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Ștefan CS, Nechita A, Dragostin OM, Fulga A, Lisă EL, Vatcu R, Dragostin I, Velicescu C, Fulga I. Drugs Associated with Adverse Effects in Vulnerable Groups of Patients. Clin Pract 2024; 14:1010-1020. [PMID: 38921258 PMCID: PMC11203099 DOI: 10.3390/clinpract14030080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/11/2024] [Accepted: 05/28/2024] [Indexed: 06/27/2024] Open
Abstract
In recent years, a series of recommendations have been issued regarding the administration of drugs because of awareness of the serious side effects associated with certain classes of drugs, especially in vulnerable patients. Taking into account the obligation of the continuous improvement of professionals in the medical fields and the fact that we are in the midst of a "malpractice accusations pandemic", through this work, we propose to carry out a "radiography" of the scientific literature regarding adverse effects that may occur as a result of the interaction of drugs with the physiopathological particularities of patients. The literature reports various cases regarding different classes of drugs administration associated with adverse effects in the elderly people, such as fluoroquinolones, which can cause torsade de pointes or tendinopathy, or diuretics, which can cause hypokalemia followed by torsade de pointes and cardiorespiratory arrest. Also, children are more prone to the development of adverse reactions due to their physiological particularities, while for pregnant women, some drugs can interfere with the normal development of the fetus, and for psychiatric patients, the use of neuroleptics can cause agranulocytosis. Considering the physiopathological particularities of each patient, the drug doses must be adjusted or even completely removed from the treatment scheme, thus requiring the mandatory active participation both of clinician pharmacists and specialists in the activity of medical-pharmaceutical analysis laboratories within the structure of hospitals.
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Affiliation(s)
- Claudia Simona Ștefan
- Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35 AL Cuza st, 800010 Galati, Romania; (C.S.Ș.); (A.F.); (E.-L.L.); (R.V.); (I.D.); (I.F.)
| | - Aurel Nechita
- Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35 AL Cuza st, 800010 Galati, Romania; (C.S.Ș.); (A.F.); (E.-L.L.); (R.V.); (I.D.); (I.F.)
| | - Oana-Maria Dragostin
- Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35 AL Cuza st, 800010 Galati, Romania; (C.S.Ș.); (A.F.); (E.-L.L.); (R.V.); (I.D.); (I.F.)
| | - Ana Fulga
- Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35 AL Cuza st, 800010 Galati, Romania; (C.S.Ș.); (A.F.); (E.-L.L.); (R.V.); (I.D.); (I.F.)
| | - Elena-Lăcrămioara Lisă
- Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35 AL Cuza st, 800010 Galati, Romania; (C.S.Ș.); (A.F.); (E.-L.L.); (R.V.); (I.D.); (I.F.)
| | - Rodica Vatcu
- Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35 AL Cuza st, 800010 Galati, Romania; (C.S.Ș.); (A.F.); (E.-L.L.); (R.V.); (I.D.); (I.F.)
| | - Ionut Dragostin
- Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35 AL Cuza st, 800010 Galati, Romania; (C.S.Ș.); (A.F.); (E.-L.L.); (R.V.); (I.D.); (I.F.)
| | - Cristian Velicescu
- Faculty of Medicine, “Grigore T Popa” University of Medicine and Pharmacy Iasi, 16 University Street, 700115 Iaşi, Romania;
| | - Iuliu Fulga
- Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 35 AL Cuza st, 800010 Galati, Romania; (C.S.Ș.); (A.F.); (E.-L.L.); (R.V.); (I.D.); (I.F.)
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Rehlinghaus M, Rehker P, Che Y, Grunewald CM, Niegisch G. [Neutropenia - when is GCSF support indicated?]. Aktuelle Urol 2024; 55:38-43. [PMID: 37607583 DOI: 10.1055/a-2128-4965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Many systemic treatments used in genitourinary oncology negatively affect haematopoiesis, thus leading to neutropenia. Neutropenic patients are vulnerable to bacterial, and other infections. Often fever is the only symptom in these patients. Neutropenic fever is a major threat for these patients, as it may lead to life-threatening therapy complications that significantly impair the patient's quality of life, Moreover, it may also worsen the prognosis due to therapy delays or necessary dose modifications. Granulocyte colony stimulating factors (GCSF), which can improve neutrophil granulocyte formation, are used both for supportive treatment in febrile neutropenia and for its prophylaxis. The correct indication for such GCSF support depends on the general risk of febrile neutropenia of the therapy used, as well as on individual patient factors and the treatment intent (palliative vs. curative). Based on the current recommendations both of the German and international guidelines, this article aims to provide an up-to-date and practice-oriented overview of the use of GCSF in uro-oncology.
