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Hypoglycemia Following Antifungal Tx in Affected person With Kind 1 Diabetes

Posted in News on 8th November 2018
Micafungin is a member of the echinocandin class of antifungal agents

Micafungin is a member of the echinocandin class of antifungal agents

A recent report published in The Journal of Clinical Endocrinology and Metabolism, describes the case of a patient with type 1 diabetes mellitus (T1DM) who developed hypoglycemia following antifungal therapy for a severe infection.

The 29-year-old female patient had a long history of uncontrolled T1DM and was diagnosed with cervical necrotizing fasciitis with mediastinal spread after presenting for evaluation of worsening dysphagia and dyspnea. Several debridement surgeries as well as broad spectrum antibiotics and antifungal therapy were required to treat her. At admission, she had an HbA1c of 13.4%; due to worsening infection, continuous tube feeds, and multiple surgeries, her insulin needs subsequently increased.

To provide broader antimicrobial coverage, micafungin, a member of the echinocandin class of antifungal agents, was initiated. After administration of micafungin, the patient’s insulin requirement dropped to 0 for more than 48 hours. Upon discontinuing micafungin and switching to a different antifungal, her insulin needs increased again.

“This is the first report of decreased insulin requirements in a patient with T1DM correlating with micafungin administration,” noted the authors. While the exact mechanism by which micafungin induces hypoglycemia has yet to be established, they hypothesized that the agent reduces blood glucose levels through inhibition of sodium-glucose transporter-1 (SGLT1) function.

Extreme Acute Respiratory Misery Syndrome Following HCTZ Administration

Posted in News on 1st November 2018

October 31, 2018

Although most cases resolve with supportive care, severe cases may require intubation and vv-ECMO

Although most cases resolve with supportive care, severe cases may require intubation and vv-ECMO

A recent report published in The Journal of Emergency Medicine describes the case of a male patient who experienced hydrochlorothiazide (HCTZ)-induced pulmonary edema that was complicated by acute respiratory distress syndrome (ARDS) and discusses the approach that was taken for his treatment.

The patient, who was in his 50s, had a past medical history significant for hypertension, which was managed with HCTZ. The study authors reported that the patient began to feel unwell and experienced difficulty breathing 30 minutes after administration of HCTZ. After developing ARDS and progressive hypoxemia in the emergency department of a referring hospital, he was transferred to the study authors’ institution for evaluation of refractory hypoxemia. During his transfer of care, the patient’s pulses could not be palpated, therefore chest compressions and intravenous epinephrine were initiated. Chest compressions were discontinued once his pulses were palpated again.

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After performing a physical examination and various laboratory tests, vasopressors were initiated. “Although the patient was persistently hypotensive and requiring high-dose vasopressors, we thought that this was most likely due to profound hypoxemia and acidemia causing global myocardial depression and vasoplegia rather than a primary cardiogenic shock,” the study authors explained.

The patient was therefore cannulated for venovenous extracorporeal membrane oxygenation (vv-ECMO) in the emergency department. “Packed red blood cells were infused empirically when the patient was placed on the ECMO circuit and within 15 min of ECMO cannulation, persistent pulse oximetry readings above 88% were achieved,” the study authors reported.

The patient’s ARDS resolved after several days of ECMO, at which point, he was decannulated and extubated. The allergy and medical teams later obtained an extensive patient history, which revealed that the patient had likely experienced 2 previous episodes of HCTZ-induced pulmonary edema.

“One of the most commonly prescribed antihypertensives, HCTZ is associated with rare cases of pulmonary edema, which typically develop within minutes to hours of the initial dose of the medication,” the study authors stated. They added, “Although most cases resolve with supportive care, severe cases may require intubation and even vv-ECMO.”


Jansson PS, Leisten DC, Sarkisian TM, Wilcox SR, Lee J. Recurrent Hydrochlorothiazide-Induced Acute Respiratory Distress Syndrome Treated With Extracorporeal Membrane Oxygenation. The Journal of Emergency Medicine. 2018 DOI:

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Case: Hypertensive Disaster Following Use of Armodafinil + MAOI

Posted in News on 16th August 2018

August 15, 2018

In the ED, the patient was found to be hypertensive with a blood pressure of 186/120 mmHg

Within the ED, the affected person was discovered to be hypertensive with a blood strain of 186/120 mmHg

A report printed within the Journal of the Neurological Sciences particulars a case of acute hypertensive disaster and extreme headache following concurrent remedy with armodafinil and tranylcypromine.

Whereas the labeling for armodafinil and modafinil advises warning when prescribing these wakefulness promoters with monoamine oxidase inhibitors (MAOIs) comparable to tranylcypromine, little knowledge exist to substantiate the potential dangers related to concurrent use. This case concerned a 36-year-old feminine with bipolar dysfunction who offered to the emergency division (ED) with blurry imaginative and prescient, neck stiffness and the “worst headache of (her) life” after taking armodafinil with tranylcypromine.

