Acute Kidney Injury ; chemically induced ; Anti-Infective Agents ; adverse effects ; Child, Preschool ; Humans ; Male ; Organometallic Compounds ; adverse effects

Anaphylaxis ; chemically induced ; diagnosis ; Anti-Infective Agents, Local ; adverse effects ; Chlorhexidine ; adverse effects ; Humans ; Male ; Middle Aged

Anti-Bacterial Agents ; adverse effects ; Anti-Infective Agents ; adverse effects ; Anti-Inflammatory Agents ; adverse effects ; Biomarkers ; blood ; Chemical and Drug Induced Liver Injury ; diagnosis ; epidemiology ; Child ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Liver ; drug effects ; metabolism ; pathology ; Pediatrics ; Risk Factors

Adverse Drug Reaction Reporting Systems ; Anti-Infective Agents ; administration & dosage ; adverse effects ; therapeutic use ; Child ; Humans ; Safety

As a traditional Chinese medicine, Valeriana jatamansi has a long history of application in China. It is widely distributed and commonly adopted by many ethnic groups. In particular, its roots have a wide range of medicinal value. With the increasingly more attention on it from domestic and foreign researchers, there have been more and more studies on its pharmacological activity and mechanism. This essay summarizes domestic and foreign reports on its pharmacological activity and mechanism.
Animals ; Anti-Infective Agents ; pharmacology ; Antihypertensive Agents ; pharmacology ; Antineoplastic Agents, Phytogenic ; pharmacology ; Central Nervous System Depressants ; pharmacology ; Gastrointestinal Tract ; drug effects ; Humans ; Plant Extracts ; adverse effects ; pharmacology ; Valerian

OBJECTIVETo explore the categories of drugs causing hepatotoxicity and analyze the clinical and histological features of the corresponding drug-induced liver injury (DILI), in order to gain insights into potential diagnostic factors for DILI.

METHODSA total of 138 DILI patients treated at our hospital from April 2008 to April 2010 were retrospectively analyzed. The responsible drug for each DILI case was recorded. The Roussel Uclaf Causality Assessment Method (RUCAM) had been used to diagnose DILI. Only cases that had scored as highly probable or probable (more than or equal to 6 points by RUCAM) were included in this study. The patients' general condition, clinical manifestations, and serum biochemical and immunological parameters were assessed. Sixty-six of the patients underwent liver biopsy, and were assessed for liver pathological changes. Clinical and laboratory test data were collected and used to classify the total 138 cases as hepatocellular injury, cholestatic, or mixed hepatocellular-cholestatic types.

RESULTSWithin our patient population, the leading cause of DILI was Chinese herb medicine, accounting for 53.62% of cases. Antibiotics were implicated in 7.97% of cases, and dietary supplement in 6.52% of cases. Correlation between the clinical features and histological injury pattern was stronger at the time of biopsy (more than or equal to 3 days after laboratory results) (kappa = 0.63, P less than 0.05) than at the onset of DILI (kappa = 0.25, P less than 0.05). All modified hepatic activity index (HAI) necroinflammatory scores and fibrosis scores were more severe in the cholestatic and mixed injury types than in the hepatocellular injury type (P less than 0.01 and P less than 0.05, respectively).

CONCLUSIONChinese herbal medicine, dietary supplements and antibiotics were the main causes of DILI in our patient population. The clinical and histological features correlated well, especially at later stages of DILI. The degree of inflammation and fibrosis was significantly higher in cholestatic and mixed hepatocellular-cholestatic injury types than in the hepatocellular injury type. Assessment of both clinical and pathological features may represent a more accurate diagnostic method for DILI.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; adverse effects ; Anti-Infective Agents ; adverse effects ; Chemical and Drug Induced Liver Injury ; pathology ; Drugs, Chinese Herbal ; adverse effects ; Female ; Humans ; Liver ; pathology ; Male ; Middle Aged ; Young Adult

Metronidazole is a 5-nitroimidazole compound known as an antimicrobial agent widely used for the treatment of protozoal infection, anaerobic infection, Helicobacter pylori infection and hepatic encephalopathy. It may produce a number of neurologic side effects including peripheral neuropathy, seizure, encephalopathy, ataxic gait and dysarthritic speech. There have been ten or more reports of metronidazole-induced encephalopathy in the literatures including a few reports of brain imaging changes by magnetic resonance images (MRI). However, none of the case of metronidazole-induced encephalopathy in patients with hepatic encephalopathy has been reported yet. Recently, we experienced two cases of metronidazole-induced encephalopathy in patients with liver cirrhosis caused by chronic hepatitis B, which were diagnosed by brain MRI and MR spectroscopy. In this report, we present 2 cases of metronidazole-induced encephalopathy with MR imaging and MR spectroscopic changes including follow- up imaging performed after the discontinuation of the metronidazole with a review of the literatures.
Anti-Infective Agents/*adverse effects ; Brain Diseases/*chemically induced/diagnosis ; English Abstract ; Female ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Male ; Metronidazole/*adverse effects ; Middle Aged

Acetamides ; adverse effects ; therapeutic use ; Anti-Infective Agents ; Female ; Humans ; Infant, Newborn ; Linezolid ; Male ; Oxazolidinones ; adverse effects ; therapeutic use ; Sepsis ; drug therapy

OBJECTIVE: To summarize the occurrences of adverse drug reactions (ADR) of gatifloxacin, and to guide the rational usage of antibacterial agents in clinical practice in the future. METHODS: A total of 1 077 ADR patient who received gatifloxacin were retrospectively studied in Hunan province from August 2003 to July 2007. RESULTS: Gatifloxacin could cause multi-system and multi-organ ADRs with wide variety of clinical manifestations. Of the 1 077 ADR patients, ADR incidence rate was slightly lower in males than that in females, the age of 821 (76.23%) ADR patients were 20 approximately 59 years; 905 (84.03%) were administered intravenously; and 682 (33.07%) had severe lesions of the digestive system, followed by lesions of the skin and the appendants (490 cases, 23.76%) and the nervous system (298 cases, 14.45%). CONCLUSION ADR caused by gatifloxacin should be monitored and reported so as to reduce or avoid ADR.
Adolescent ; Adult ; Adverse Drug Reaction Reporting Systems ; Aged ; Aged, 80 and over ; Anti-Infective Agents ; adverse effects ; Child ; Child, Preschool ; China ; Drug-Related Side Effects and Adverse Reactions ; Female ; Fluoroquinolones ; adverse effects ; Gatifloxacin ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Benzalkonium chloride (BAC) is commonly used as a bactericidal preservative in nebulizer solutions, and can cause paradoxical onchoconstriction following nebulizing therapy in some asthmatics. We describe a case of anaphylactic shock in a 23-yr-old asthmatic woman following an intradermal skin test with a salbutamol solution containing BAC. Since she complained of cough and dyspnea after inhalation therapy with a nebulizer solution, we conducted an intradermal skin test using the same solution, which contained BAC. About 10 min later, the patient reported dizziness, palpitations, and dyspnea. On examination, tachycardia, tachypnea, and hypotension were found. She was resuscitated with a subcutaneous injection of epinephrine and an infusion of saline. One month later, we conducted a bronchial provocation test with BAC, and she showed a positive response.
Adult ; Anaphylaxis/*chemically induced ; Anti-Asthmatic Agents/administration & dosage ; Anti-Infective Agents, Local/*adverse effects ; Asthma/*drug therapy ; Benzalkonium Compounds/*adverse effects ; Female ; Human ; Nebulizers and Vaporizers ; Support, Non-U.S. Gov't