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Amoxicillin/clavulanic acid-associated severe neutropenia
A 72-year-old man presented with an abnormal blood count and was admitted. His history included hypertension and hyperlipidaemia with an old myocardial infarction and mild stroke; liver cirrhosis due to non-alcoholic steatohepatitis (NASH) with hypersplenism and oesophageal varices but no ascites, oedema or bleeding; and benign prostatic hypertrophy. His medications (unchanged for years) included furosemide, spironolactone, bisoprolol, rosuvastatin, alfuzosin and omeprazole. Two weeks prior, he was discharged from our department after left leg cellulitis and Streptococcus pyogenes bacteraemia responsive to parenteral clind...
Source: Postgraduate Medical Journal - March 22, 2022 Category: General Medicine Authors: Schattner, A., Dubin, I. Tags: Adverse drug reactions Source Type: research

Preventable Cases of Oral Anticoagulant-Induced Bleeding: Data From the Spontaneous Reporting System
Conclusion: Our findings describe the most reported risk factors for preventability of oral anticoagulant-induced bleedings. These factors may be useful for targeting interventions to improve pharmacovigilance activities in our regional territory and to reduce the burden of medication errors and inappropriate prescription. Introduction Oral anticoagulant therapy is widely used for the prevention of stroke and systemic embolism in patients with atrial fibrillation, or for the prevention and treatment of deep vein thrombosis and pulmonary embolism (Raj et al., 1994; Monaco et al., 2017). Oral anticoagulants can be di...
Source: Frontiers in Pharmacology - April 29, 2019 Category: Drugs & Pharmacology Source Type: research

Interaction between warfarin and astaxanthin: A case report
This report explains the potential interaction between warfarin and astaxanthin in a 69-year-old Thai woman with history of ischemic stroke. Before taking astaxanthin, the patient used constant doses of warfarin, atenolol, digoxin, aspirin, omeprazole, and simvastatin concomitantly for 17 days without any signs and symptoms of adverse events. One day after astaxanthin was supplemented to her treatment regimen, ecchymosis was found on the right side of her groin and thigh. On the next day, area of ecchymosis was larger. International normalized ratio (INR) values increased from 1.4 to 10.38. Warfarin and astaxanthin were wi...
Source: Journal of Cardiology Cases - February 19, 2019 Category: Cardiology Source Type: research

Dabigatran in patients with myocardial injury after non-cardiac surgery (MANAGE): an international, randomised, placebo-controlled trial
Publication date: 9–15 June 2018 Source:The Lancet, Volume 391, Issue 10137 Author(s): P J Devereaux, Emmanuelle Duceppe, Gordon Guyatt, Vikas Tandon, Reitze Rodseth, Bruce M Biccard, Denis Xavier, Wojciech Szczeklik, Christian S Meyhoff, Jessica Vincent, Maria Grazia Franzosi, Sadeesh K Srinathan, Jason Erb, Patrick Magloire, John Neary, Mangala Rao, Prashant V Rahate, Navneet K Chaudhry, Bongani Mayosi, Miriam de Nadal, Pilar Paniagua Iglesias, Otavio Berwanger, Juan Carlos Villar, Fernando Botto, John W Eikelboom, Daniel I Sessler, Clive Kearon, Shirley Pettit, Mukul Sharma, Stuart J Connolly, Shrikant I Bangdiwala, ...
Source: The Lancet - June 8, 2018 Category: General Medicine Source Type: research

Design of a Randomized Placebo-Controlled Trial to Assess Dabigatran and Omeprazole in Patients with Myocardial Injury after Noncardiac Surgery (MANAGE)
Conclusion MANAGE is the first randomized controlled trial to evaluate a potential treatment of patients who suffered MINS.
Source: Canadian Journal of Cardiology - February 3, 2018 Category: Cardiology Source Type: research

Heartburn drugs linked to premature death
Conclusion This larger set of observational data finds that PPI drugs are associated with an increase in the risk of early death compared with either H2 blockers or no acid suppression drugs. This was the case for participants both with and without gastrointestinal problems. It also appears as though the longer the PPIs drugs are taken, the greater the risk of death. Considering that these drugs are widely used in the UK, these findings may cause concern. But the research has a number of important limitations: The study was conducted in a population of mostly white, older US male veterans, which might limit the ability...
Source: NHS News Feed - July 4, 2017 Category: Consumer Health News Tags: Medication Source Type: news

