Neuritis, peripheral

A deficiency of niacin also affects the nervous system. Numbness is initially observed and later, paralysis, particularly in the extremities is common. Severe cases are characteri2ed by tremor and a spastic or ataxic gait and are frequentiy associated with peripheral neuritis. Left untreated, severe thought disorders can ensue (1). 

The nurse instructs patients to report any symptoms of infection such as an elevated temperature (even a slight elevation), sore throat, difficulty breathing, weakness, or lethargy. The patient must be aware of possible signs of pancreatitis (nausea, vomiting, abdominal pain, jaundice [yellow discoloration of the skin or eyes]) and peripheral neuritis (tingling, burning, numbness, or pain in the hands or feet). Any indication of pancreatitis or peripheral neuritis must be reported at once. 

The water-soluble vitamins comprise the B complex and vitamin C and function as enzyme cofactors. Fofic acid acts as a carrier of one-carbon units. Deficiency of a single vitamin of the B complex is rare, since poor diets are most often associated with multiple deficiency states. Nevertheless, specific syndromes are characteristic of deficiencies of individual vitamins, eg, beriberi (thiamin) cheilosis, glossitis, seborrhea (riboflavin) pellagra (niacin) peripheral neuritis (pyridoxine) megaloblastic anemia, methyhnalonic aciduria, and pernicious anemia (vitamin Bjj) and megaloblastic anemia (folic acid). Vitamin C deficiency leads to scurvy. 

Thiamin deficiency can result in three distinct syndromes a chronic peripheral neuritis, beriberi, which may or may not be associated with heart ilure and edema acute pernicious (fulminating) beriberi (shoshin beriberi), in which heart failure and metabolic abnormalities predominate, without peripheral neuritis and Wernicke s encephalopathy with KorsakofPs psychosis, which is associated especially with alcohol and dmg abuse. The central role of thiamin diphosphate in... 

The answer is b. (Hardmanr p 1158.) Isoniazid inhibits cell-wall synthesis in mycobacteria. Increasing vitamin B6 levels prevents complications associated with this inhibition, including peripheral neuritis, insomnia, restlessness, muscle twitching, urinary retention, convulsions, and psychosis, without affecting the antimycobacterial activity of INH. 

The answer is c. (Hardman7 pp 1269—1271.) Cisplatin causes acoustic nerve damage. Paclitaxel causes peripheral neuritis. Dose-... 

The answer is e. (Hardman, p 1563 ) The toxicity of INI I is mainly on the peripheral and central nervous systems (PNS, CNS). This is attributable to competition of 1NH with pyridoxal phosphate for apotryp-tophanase. This results in a relative deficiency of pyridoxine, which causes peripheral neuritis, insomnia, and muscle twitching among other effects. 

Gl intolerance, optic neuritis, peripheral neuritis Rash, Gl intolerance Neutropenia, discolored urine, uveitis Gl intolerance... 

Classic beri-beri, rarely seen in the United States and Europe, except in alcoholism (P4), is endemic in the Far East because of the prevalent diet of decorticated rice (F6). It occurs in two forms wet beri-beri, characterized by edema and cardiovascular symptoms (G6), and dry beri-beri with peripheral neuritis, paralysis, and atrophy of the muscles. Conditions which may predispose to deficiency by increasing thiamine requirements are pregnancy (see section 2.4), and lactation, hyperthyroidism, malignant disease, febrile conditions, increased muscular activity, high carbohydrate diets, and parenteral administration of glucose solutions. A constant supply of thiamine is required for optimal nutrition because storage in the liver and elsewhere is limited. Thiamine is synthesized by bacteria in the intestinal tract of various animals, but this is not a dependable source for man. 

Nitrofurantion D-Penicillamine Peripheral neuritis Autoimmunity drug-induced SLE, myasthenia gravis, pemphigus, glomerulonephritis, Goodpasture s disease... 

Disulfiram is used as an adjunct in the management of alcohol dependence. It is contraindicated in patients with a history of cerebrovascular accident, cardiac failure, coronary artery disease, hypertension and psychosis. Side-effects that may be present include initial drowsiness and fatigue, nausea, vomiting, halitosis, reduced libido, psychotic reactions, allergic dermatitis, peripheral neuritis and hepatic cell damage. 