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Affiliation(s)
- Marc Rehlinghaus
- Department of Urology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Centrum für Integrierte Onkologie (CIO) Düsseldorf, CIO Aachen Bonn Köln Düsseldorf, Düsseldorf, Germany
| | - Philipp Rehker
- Department of Urology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Centrum für Integrierte Onkologie (CIO) Düsseldorf, CIO Aachen Bonn Köln Düsseldorf, Düsseldorf, Germany
| | - Yue Che
- Department of Urology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Centrum für Integrierte Onkologie (CIO) Düsseldorf, CIO Aachen Bonn Köln Düsseldorf, Düsseldorf, Germany
| | - Camilla Marisa Grunewald
- Department of Urology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Centrum für Integrierte Onkologie (CIO) Düsseldorf, CIO Aachen Bonn Köln Düsseldorf, Düsseldorf, Germany
| | - Günter Niegisch
- Department of Urology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Centrum für Integrierte Onkologie (CIO) Düsseldorf, CIO Aachen Bonn Köln Düsseldorf, Düsseldorf, Germany
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McAvoy C, Fields P, Otto D, Kreimer A, Ellis CS. Incidence of pulmonary toxicity in bleomycin-containing regimens for testicular cancer with and without the use of growth factor. J Oncol Pharm Pract 2024:10781552231225766. [PMID: 38291671 DOI: 10.1177/10781552231225766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
INTRODUCTION The concurrent use of bleomycin and granulocyte colony-stimulating factors (G-CSFs) has historically been debated as a risk factor for bleomycin-induced pulmonary toxicity in patients with both testicular cancer and Hodgkin's lymphoma. The purpose of this study is to evaluate the incidence of pulmonary toxicity in patients with testicular cancer who were treated with bleomycin and pegfilgrastim concurrently. METHODS This is a retrospective study that includes male patients over the age of 18 years old diagnosed with testicular cancer who received bleomycin-containing chemotherapy regimens with and without the use of G-CSF agents. RESULTS There were a total of 33 patients identified as receiving bleomycin, with 30 of those patients having received concurrent G-CSF therapy. Of the patients who received G-CSF therapy, 11 patients (36.6%) experienced pulmonary toxicity leading to discontinuation of bleomycin or changes in chemotherapy regimens altogether. CONCLUSION There were no major differences in patient demographics or risk factors between those who received G-CSF and developed pulmonary toxicity and those who received G-CSF but did not develop pulmonary toxicity. Further studies are needed in order to fully assess the risk of pulmonary toxicity with this chemotherapy regimen.
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Affiliation(s)
- Claire McAvoy
- Department of Pharmacy Services, UK HealthCare Albert B. Chandler Medical Center, Lexington, KY, USA
- Markey Cancer Center, UK HealthCare Albert B. Chandler Medical Center, Lexington, KY, USA
| | - Paige Fields
- University of Kentucky College of Pharmacy, Lexington, KY, USA
| | - Danielle Otto
- Department of Pharmacy Services, UK HealthCare Albert B. Chandler Medical Center, Lexington, KY, USA
- Markey Cancer Center, UK HealthCare Albert B. Chandler Medical Center, Lexington, KY, USA
| | - Alexander Kreimer
- Department of Pharmacy Services, UK HealthCare Albert B. Chandler Medical Center, Lexington, KY, USA
- Markey Cancer Center, UK HealthCare Albert B. Chandler Medical Center, Lexington, KY, USA
| | - Carleton S Ellis
- Department of Pharmacy Services, UK HealthCare Albert B. Chandler Medical Center, Lexington, KY, USA
- Markey Cancer Center, UK HealthCare Albert B. Chandler Medical Center, Lexington, KY, USA
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