|Files in This Item:|
|Title: ||Reports of side effects associated with the use of drugs 1985|
|Publisher: ||National Drugs Advisory Board (NDAB)|
|Issue Date: ||1985 |
In the ten year period of 1970 to 1980 the Board received 9 reports of hepatitis (2 fatal) associated with the repeated
use of halothane. This mirrors experience in other countries. Although the mechanism of action is not as yet generally
accepted, the role of allergenicity is considered highly significant. It is recommended that where ever possible
administration of halothane should not be repeated at less than 3 monthly Intervals.
A second potential source of risk from halothane lies in its cardiodepressant action, a tendency to bradycardia, and to
arrhythmias which may lead to particular problems when the anaesthetic is administered to patients maintained on
beta-adrenoceptor blockade. It Is essential that anaesthetists be aware of medications used on patients coming
under their cam so that appropriate precaution can be taken.
This drug Is being used more frequently in the management not only of epilepsy but for other conditions. It is useful
therefore to review the types of side effects for which clinicians need to be on the alert. The most Important of these
concern the central nervous system with incoordination, drowsiness and ataxia, hypersensitivity reactions affecting
skin, liver, blood and lung particularly, and those apparently directly related to plasma levels of carbamazepine such
as the syndrome of inappropriate secretion of antidiuretic hormone.
This drug was withdrawn from the market in 1983. As has been reported in other countries its use has been associated
with cases of dependence.
The Neuroleptic Malignant Syndrome characterised by hyperthermia, semi coma to coma, muscular rigidity and
autonomic disorders is generally recognised as being most frequently associated with the high potency anti psychotic
drugs such as chlorpromazine, flupenthixol and trifluoperazine. It is less commonly known that a similar adverse
effect can develop with prolonged antihistamine therapy especially with the phenothiazines, but also with some of the
other antihistamines. Recovery is delayed with those drugs having a long half life or presented as a dep6t preparation.
The reaction can be particularly severe in the young.
It is again noteworthy that central nervous system irritability manifested as confusion, bizzare behaviour, nightmares,
hallucinations, aggression, and occasionally withdrawal syndrome, etc. occurs In some individuals in association
with drugs of this group particularly those with a short half-life, when used over prolonged periods, in association with
other centrally active drugs, or in the elderly.
It is important tl1at use of benzodiazepines should be limited to short periods of 4 to 6 weeks or less, whether the drug
is intended for Insomnia or anxiety, kept to as low a dose as possible if given concomitantly with other central nervous
system drugs, and used at minimal levels for the elderly.
This short acting benzodiazepine has been available for about 18 months as a parenterally administered anaesthetic
for short duration minor procedures. Particular care is required in its rate of administration and in the selection of
patients for its use since It has a significant propensity for cardiorespiratory functional depression|
|Appears in Collections: ||National Drugs Advisory Board|
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