Fixed Drug Eruptions

HISTORY OF PRESENT ILLNESS: This patient is a 57-year-old Cuban woman with a long history of rheumatoid arthritis. She has received methotrexate on a weekly basis as an outpatient for many years. Approximately 2 weeks ago she developed a respiratory infection, for which she received antibiotics, and completed that course of antibiotics. She developed some ulcerations of her mouth and was instructed to

Adverse reactions to drugs are common and almost any drug can cause an adverse reaction.

Sanity is in the mind of the beholder; one person's reality is not necessarily the reality for everyone. In the short story, “The Yellow Pill” by Rog Phillips, this is the main idea when two men, Dr. Elton and Jerry Bocek, meet in either a psychiatrist’s office or in a spaceship. By the end of the story, it is clear that Dr. Elton is living in reality and the story takes place on earth.

Mindy Perkins is 48 year old woman who presents to the ED with 10- 15 loose, liquid stools daily for the past 2 days. She completed a course of oral Amoxicillin seven days ago for a dental infection. In addition to loose stools, she complains of lower abdominal pain that began 2 days ago as well. She has not noted any blood in the stool. She denies vomiting, fever, or chills. She is on Prednisone for Crohn’s disease as well as Pantoprazole (Protonix) for severe GERD.

Based on the member’s clinical presentation, the requested Flector 1.3% patch is not medically necessary for the treatment of this member’s

Unfortunately, this topic affects a lot of people, taking away their freedoms. “Among them are… Zondenta McCarter, a sixty six year old woman, a first offender, poor and illiterate, suffering from diabetes, described as naive, trusting and childlike… sentenced to 8 years in prison.” (Schlosser, 4) The author explains that just because she used something once that she’s a dangerous criminal, but if she wasn’t apart of violent crimes she shouldn’t be getting such a harsh sentence. Mark Bennett interviewed some of the criminals, “18 were pill smurfers… single mothers… yet all of them face… sixty to 120 months.” (Bennett, 1-2) None of them were violent crimes, sadly, they get sentences that not only affect them but their families and the world.

Nausea, vomiting, and oral thrush can occur with repeated or prolonged usage. Other side effects of antibiotics can be diarrhea. The diarrhea may also be a sign of a new infection such as, clostridium difficile. Anti-diarrheal medications are not indicated unless instructed by your provider (rxlist, n.d.).

As the population continues to live longer the older adult has had an increase in chronic conditions develop, resulting in an increase in multimorbidity. This causes the older adult to be more vulnerable to disability, poor quality of life, risk of death and adverse drug reactions (Salive, 2013). In general, the older adult is vulnerable to having an adverse reaction to medications. The older adult not only has a higher risk of an adverse reaction to any particular medication given, there is an increase in risk of reactions associated with the multiple medications older adults are frequently prescribed due to multi-chronic conditions (Hubbard, O’Mahony, & Woodhouse, 2013). Adverse drug reaction and multimorbidity can benefit from additional research to better understand the older adult reaction to medications and dosages, as well as management of multimorbidity. Until then physicians, nurses, the older adult, and the family need to collaborate to find the treatment plan that works best with the least amount of side effects from medications. Often times starting low with medication dosing and increasing to the dose to achieve therapeutic levels is done with the older adult to help decrease an adverse reaction to medication. Management of multimorbid conditions in which maximizing the quality of life the older adult has is the goal. This can be done by frequent assessment of the treatment plan and making

Last QDRR in 5/30/17 indicates that patient is free from poly-pharmacy but he is not free of potential drug interaction:

Generally adverse effects of nifurtimox or benznidazole are lower in children than in adult. There are two adverse effects of benznidazole i.e. allergic dermitis and peripheral neuropathy. Allergic dermitis occur within 8-10 days after treatment starts and there is no need to reduce dose in most patients. While sensitive neuropathy result in last part of treatment and affect mainly lower parts of limbs. The treatment should stopped in this case. Rare adverse effects includes leucopenia, weight loss, vomiting, insomnia, and nausea 26, 28.

Prescription and over-the-counter drug use in America has increased steeply over the past fifty years. This is a cause for concern. Too often, these medications only treat the symptoms and not the underlying cause of the disease. And they all come with dangerous side effects. Adverse drug reactions are America’s fourth leading cause of death. Do not assume that OTC medications are safe. They can cause serious adverse reactions on their own and also interact with prescribed drugs to increase risk.

HISTORY OF PRESENT ILLNESS: This patient is a 57 yr. old, Cuban woman with a long history of rheumatoid arthritis. She has received methotrexate on a weekly basis as an outpatient for many years, approximately 2 weeks ago she developed a respiratory infection for which she received antibiotics and completed that course of antibiotics. She developed some ulcerations of her mouth and was instructed to discontinue the

Adverse reactions to this medication are migraine, speech disorders, rhinitis, sinusitis, hyperglycemia, elevated liver function, elevated serum creatinine level, pancytopenia, bronchitis, dyspnea, toxic epidermal necrolysis, anaphylaxis, elevated creatine kinase, generalized pain, and infection. Nursing considerations with this medication is to have the patient swallow the whole tablet and not to chew. Watch for aspiration while watching the patient take the medication. Educate the patient about the medication and inform them to notify a physician if bleeding

botulinum antibiotics are recommended for their treatment (Mayo Clinic Staff, 2015). However, antibiotics should not be used on patients with other types of C. botulinum because it can advance the release of the toxins (Mayo Clinic Staff, 2015). There are three different antibiotics that can be used on wound C. botulinum patients, Penicillin G (Pfizerpen), Chloramphenicol (Chloromycetin), and Clindamycin (Cleocin). Penicillin G is the preferred drug for wound C. botulinum the other two are an alternative to penicillin (Chan-Tack, 2015). “Penicillin G interferes with synthesis of cell wall mucopeptide during active multiplication, resulting in bactericidal activity against susceptible microorganisms” (Chan-Tack, 2015). “Chloramphenicol binds to 50S bacterial-ribosomal subunits and inhibits bacterial growth by inhibiting protein synthesis. Effective against gram-negative and gram-positive bacteria” (Chan-Tack, 2015). “Clinadmycin inhibits bacterial growth, possibly by blocking dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest” (Chan-Tack, 2015). The adverse effects of Penicillin G are seizures and anemia. The adverse effects of Chloramphenicol have a less than one percent frequency, but include nightmares, headache and a rash (Chan-Tack, 2015). The adverse effects of Clindamycin include abdominal pain, diarrhea and fungal overgrowth (Chan-Tack,

Following IV administration of difloxacin in goats, the disposition kinetic curve declined in a biphasic manner, suggesting that the drug disposition followed a two-compartment open model. This finding is in agreement with previous reports in goats (Atef et al., 2002, Marin et al., 2007a). Difloxacin has good distribution characteristics represented by short distribution half-life (t1/2α = 0.22 h). Similar findings have been reported for other fluoroquinolones as levofloxacin in ducks (0.30 h; Aboubakr and soliman, 2014), marbofloxacin in quails (0.24 h; Aboubakr and Abdelazem, 2015), longer than norfloxacin in goldfish (0.12 h; Aboubakr et al., 2014) and shorter than difloxacin in broiler chicken (0.69 h; Ding et al., 2008).