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Reports of the side effects associated with the use of drugs 1979
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|Title: ||Reports of the side effects associated with the use of drugs 1979|
|Publisher: ||National Drugs Advisory Board (NDAB)|
|Issue Date: ||1979 |
|Description: ||During 1979 the National Drugs Advisory Board received 474 reports from which 873 side-effects were
recorded. These figures are less than previously, but considering the problems accompanying the postal
strike the National Drugs Advisory Board was pleased' that so many practitioners continued to maintain contact.
Eight of the reports concerned interactions between drugs.
The complicated interaction between amitriptyline and rauwolfia alkaloids emphasises the difficulty that
can arise with multiple therapy, in this case each drug nullified the desired effect of the other. The use of
additional therapy with the anticoagulant warfarin always requires great caution as shown by the interaction
with carbimazole resulting in a prolonged prothrombin time.
Eighteen deaths were reported in association with the use of drugs.
Two cases of hepatic failure occurred, one with an antidepressant and one with perhexiline. There was
another case of cardiac asystole following the use of salbutamol by inhalation and 2 cases of myocardial
infarction, one of these secondary to coma induced by a relative overdose of antidepressant. Four of the
deaths were related to infants with congenital abnormalities. In view of the difficulty in obtaining information
on the precise timing of the medications it is impossible to assign a relationship to the drug ingestion with
any great certainty. The National Drugs Advisory Board can only reiterate its firm recommendation that no
medication should be used in the first 12 weeks of pregnancy unless it is absolutely essential. There was
one death in an older woman who was sensitive to. sulphonamides and developed an erythroderma with
indapamide, this progressed to an exfoliative dermatitis and was complicated by a myocardial infarction,
ventricular fibrillation and consequent brain damage.
Lithium Carbonate has been known to have as one of its pharmacological actions, a capacity to inhibit
antidiuretic hormone. However recent reports suggest that the drug may also have a more direct effect on
renal tubules even at acceptable plasma levels of drug. The National Drugs Advisory Board has received
one report of renal insufficiency associated with the use of lithium carbonate. It is recommended that in
addition to frequent and regular assays of serum lithium, creatinine clearance and serum creatinine should
also be checked. One study has suggested that a reasonably simple screening procedure is the assessment
of renal concentrating ability or osmolality regularly to detect progressive change.
The case of fatal aplastic anaemia reported in association with long term use of a product containing
propyphenazone has stimulated the reformulation of the product to exclude this ingredient. Products available
without prescription should not contain ingredients capable of producing such serious side-effects.
Ibuprofen which has been on the market for about 10 years was claimed for a long time to be free of any
capacity to affect peptic ulceration or induce haematemesis. The present reports suggest that these side effects
can occur especially with long term use. In addition the National Drugs Advisory Board has had
reports of 4 cases of thrombocytoperia, one of which was fatal. Until now relatively few cases have been
reported in the literature and it is uncertain whether this is a direct toxic effect or an allergic reaction.|
|Appears in Collections: ||National Drugs Advisory Board|
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