Nitro-5 patch daily, the patient was found to have two macular erythematous areas on his chest that corresponded to the exact sites of the nitroglycerin patch. Follow-up with the same patient, using a placebo Transderm-Nitro, elicited a reaction similar in appearance.The exact causative agent is unknown, but it is believed to be from the transdermal delivery system and not the nitroglycerin.