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Drug toxicity: Idiosyncratic Reactions01:16

Drug toxicity: Idiosyncratic Reactions

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Idiosyncratic drug reactions represent abnormal chemical responses that vary significantly among individuals, ranging from extreme sensitivity to low doses to insensitivity to high doses. These reactions often occur due to the drug's covalent binding with serum proteins, forming a foreign hapten that triggers an immunotoxicological response. The variability in drug reactions has a strong pharmacogenetic foundation, with genetic differences crucial in how individuals metabolize drugs. For...
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Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists01:27

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5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
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Drug Toxicity: Allergic Reactions01:30

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Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial...
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Renal Failure: Dose Adjustments01:11

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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
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Drug Toxicity: Risk factors01:24

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Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
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Chemotherapy-Induced Nausea and Vomiting: Dopamine Receptor Antagonists01:29

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Dopamine receptor antagonists, also known as antipsychotic agents, are critical in managing chemotherapy-induced vomiting. These antiemetic agents block dopamine receptors in the chemoreceptor trigger zone (CTZ), inhibiting signal transmission to the vomiting center. Antipsychotic agents encompass phenothiazines (PTZ), butyrophenones, benzamides, and thienobenzodiazepines (Zyprexa), which are utilized for their antiemetic and sedative properties.
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Risperidone-induced reversible neutropenia.

Vasanth Kattalai Kailasam1, Victoria Chima2, Uchechukwu Nnamdi3

  • 1College of Medicine, University of Illinois, Chicago, IL, USA.

Neuropsychiatric Disease and Treatment
|August 11, 2017
PubMed
Summary
This summary is machine-generated.

A patient with schizophrenia developed neutropenia (low white blood cell count) while taking risperidone. Symptoms improved after stopping risperidone and switching to olanzapine, highlighting a potential adverse effect of this antipsychotic.

Keywords:
antipsychoticsblood dyscrasiasneutropeniarisperidone

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Area of Science:

  • Psychiatry
  • Pharmacology
  • Hematology

Background:

  • Schizophrenia treatment often involves antipsychotic medications.
  • Risperidone is a commonly prescribed second-generation antipsychotic.
  • Neutropenia is a potential, though rare, adverse effect of some antipsychotics.

Observation:

  • A 44-year-old male patient with schizophrenia experienced neutropenia during risperidone therapy.
  • Laboratory results indicated a progressive decrease in leukocytes and neutrophils.
  • Neutropenia resolved upon discontinuation of risperidone and recurred upon rechallenging.

Findings:

  • The case demonstrates a clear link between risperidone use and the development of neutropenia.
  • Switching to olanzapine successfully reversed the neutropenia.
  • This suggests a potential drug-induced neutropenia attributable to risperidone.

Implications:

  • Clinicians should monitor white blood cell counts in patients on risperidone, especially those with risk factors.
  • Early recognition and management of risperidone-induced neutropenia are crucial.
  • This case contributes to the understanding of adverse drug reactions in psychiatric pharmacotherapy.