DNP induced cataractogenesis appears to vary widely. Development of agranulocytosis, peripheral neuritis, and dermal effects such as rash, pruritus, urticaria, and maculopapular skin lesions were also observed. ... 

Peripheral neuritis Peripheral neuritis evidenced by paresthesias, numbness, and tingling, has been observed. Add pyridoxine to the regimen if symptoms develop. Hematologic effects Blood dyscrasias consisting of reduction in hemoglobin and red cell count, leukopenia, agranulocytosis, and purpura have been reported. If such abnormalities develop, discontinue therapy. Periodic blood counts are advised. Tartrazine sensitivity Some of these products contain tartrazine, which may cause allergic-type reactions in susceptible individuals. Tartrazine sensitivity is frequently seen in patients who also have aspirin hypersensitivity. 

Adverse reactions may include bone marrow depression with aplastic anemia agranulocytosis or thrombocytopenia (long-term therapy) peripheral neuritis purpura myopathy loss of hair reversible azoospermia dermatoses hypersensitivity vomiting diarrhea abdominal pain nausea elevated alkaline phosphatase and AST. 

Adverse reactions may include nausea vomiting glossitis stomatitis diarrhea headache mild depression mental confusion fever macular/vesicular rashes angioedema urticaria anaphylaxis optic and peripheral neuritis. 

Adverse reactions may include anaphylactoid reactions, dermatitis, pruritus, decreases in visual acuity, anorexia, nausea, vomiting, Gl upset, abdominal pain, fever, malaise, headache, dizziness, mental confusion, disorientation, possible hallucinations, peripheral neuritis, elevated serum uric acid levels, precipitation of acute gout, transient impairment of liver function, and joint pain. 

Adverse reactions may include the following Depression drowsiness and asthenia convulsions peripheral neuritis and neuropathy olfactory disturbances blurred vision diplopia optic neuritis dizziness headache restlessness tremors ... 

The risk of severe neurotoxic reactions is sharply increased in patients with impaired renal function or prerenal azotemia. These include disturbances of vestibular and cochlear function, optic nerve dysfunction, peripheral neuritis, arachnoiditis, and encephalopathy. The incidence of clinically detectable, irreversible vestibular damage is particularly high in patients treated with streptomycin. 

Suramin is a non-specific inhibitor of many enzymes. Suramin can only be given intravenously. Toxic reactions are frequent and sometimes severe, including gastrointestinal complaints, nephrotoxicity, peripheral neuritis and exfoliative dermatitis. 

A. Ethambutol is associated with retrobulbar neuritis, resulting in loss of central vision and impaired red-green discrimination. Ethionamide (B) is an analogue of isonicotinic acid and is associated with GI intolerance and peripheral neuropathy, but not the optic neuritis or color vision discrimination problems. Aminosalicylic acid (C) can cause GI irritation and bleeding problems, so caution is required in peptic ulcer patients. It has no neurological side effects. Rifampin (D) is associated with red-orange discoloration of saliva, tears, and urine but not the color vision problems. Isoniazid (E) is associated with peripheral neuritis in chronic alcoholics and malnourished individuals and requires pyridoxine supplements. It is not associated with optic neuritis. 

Bone marrow depression, hepatic toxicity, peripheral neuritis, and acute renal failure occur rarely. 

Peripheral neuritis (numbness and weakness in feet and hands), rash, shortness of breath, confusion, headache, optic neuritis (blurred vision, eye pain)... 

Optic neuritis (more common with high-dosage or long-term ethambutol therapy), peripheral neuritis, thrombocytopenia, and an anaphylactoid reaction occur rarely. 

Signs and symptoms of peripheral neuritis, as evidenced by burning, numbness, or tingling of the extremities... 

Abdominal pain, nausea, vomiting, weakness, postural hypotension, psychiatric disturbances, drowsiness, dizziness, headache, confusion, anorexia, headache, metallic taste, anorexia, diarrhea, stomatitis, peripheral neuritis Rare... 

Prolonged therapy may result in peripheral neuritis, neuromyopathy, hypotension, ECG changes, agranulocytosis, aplastic anemia, thrombocytopenia, seizures, and psychosis. 

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