Adverse drug reactions informing patients

Educating the Patient and Family The nurse explains die therapeutic regimen and adverse drug reactions to the patient and family. The type of information included in the teaching plan will depend on the drug and the reason for its use. It is important to emphasize die importance of following the recom-... 

Diplopia may be an early sign of generalized drug-induced muscle dysfunction. Altogether, 71 cases of diplopia, possibly related to various HMG-CoA inhibitors, have been collected from adverse drug reactions-report-ing databases. The information was mostly too scanty to judge a causal relation, but improvement occurred in 33 on withdrawal, and two patients had positive rechallenge data (52). 

The relative contributions of amoxicillin and clavula-nate to co-amoxiclav-induced hepatotoxicity are incompletely understood. In patients with co-amoxiclav hepatotoxicity, previous use of amoxicillin and rechallenge with amoxicillin were both uneventful, pointing to clavulanic acid as the more likely culprit (16). In a report from the UK, the incidence of liver injury with amoxicillin alone was 0.3 per 10000 prescriptions versus 1.7 with co-amoxiclav (32). The risk increased after multiple use and with increasing age to 1 per 1000 prescriptions of co-amoxiclav. The main message is that the combination should be used with caution in elderly patients. A patient who has had documented hepatotoxicity related to co-amoxiclav should be well informed about this adverse drug reaction and any future use should be prohibited. 

If this complication occurs, the drug should be withdrawn immediately (7). A report has given some data on the frequency with which tiaprofenic acid cystitis-related disorders were reported to the UK s Committee on Safety of Medicines. Between 1981 and 1996, 770 adverse drug reactions involving 221 patients were reported. A peak in the reporting of cystitis was noted in 1994, when tiaprofenic acid product information was changed and advice was sent to UK doctors warning about cystitis-related... 

In 1993, the Royal Pharmaceutical Society of Great Britain created checklists for pharmacists that served as a guide to the types of communication that should occur between hospital and community pharmacists regarding patients medication and pharmaceutical needs. These checklists contained information that should be completed by the community pharmacist to the hospital pharmacist on hospital admission of a patient, such as the medication history and domiciliary circumstances and known adverse drug reactions (ADRs),... 

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