In adverse reaction

Benzodiazepines are excreted more slowly in older adults causing a prolonged drug effect. The drugs may accumulate in the blood, resulting in an increase in adverse reactions or toxicity. For this reason, the initial dose should be small, and the nurse should increase dosages gradually until a therapeutic response is obtained. 

Allwood M.C. (1990) Adverse reactions to parenterals. In Topics in Pharmacy Formulation Factors in Adverse Reactions (eds AT. Florence AG. Salole). London Wright. 

Horence AT, Salole EG. Formulation Factors in Adverse Reactions. London Wright, 1990. 

Contraceptives (oral) and estrogens Ascorbic acid increases serum levels of estrogen and estrogen contained in oral contraceptives, possibly resulting in adverse reactions. 

Drug interactions In a randomized, double-blind study, Zenapax or placebo was added to an immunosuppressive regimen of cyclosporine, mycophenolate mofetil, and steroids to assess tolerability, pharmacokinetics, and drug interactions. The addition of Zenapax did not result in an increased incidence of adverse events or a change in the types of adverse events reported. The following medications have been administered in clinical trials with Zenapax with no incremental increase in adverse reactions cyclosporine, mycophenolate mofetil, ganciclovir, acyclovir, azathioprine, and corticosteroids. 

Drug interactions No formal drug-drug interaction studies have been conducted. The following medications have been administered in clinical trials with Simulect with no incremental increase in adverse reactions azathioprine, corticosteroids, cyclosporine, mycophenolate mofetil, and muromonab-CD3. 

The cost of drug development continues to spiral upward. Inflation and increased regulatory requirements, however, only account for a small portion of this increase. At this time, productivity is a major issue. A review of 198 new drug candidates that reached phase I clinical studies indicates a 60% failure rate due to poor pharmacokinetic properties or toxicity [23]. On the average, less than 2% of the drug failures could be attributed to drug interactions that resulted in adverse reactions [24], In elderly patients, however, drug interactions could contribute... 

No malignancies reported in Adverse Reactions in clinical trials... 

Other hereditary enzyme deficiencies that may result in adverse reactions to certain drugs are comparatively rare, often familial, and of worldwide distribution. Examples of these conditions are pseudocholinesterase deficiencies in certain people who, when given succinylcholine or suxamethonium, develop a profound, general neuromuscular blockade with apnea (38). 

Weiner, M. Bernstein, I.L., Eds. Adverse effects bulk materials. In Adverse Reactions to Drug Formulation Agents Marcel Dekker, Inc. New York, 1989 89-113, Ch. 6. 

A retrospective analysis of aU adverse events related to herbal medicines and dietary supplements reported to the California Poison Control System has given data on the risks of the adverse effects of herbal medicines (112). Between January 1997 and June 1998, 918 calls relating to such supplements were received. Exposures resulting in adverse reactions occurred most often at recommended doses. There were 233 adverse events, of which 29% occurred in children. The products most frequently implicated were zinc (38%), Echinacea (8%), witch hazel (6%), and chromium picolinate (6%). Most of the adverse events were not severe and required no treatment hospitalization was required in only three cases. 

Debets JM, Leunissen KM, van Hooff HJ, van der Linden CJ, Buurman WA. Evidence of involvement of tumor necrosis factor in adverse reactions during treatment of kidney allograft rejection with antithymocyte globulin. Transplantation 1989 47(3) 487-92. 

D Arcy PF. Adverse reactions to excipients in pharmaceutical formulations. In Florence AT, Salole EG, eds. Formulation Factors in Adverse Reactions. London Wright, 1990 1-22. 

Chapman C, Courage P, Nielsen I et al 1992 The role of procaine in adverse reactions to procaine penicillin in horses. Australian Veterinary Journal 69 129-133... 

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