Adverse drug event symptoms associated with

Inform patients who are receiving prophylactic therapy on the importance of its use, potential adverse drug events, and the possible alarm symptoms associated with PUD. 

There are a number of different ways to assess and identify an ADE. Listed below are a number of tables that will assist in interpreting signs or symptoms that may indeed be an adverse drug event. Table 4 identifies disease states that may contribute to similar symptoms that may be misdiagnosed as an ADE. Other syndromes that are most commonly associated with toxicity or side effects from specific medications are shown in Table 5. Finally, medication classes that most commonly causes ADEs in the elderly are presented in Table 6. 

Most side effects are felt after the first treatment with rituximab and attention should be given to the rate of infusion. The most common immediate side effects of rituximab are fever, chills and respiratory symptoms, but these effects are much milder than the traditional chemotherapy. Other infusion reactions include nausea, angioedema, headache, hypotension, puritus, utricaria, rash and vomiting. The adverse effects decrease with each subsequent administration of the drug. Other side effects associated with rituximab include B-cell depletion, cytopenia, immuno-genicity and multiple pulmonary events. 

A meta-analysis of the effect of olanzapine for the behavioral and psychological symptoms of dementia has shown that olanzapine may also be associated with an increased risk of cerebrovascular adverse effects (598). Nevertheless, several studies have not found any association between the use of atypical neuroleptic drugs and cerebrovascular events (599) (600). 

Two reviews have systematically addressed the safety of St. John s wort. One showed that the most common adverse events were gastrointestinal symptoms, dizziness, confusion, tiredness, sedation, and dry mouth (3). A second review compared the adverse effect profile of St. John s wort with those of conventional antidepressants (4). The adverse effects of St. John s wort were fewer and less serious than those associated with conventional antidepressant drugs. 

A wide range of adverse events has been reported in most patients (5). A transient flu-hke syndrome is very common (50-90%), particularly after the first infusion of rituximab, and is often associated with various hypersen-sitivity-hke symptoms (5-20%). In the most severe cases, patients had hfe-threatening cytokine release syndrome with dyspnea, bronchospasm, hypoxia, hypotension, urticaria, and angioedema. Deaths have been reported in eight of 12 000-14 000 patients after drug launch. 

Bupropion appears to reduce nicotine withdrawal symptoms and may simulate the actions of nicotine on the brain reward system. The most common side-effects related to bupropion are insomnia (30-45% at a dose of 300 mg/day) and dry mouth. Other commonly reported adverse events include hypertension, headache, and nausea. Seizures are a known risk associated with the use of somewhat higher doses compared with other antidepressants (0.1-0.4%), especially for the immediate-release form of the drug and when given at dosages of 450 mg/day or higher. Bupropion, unlike the TCAs, is virtually free of adverse cardiovascular effects, which makes it quite attractive for specific populations. 

No serious adverse events have been reported from artemisinin or artemisinin derivatives used as antimalarial drugs. Mild adverse events associated with the use of these compounds include nausea, vomiting, and diarrhea, although these have also been noted as symptoms of malaria (Gordi and Lepist 2004 McGready et al. 1998 Meshnick 2002 Meshnick et al. 1996 Ribeiro and Olliaro 1998). 

One woman experienced repeated attacks of sweating, nausea, colicky abdominal pain, diarrhea, vomiting, weakness, and collapse after taking a milk thistle product (Adverse Drug Reactions Advisory Committee 1999). Other cases of adverse events, reported without details, include a case of abdominal pain, nausea, listlessness, and insomnia and one case of thrombocytopenia (Adverse Drug Reactions Advisory Committee 1999). The symptoms in these reports are similar to those associated with liver disease, for which the patients may have been taking milk thistle. 

Patient files (752) from 19 skin cancer cenfres were screened and analysed for rare ipilimumab-associated adverse event. Previously unreported adverse events including drug reaction (rash) with eosinophilia and systemic symptoms, granulomatous inflammation of the CNS and aseptic meningitis were associated with ipilimumab for tiie first time. Other rare, often life-threatening or even fatal, adverse events documented were Guillain-Barri syndrome, neuropathy, myopathy, leucopenia, uveitis and sarcoidosis [159 ]. 

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