Delayed adverse effects,

Some 6,720 soldiers took part In this program. To understand the extent to which they might have experienced unanticipated longterm or delayed adverse effects, an extensive search of reports, records, and other data was undertaken. This search and study and evaluation of all available information on the involved chemicals themselves were accomplished by expert panels under the direction of the Committee on Toxicology. 

Adverse effects can be explained in a matter-of-fact way without arousing alarm. The precise nature of the explanation should be tempered to match the patient s clinical state, but it should never be entirely overlooked. An acutely disturbed schizophrenic may comprehend little, but will still cooperate more readily if some rapport is attained. Depressed, anxious, or obsessive patients may require reassurance that they will not become addicted to medication, and it may also be necessary to explain that, although therapeutic effect is somewhat delayed, adverse effects can be immediate. 

Long-Term Adverse Effects. Available long-term data (6 months or more) should be summarized, and any delayed adverse effects should be noted. 

Stinchcombe SJ, Davies P. Acute toxic myopathy a delayed adverse effect of intravenous urography with iopamidol 370. Br J Radiol 1989 62(742) 949-50. 

Although the analgesic effect of spinal opioids is largely due to a spinal effect, the opioid can spread rostrally to the brainstem and higher centers, and can cause delayed adverse effects. Lipid solubility affects the rate at which an opioid is absorbed into the spinal cord from the cerebrospinal fluid (CSF), and therefore predicts the likelihood of rostral spread. Hydrophilic drugs, such as... 

UV radiation has both acute and delayed adverse effects on the human skin. The acute effects are inflammation and sunburn, and the delayed or chronic effects are primarily photoaging and photocarcinogenesis. 

There are no known delayed adverse effects of cannabis administration. Assuming that the above precautions have been taken, there is little need for further follow-up of research subjects after their discharge from a cannabis-administration study. 

Formulas for safety factors are calculated according to cumulative properties, species sensitivity coefficient, and occurrence of delayed adverse effects (Sidorov 1980). It should be noted that the safety factor is designed mainly to allow for the potentially higher sensitivity of humans to specific pesticides than laboratory animals. This factor should also ensure the safety of a selected dose or concentration if new, unexpected adverse properties are identified for the substance in question. The final adjustment of health standards is based on clinical and epidemiological examinations of people exposed to that substance. 

All organophosphates recommended as pesticides are subjected to screening for delayed neurotoxicity through research into their influence on neurotoxic esterase, as well as in direct experiments on hens. Enough data have been collected to show pesticides as potential producers of various delayed adverse effects, which may be irreversible or somewhat reversible (atherosclerosis, hepatocirrhosis, pulmonary fibrosis, demyelinization of nerve trunks). These effects should be projected and considered in human health assessments of pesticides. 

Accepted criteria for toxicological and hygienic pesticide assessments in the USSR are also systematically reviewed, with respect to the evaluation of physical and chemical properties, toxicity as defined through acute and subacute experiments, cumulative properties, and effects on skin and mucous membranes. The methodology for establishing threshold and noneffective (harmless) levels is also described, along with the prediction of delayed adverse effects. 

Penicillamine (29) can be effective in patients with refractory RA and may delay progression of erosions, but adverse effects limit its useflilness. The most common adverse side effects for penicillamine are similar to those of parenteral gold therapy, ie, pmritic rash, protein uria, leukopenia, and thrombocytopenia. Decreased or altered taste sensation is a relatively common adverse effect for penicillamine. A monthly blood count, platelet count, and urinalysis are recommended, and also hepatic and renal function should be periodically monitored. Penicillamine is teratogenic and should not be used during pregnancy. 

Systemic adverse effects are dose-dependent and are rare at low to medium doses however, high-dose inhaled corticosteroids have been associated with adrenal suppression, decreased bone mineral density, skin thinning, and easy bruising.3,29 Growth suppression in children may occur even with low-dose inhaled corticosteroids however, suppression appears to occur primarily in the first year of treatment and may be due to delayed growth with the potential of future catch-up growth.30... 

Once the first dose of benzodiazepine is given, an antiepileptic drug must be started to prevent further seizures from occurring. AEDs must not be given as first-line therapy since they must be infused relatively slowly to avoid adverse effects, delaying their onset of action. 

The initial therapeutic modality selected depends in part on the patient s age, risk of psychiatric adverse effects, and degree of physical impairment. The current approach to treatment is to delay medication therapy until the symptoms begin to interfere with the patient s ability to function or impact their QOL. 

The most common adverse events reported with sirolimus are leukopenia (20%), thrombocytopenia (13% to 30%), and hyperlipidemia (38% to 57%).11,31 Other adverse effects include delayed wound healing, anemia, diarrhea, arthralgias, rash, and mouth ulcers. Sirolimus has an FDA black-box warning in newly transplanted liver and lung recipients.11 In liver transplant recipients, use of sirolimus immediately after transplant is associated with an increased risk of hepatic artery thrombosis, graft loss, and death. In lung transplant... 

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