Patient-centered Outcomes with Concomitant Use of Proton Pump Inhibitors and Other Drugs.
Abstract PURPOSE: We performed a systematic review of patient-centered outcomes after the concomitant use of proton pump inhibitors (PPIs) and other drugs. METHODS: We searched 4 databases in July 2016 to find studies that reported mortality and morbidity after the concomitant use of PPIs and other drugs. We conducted direct meta-analyses using a random-effects model and graded the quality of evidence according to the Grading of Recommendations Assessment, Development and Evaluation working group approach. FINDINGS: We included data from 17 systematic reviews and meta-analyses, 16 randomized controlled t...
Source: Clinical Therapeutics - February 8, 2017 Category: Drugs & Pharmacology Authors: Shamliyan TA, Middleton M, Borst C Tags: Clin Ther Source Type: research

Link between indigestion drugs and dementia 'inconclusive'
Conclusion This study found people taking PPIs had a 44% higher risk of developing dementia in a seven-year period compared with those not taking the drugs. However, it's not accurate to say this was down to the PPIs – the study couldn't prove this, and there are many possible explanations. For a start, the groups weren't very similar. Those taking PPIs had poorer health, and were more likely to be taking a number of medicines and have conditions linked to a higher risk of dementia, such as diabetes and heart disease. After taking these factors into account in the analysis, the link between PPIs and dementia reduc...
Source: NHS News Feed - February 16, 2016 Category: Consumer Health News Tags: Medication Neurology Older people Source Type: news

Conflicting Results Between Randomized Trials and Observational Studies on the Impact of Proton Pump Inhibitors on Cardiovascular Events When Coadministered With Dual Antiplatelet Therapy: Systematic Review Original Articles
Conclusions— Large, well-conducted observational studies of PPIs and randomized controlled trials of omeprazole seem to provide conflicting results for the effect of PPIs on cardiovascular outcomes when coadministered with DAPT. Prospective trials that directly compare pharmacodynamic parameters and clinical events among specific PPI agents in patients with unstable angina/non–ST-segment–elevation myocardial infarction treated with DAPT are warranted.
Source: Circulation: Cardiovascular Quality and Outcomes - January 20, 2015 Category: Cardiology Authors: Melloni, C., Washam, J. B., Jones, W. S., Halim, S. A., Hasselblad, V., Mayer, S. B., Heidenfelder, B. L., Dolor, R. J. Tags: Secondary prevention Original Articles Source Type: research

Effect of omeprazole on the concentration of interleukin-6 and transforming growth factor-β1 in patients receiving dual antiplatelet therapy after percutaneous coronary intervention.
Authors: Hudzik B, Szkodzinski J, Danikiewicz A, Wilczek K, Romanowski W, Lekston A, Polonski L, Zubelewicz-Szkodzinska B Abstract BACKGROUND: Dual antiplatelet therapy (aspirin plus clopidogrel) is recommended in patients undergoing percutaneous coronary intervention (PCI). Treatment with proton pump inhibitors (PPIs) decreases bleeding rate. Alarming reports have been made that PPIs may decrease the antiplatelet activity of clopidogrel. We sought to determine whether levels of interleukin-6 (IL-6) and transforming growth factor-β1 (TGF-β1) might help distinguish individuals at risk for adverse events. METHO...
Source: European Cytokine Network - November 25, 2014 Category: Neuroscience Tags: Eur Cytokine Netw Source Type: research

Daily low-dose aspirin can prevent heart attack and stroke but is often misused
Aspirin is often hailed as a wonder drug, thanks to its ability to help stave off heart attacks and clot-caused strokes. But fewer than half of people who could benefit from a daily low-dose aspirin take it, while many others take it when they shouldn't, reports the January 2014 Harvard Heart Letter. If you don't have heart disease, but do have high blood pressure, diabetes, or other risk factors for heart disease, don't automatically assume that taking aspirin every day is a good idea. "A lot of people take aspirin who really shouldn't," says Dr. Christopher Cannon, a cardiologist at Brigham and Women's Hospital and profe...
Source: New Harvard Health Information - December 20, 2013 Category: Consumer Health News Source Type: news

Taking over the counter pain relievers safely
For aching joints or a throbbing head, millions of Americans turn to aspirin, ibuprofen (Advil, Motrin), or other nonsteroidal anti-inflammatory drugs (NSAIDs) every day. They are generally safe, but if not used carefully NSAIDs can have a dark side, according to the September 2013 Harvard Women's Health Watch. NSAIDs are widely used because they perform double duty. “They not only relieve pain, but they reduce inflammation too,” says Dr. Lucy Chen, an assistant professor at Harvard Medical School and attending physician in the anesthesia, critical care, and pain medicine department at Massachusetts General Hos...
Source: New Harvard Health Information - August 23, 2013 Category: Consumer Health News Source Type: news