Other Adverse Effects

The U.S. Clean Air Amendments of 1977 define two kinds of air quality standards primary standards, levels that will protect health but not necessarily prevent the other adverse effects of air pollution, and secondary standards, levels that will prevent all the other adverse effects of air pollution (Table 22-7). The amendments also define air quality levels that cannot be exceeded in specified geographic areas for "prevention of significant deterioration" (PSD) of the air of those areas. Although they are called "increments" over "baseline air quality" in the law, they are in effect tertiary standards, which are set at lower ambient levels than either the primary or secondary standards (Table 22-8). 

The nurse observesthe elderly patient receiving a cholinergic blocking drug at frequent intervals for excitement, agitation, mental confusion, drowsiness urinary retention, or other adverse effects. If any of these should occur, it is important to withhold the next dose of the drug and contact the primary health care provider. The nurse ensures patient safety until these adverse reactions disappear. 

Soy protein Conflicting evidence short-term (less than 6 weeks) symptomatic relief demonstrated benefit questionable 50-80 mg isoflavones daily Gl upset other adverse effects unknown... 

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... 

The most common adverse effect with omalizumab is injection-site reaction, reported in 45% of patients in clinical trials. Other adverse effects include viral and upper respiratory tract infections, sinusitis, headache, and pharyngitis. Rare cases of malignant neoplasms and anaphylaxis were reported during clinical trials of omalizumab in asthma. Patients should be monitored for at least 2 hours following the injection so that anaphylaxis and/or injection-site reactions may be managed.25... 

There is a bath PUVA and an oral PUVA. Bath PUVA therapies involve soaking in a bath of psoralens liquid for 15 minutes prior to UVA treatment. Oral PUVA involves taking an oral psoralens capsule the day prior to a UVA treatment. Oral psoralens such as methoxsalen cause nausea in many patients. Other adverse effects of PUVA include photosensitivity, which necessitates the use of eye protection and UVA-blocking sunscreen for 24 hours after a PUVA treatment macular melanosis at exposed sites (PUVA lentigines) and increased risk of skin cancers, especially squamous cell carcinoma.21... 

These findings suggest that CNT exposure should be evaluated as a potential cardiovascular risk factor. It should be noted, however, that no thrombosis or other adverse effects on the cardiovascular homeostasis were reported after intravenous injection in healthy animals, when this administration route was used for investigating the biokinetics of CNTs [119-126]. 

Toxicity and exposure studies indicate PFOA is immunosuppressive and can cause developmental problems and other adverse effects in laboratory animals, such as rodents [Lau et al (2004), Lau et al (2006)]. In 2005 the US Environmental Protection Agency (EPA) released a draft risk assessment of its potential human health effects [U S. EPA (2005)]. A subsequent review by the EPA science advisory board concluded that there is sufficient evidence to classify PFOA as likely human carcinogenic. 

Concern for the continued widespread use of chlordane centers on its ability to cause liver cancer in domestic mice. Other adverse effects in mammals, such as elevated tissue residues and growth inhibition, were frequently associated with diets containing between 0.76 and 5.0 mg chlordane/kg feed. Metabolism of technical chlordane by mammals results primarily in oxychlordane, a metabolite that is about 20 times more toxic than the parent compound and the most persistent metabolite stored in adipose tissues. Chlordane interactions with other agricultural chemicals produced significant biological effects in warm-blooded organisms, indicating a need for additional research on this subject. 

After 48 h, mortality was 35% in caged fish and 84% in caged shrimp no other adverse effects were noted during the next 27 days (Wall and Marganian 1971)... 

Thiocyanate can accumulate in tissues and has been associated with developmental abnormalities and other adverse effects. 

Constipation occurs in fewer than 10% of patients taking statins. Other adverse effects include elevated serum aminotransferase levels (primarily alanine aminotransferase), elevated creatine kinase levels, myopathy, and rarely rhabdomyolysis. 

Nitroprusside is the agent of choice for minute- to-minute control in most cases. It is usually given as a continuous IV infusion at a rate of 0.25 to 10 mcg/kg/min. Its onset of hypotensive action is immediate and disappears within 1 to 2 minutes of discontinuation. When the infusion must be continued longer than 72 hours, serum thiocyanate levels should be measured, and the infusion should be discontinued if the level exceeds 12 mg/dL. The risk of thiocyanate toxicity is increased in patients with impaired kidney function. Other adverse effects include nausea, vomiting, muscle twitching, and sweating. 

Tetracyclines inhibit P. acnes, reduce the amount of keratin in sebaceous follicles, and have antiinflammatory properties (inhibiting chemotaxis, phagocytosis, complement activation, and cell-mediated immunity). Drawbacks to tetracyclines include hepatotoxicity and predisposition to infections (e.g., vaginal candidiasis). Other adverse effects include GI disturbances, photosensitivity, tooth discoloration in children, and inhibition of skeletal growth in the developing fetus. Tetracyclines must not be combined with systemic retinoids because of an increased risk of intracranial hypertension. / Tetracycline is the least expensive agent in this class and is often... 

Selegiline also increases the peak effects of L-dopa and can worsen preexisting dyskinesias or psychiatric symptoms such as delusions and hallucinations. Other adverse effects include insomnia, jitteriness. 

Other adverse effects of topical decongestants include burning, stinging, sneezing, and dryness of the nasal mucosa. 

In general, a determination that a risk associated with a chemical substance or mixture is unreasonable involves balancing the probability that harm will occur and the magnitude and severity of that harm against the effect of proposed regulatory action on the availability to society of the benefits of the substance or mixture, taking into account the availability of substitutes for the substance or mixture which do not require regulation, and other adverse effects which such proposed action may have on society. 

The 3T3-neutral red uptake test, however, is unable to predict other adverse effects that might result from the combined interaction of chemicals with light. 

Other adverse effects LSD is not teratogenic, but it can increase spontaneous abortions due to uterotonic effects. Use during pregnancy is unnecessary and clearly contraindicated. LSD appears to have weak, if any, mutagenic effects (Cohen and Shiloh 1977-78). Claims of chromosomal damage have showed conflicting results, and have not been supported in humans. 

Doses above 6 mg/day for twice-daily dosing were associated with more extrapyramidal symptoms and other adverse effects and generally are not recommended. The safety of doses above 16 mg/day has not been evaluated. 

Children (6 years of age and o/c/erj. Start with small doses (eg, 5 mg before breakfast and lunch) with gradual increments of 5 to 10 mg/wk (IR tablets, chewable tablets, and oral solution). Daily dosage above 60 mg is not recommended. If improvement is not observed after dosage adjustment over 1 month, discontinue use. If paradoxical aggravation of symptoms or other adverse effects occurs, reduce dosage or discontinue the drug. 

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