Adverse reaction enzyme

The adverse reaction enzymes profile from M DS Pharma including 41 enzymatic assays to predict moderate to serious adverse effects. 

DIDANOSINE Although rare, pancreatitis and peripheral neuropathy are possible adverse reactions seen with didanosine The nurse must be alert for symptoms of pancreatitis (nausea, vomiting, abdominal pain, jaundice, elevated enzymes) and for signs of peripheral neuropathy (numbness, tingling, or pain in the feet or hands). It is important to immediately report these signs to the primary health care provider. 

The anti-inflammatory effects of the NSAIDs are carried out by inhibition of COX-2. The gastrointestinal adverse reactions are caused by inhibition of COX-1. The newer NSAIDs (celecoxib and rofecoxib) appear to work by specifically inhibiting the COX-2 enzyme, without inhibiting the COX-1 enzyme. Celecoxib and rofecoxib relieve pain and inflammation with less potential for gastrointestinal adverse... 

No adverse reactions have been reported with the use of digestive enzymes however, high doses may cause nausea and diarrhea. 

It has now been established that genetic polymorphisms in drug metabolizing enzymes such as the cytochrome P450s (CYP) and the phase II enzyme, thiopu-rine methyltransferase, are responsible for inter-individual variability in response and adverse reactions [12, 13]. However, at the present time, the impact of poly-... 

Angiotensin converting enzyme (ACE) inhibitors are associated with a high incidence of which of the following adverse reactions ... 

Ora/-Adverse reactions requiring discontinuation include Pulmonary infiltrates or fibrosis paroxysmal ventricular tachycardia CHF elevation of liver enzymes visual disturbances solar dermatitis blue discoloration of skin hyperthyroidism hypothyroidism. Adverse reactions occurring in at least 3% of patients include CFIF Gl complaints (nausea, vomiting, constipation, anorexia) dermatologic reactions (photosensitivity, solar dermatitis) neurologic problems (malaise, fatigue, tremor/abnormal involuntary movements, lack of coordination, abnormal gait/ataxia, dizziness, paresthesias) abnormal liver function tests. 

Dose-related adverse reactions Because the frequency of adverse effects (particularly elevated liver enzymes and thrombocytopenia) may be dose-related, weigh the benefit of improved therapeutic effect with higher doses against the possibility of a greater incidence of adverse reactions. The probability of... 

Fast/Slow acetylators The metabolism of SP to AcSP is mediated by polymorphic enzymes such that 2 distinct populations of slow and fast metabolizers exist. Approximately 60% of the white population can be classified as belonging to the slow acetylator phenotype. These subjects will display a prolonged plasma half-life for SP (14.8 vs 10.4 hours) and an accumulation of higher plasma levels of SP than fast acetylators. Subjects who were slow acetylators of SP showed a higher incidence of adverse reactions. 

Adverse reactions occurring in at least 3% of patients included the following abnormal vision, alkaline phosphatase increased, ALT/AST increased, chills, fever, hallucinations, headache, hepatic enzymes increased, liver function test abnormal, nausea, peripheral edema, photophobia, rash, vomiting. 

Adverse reactions occurring in at least 3% of patients include the following Diarrhea, dyspepsia, rash, liver enzyme abnormalities, headache. 

Fligh doses of rifampin (greater than 600 mg) given once or twice weekly have resulted in a high incidence of adverse reactions including the following Flu-like syndrome hematopoietic reactions cutaneous, Gl, and hepatic reactions shortness of breath shock renal failure asymptomatic elevations of liver enzymes rash. Rifabutin... 

Overdose relative to a particular patient. Adverse reactions may be explained by the way drugs are metabolised in phenotypically different sub-sets the population. There are, for example, differences in the way that some drugs are metabolised by the liver microsomal enzymes (dealt with elsewhere), which alter the kinetics of the drug and its metabolites. Special care must be taken with such drugs and interactions with other drugs. 

Trimethoprim is a competitive inhibitor of the enzyme dihydrofolate reductase and can thus prevent the formation of tetrahydrofolate thereby blocking the synthesis of purines. The affinity of trimethoprim for the enzyme in microorganisms is 10,000 times higher than for the human enzyme which explains the selective toxicity. Used alone its main indication is acute uncomplicated urinary tract infections. It is then as effective as co-trimoxazole but has the advantage of fewer adverse reactions. 

Isoniazid can induce a wide variety of potentially serious adverse reactions. Some hepatotoxicity can manifest itself as transient elevations of liver enzymes and this occurs in 10-20% of patients. Progressive and potentially fatal liver damage is age dependent with a very low incidence below the age of... 

The adverse effects that most frequently result in discontinuation of rifabutin include GI intolerance, rash, and neutropenia. Rifabutin levels will be increased with concurrent administration of fluconazole and clarithromycin, resulting in anterior uveitis, polymyalgia syndrome, and a yellowish-tan discoloration of the skin (pseudojaundice). Other adverse reactions are similar to those of rifampin, such as hepatitis, red-orange discoloration of body fluids, and drug interactions due to effects on the hepatic P450 cytochrome enzyme system. 

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