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A case of almagel-induced methemoglobinemia after pancreatoduodenal resection

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Gudaityte J., Borodiciene J., Zalys R., Rugyte D., Macas A., Latkauskas T.

Open Medicine

2011

vol. 6

issue 6

773-777

We are reporting the case of severe methemoglobinemia resulting from Almagel which was given for treatment of gastrointestinal ulcers after pancreatoduodenal resection. A 64 year old man was treated with Almagel A postoperatively. One day after treatment began, the patient reported what appeared to be cyanotic discolorations of his lips and fingers. (SpO2 80%, normal pO2). Two days later, the patient was diagnosed with methemoglobinemia via co-oximetry and treated with methylene blue. The causes of methemoglobinemia remained unclear, and Almagel A was reinitiated until the second episode of methemoglobinemia, was diagnosed and treated promptly. The dose of benzocaine in Almagel A (100 mg/5 ml) was sufficient enough to cause methemoglobinemia, confirmed using multiwavelength co-oximeter and successfully treated with methylene blue.

Spontaneous reporting of adverse drug reactions at a department of Internal Medicine

100%

Jovic Z., Djordjevic V., Milena M., Vasic K.

Open Medicine

2010

vol. 5

issue 3

338-346

The aim of the present study was to characterize the pattern of adverse drug reactions (ADRs) reported in a university teaching hospital in south-east Serbia. The study was conducted based on ADRs reported during a six-month period to the ADR reporting unit of the university clinical center. Evaluation of data was done for various parameters, such as patient demographics, drug and reaction characteristics, and outcome of reactions. Assessment was also done for causality, severity and predisposing factors. During the 6-month study period, 44 ADRs were reported, with an overall incidence of 0.33%. No significant difference was seen in the overall incidence of ADRs observed in males and females. Incidence of ADRs among elderly (43.2%) and older (25%) adults was significantly higher than in other age groups. Type A reactions (66.7%) accounted for majority of the reports. The most commonly affected organ system was the renal system, (22.7%) with hyperkalemia as the only reported reaction. ACE inhibitors (48.6%) were the drug class most commonly involved, where fosinopril (25.7%) was the individual drug most frequently reported. Additional treatment was pursued for management of ADRs in majority (52.3%) of the reports. In 52.3 % of the reports, the patient had recovered from the reaction by the time of evaluation. Upon causality assessment, the majority of the reports were rated as probable (43.2%). Mild and moderate reactions accounted for 43.2% and 54.6%, respectively. In 36.3% of the reports, the reaction was considered to be preventable. The most common predisposing factors were polypharmacy and multiple disease state. The pattern of ADRs reported in our hospital is comparable to the results of studies conducted in hospital set up elsewhere. Our evaluations revealed opportunities for intervention to ensure safer drug use.

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2 Open Medicine

1 2011

1 2010

1 Borodiciene J.

1 Djordjevic V.

1 Gudaityte J.

1 Jovic Z.

1 Latkauskas T.

1 Macas A.

1 Milena M.

1 Rugyte D.

1 Vasic K.

1 Zalys R.

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A case of almagel-induced methemoglobinemia after pancreatoduodenal resection

Spontaneous reporting of adverse drug reactions at a department of Internal Medicine