Her remedy historical past indicated that she had been taking tranylcypromine (20mg twice every day) with armodafinil (250mg every day) for two months, along with brexpiprazole zero.5mg every day. The morning of her admittance to the ED, the tranylcypromine dose was adjusted from 20mg twice every day to 40mg within the morning.

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Within the ED, the affected person was discovered to be hypertensive with a blood strain (BP) of 186/120 mmHg. She was handled with intravenous morphine, which diminished the severity of the headache, and her BP decreased over the course of the day. She was admitted for statement throughout which her drugs had been discontinued; three days later, her signs had subsided.

To analyze the outcomes of comparable circumstances, the authors carried out a literature evaluation and recognized 6 different circumstances the place sufferers had been handled with modafinil and an MAOI; 5 of those sufferers had no adversarial occasions, whereas 1 (Vytopil et al. 2007) developed acute chorea and hyperthermia three days after modafinil was added to tranylcypromine. Relating to brexpiprazole, the authors famous latest research which confirmed that the usage of atypical antipsychotics with MAOIs or armodafinil gave the impression to be secure, nonetheless, they added “it’s doable that brexpiprazole exacerbated or contributed to the underlying signs.”

Primarily based on the findings of this case and others within the literature, the authors concluded, “We […] advocate that physicians train warning if utilizing these lessons of medication collectively.”

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National Defective Drug Lawyers Investigating Z-Pak Wrongful Death Lawsuits, Following Study Linking Zithromax Side Effects with an Increased Risk of Sudden Cardiac Death

Posted in Zithromax on 22nd May 2014

New York, New York (PRWEB) May 21, 2012

Parker Waichman LLP, a national law firm dedicated to protecting the legal rights of people injured by defective drugs, is investigating potential wrongful death lawsuit claims stemming from sudden, heart related deaths that might be associated with use of the antibiotic, Zithromax (azithromycin). On May 17, 2012, The New England Journal of Medicine (NEJM) published a study which found people using Zithromax, known popularly as Z-Pak, faced an increased risk of sudden cardiac death, compared to patients not treated with an antibiotic, as well as those taking alternative antibiotics. []

The NEJM study analyzed health records and data on millions of prescriptions for several antibiotics given to more than half a million Medicaid patients from 1992 to 2006. The risk of death reported in people taking Zithromax was more than double that of patients on amoxicillin, or those who took none. The highest risks were seen in Z-Pak users with pre-existing heart problems.

On May 18, the U.S. Food & Drug Administration (FDA) said in a statement it was reviewing the Zithromax study. The FDA’s statement also pointed out that Zithromax belongs to a class of antibacterial drugs called macrolides, which have been associated with cardiovascular effects; specifically, prolongation of the QT interval. Prolongation of the QT interval can lead to torsades de pointes (TdP), an abnormal heart rhythm, which can be fatal, the agency said. []

Zithromax is an antibiotic used to treat a number of bacterial infections, including respiratory infections, skin infections, ear infections and sexually transmitted diseases. While other antibiotics must be taken for at least 10 days, Z-Pak is only a 5-day course of treatment. The shorter treatment time has made Zithromax one of the more popular antibiotics on the market.

Parker Waichman LLP is offering free lawsuit evaluations to anyone who lost a loved one as a result of a sudden, heart related death that could be associated with use of Zithromax. Please contact their office by visiting the Zithromax Sudden Death page at Free case evaluations are also available by calling 1 800 LAW INFO (1-800-529-4636).

For more information regarding Z-Pak lawsuits and Parker Waichman LLP, please visit or call 1-800-LAW-INFO (1-800-529-4636).


Parker Waichman LLP

Gary Falkowitz, Managing Attorney

(800) LAW-INFO

(800) 529-4636

Which of the following drugs is classified as a topical steriod?

Posted in Serevent on 18th April 2012

Question by Marie: Which of the following drugs is classified as a topical steriod?
Albuterol (ventolin, Proventil)
Salmeterol (Serevent)
Fluocinolone (Synalar)
Prednisone (Deltasone)

Best answer:

Answer by matador 89
These details could have been researched personally using your library or the internet. I presume that this method involves less work for you. Your answer should be Fluocinolone (Synalar) which is a topical steroid. Prednisone (Deltasone) is a Corticosteroid, which is a medication that is chemically similar to natural steroids and duplicates their actions. Salmeterol (Serevent) is a long-acting beta2-adrenergic receptor agonist drug that is currently prescribed for the treatment of asthma and chronic obstructive pulmonary disease (COPD). Albuterol (ventolin, Proventil) is a bronchodilator used for asthma and emphysema and other lung conditions.


It is extremely important to obtain an accurate diagnosis before trying to find a cure. Many diseases and conditions share common symptoms.

The information provided here should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions.

Hope this helps
matador 89

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