European Journal of Clinical Pharmacology

Figueras, Albert

doi: 10.1007/s00228-011-1024-5pmid: 21431396

Peterson, Curt

doi: 10.1007/s00228-011-1011-xpmid: 21336995

Cancer chemotherapy was introduced at the same time as antibacterial chemotherapy but has not been nearly such a success. However, there is a growing optimism in oncology today due to the introduction of several more or less target-specific drugs as complements to the conventional cytotoxic drugs introduced half a century ago. The success in the treatment of chronic myelogenous leukemia by imatinib, inhibiting the bcr-abl-activated tyrosine kinase and thereby interrupting the signal transduction pathways that lead to leukemic transformation with impressive survival benefit, has paved the way for this new optimism. Another success story is the introduction of trastuzumab in breast cancers overexpressing the HER-2 receptor. In contrast, there has been little progress in other malignancies such as metastatic malignant melanoma, although very recently, clinical trials with new targeted drugs have shown increased survival. All major pharmaceutical companies now have ambitious development programs in the cancer area. However, the high costs of the novel drugs cause economic distress in the health care system in many countries leading to an intense debate on the cost-effectiveness of these drugs in relation to other health care activities.

Mukattash, Tareq; Hawwa, Ahmed; Trew, Karen; McElnay, James

doi: 10.1007/s00228-010-0978-zpmid: 21243345

The use of unlicensed and off-label medicines remains a major issue in paediatric medicine. Until such times as more licensed medicines are available for children, clear guidance should be developed to allow consistency in practice across the spectrum of healthcare professionals who are involved with such medicines in their routine practice.

Pereira de Silva, Nahuel; Piquioni, Paulo; Kochen, Silvia; Saidon, Patricia

doi: 10.1007/s00228-011-1005-8pmid: 21359537

PurposeDRESS (drug reaction with eosinophilia and systemic symptoms) is an idiosyncratic entity associated with the use of drugs. Its pathophysiology is not known, but is associated with immunological or genetic factors. The incidence is 0.4 cases per 1,000,000 general population. The syndrome usually develops at the beginning of treatment and is characterized by the presence of rash, fever, eosinophilia and systemic manifestations. The aim of our study was to describe the clinical manifestation and treatment of patients with DRESS associated with antiepileptic drugs (AEDs).MethodsThis is a descriptive study with the aim of describing the clinical manifestation and treatment associated with DRESS produced by aromatic and non-aromatic AEDs.ResultsEight patients treated with AEDs developed DRESS between January 2007 and May 2010 at our hospital. All had dermatological manifestations, eosinophilia and systemic (haematological and hepatic) manifestations that could be attributed to treatment with aromatic AEDs (carbamazepine, 2 patients; lamotrigine, 3 patients; phenytoin, 3 patients). Therapeutic management included removal of the drug from the therapeutic regime, symptomatic management, life support and use of corticosteroids. There was no mortality associated with the syndrome. Reversion of systemic manifestations was very slow: between 1 and 6 months.ConclusionsDRESS is a severe cutaneous reaction, with high morbidity and mortality, whose development seems to be associated with individual susceptibility, type of antiepileptic drug used (more common with aromatic drugs), titration rate and concomitant medications.

Holstein, Andreas; Hahn, Michael; Patzer, Olaf; Seeringer, Angela; Kovacs, Peter; Stingl, Julia

doi: 10.1007/s00228-010-0976-1pmid: 21213107

In the present cohort of 102 patients with SH, a low HbA 1c value was related to the risk for SH. There was no overrepresentation observed of the CYP2C9 slow-metabolizer genotypes in the hypoglycemic patients group, but the drug exposure in the slow-metabolizer genotypes was estimated to be higher in hypoglycemic patients, which might partly have contributed to their risk for SH.

Banaś, Anna; Płońska, Edyta; Kurzawski, Mateusz; Gornik, Wanda; Droździk, Marek

doi: 10.1007/s00228-011-1000-0pmid: 21305273

The ADRB1 1165C>G and 145A>G polymorphisms are not associated with the HR, SBP and DBP responses in Polish Caucasian patients requiring diagnostic dobutamine stress echocardiography

Nobili, Alessandro; Licata, Giuseppe; Salerno, Francesco; Pasina, Luca; Tettamanti, Mauro; Franchi, Carlotta; Vittorio, Luigi; Marengoni, Alessandra; Corrao, Salvatore; Iorio, Alfonso; Marcucci, Maura; Mannucci, Pier

Antoniou, Tony; Gomes, Tara; Mamdani, Muhammad; Juurlink, David

doi: 10.1007/s00228-010-0985-0pmid: 21234553

Treatment with ciprofloxacin is associated with a significant increase in the risk of theophylline toxicity. When clinically appropriate, alternate antibiotics should be considered for elderly patients receiving theophylline.

Alrwisan, Adel; Ross, Jennifer; Williams, David

doi: 10.1007/s00228-010-0986-zpmid: 21240481

The majority of medication incidents in this study were reported by nursing and midwifery staff, and were due to administration incidents. There is a clear need to elucidate the reasons for the limited contribution of the medical and dental professionals to reporting medication incidents.