Leucopenia associated with metamizole: a case-control study.

Aims Of The Study: The aim of this study was to identify possible risk factors for the development of leucopenia associated with metamizole use.

Methods: A retrospective case-control study was performed. Cases of metamizole-associated leucopenia managed at a single centre (2005-2013) were characterised and compared with matched controls who took metamizole without developing complications.

Leucopenia associated with metamizole: a case-control study.

Aims Of The Study: The aim of this study was to identify possible risk factors for the development of leucopenia associated with metamizole use.

Methods: A retrospective case-control study was performed. Cases of metamizole-associated leucopenia managed at a single centre (2005-2013) were characterised and compared with matched controls who took metamizole without developing complications.

Pharmacokinetic interaction between taxanes and amiodarone leading to severe toxicity.

Adverse Event: A drug interaction leading to severe skin and mucosal toxicity.

Drugs Implicated: Paclitaxel, docetaxel and amiodarone.

The Patient: A 77-year-old woman with a history of hypertension, hyperlipidemia, and palpitations, managed with amiodarone, was treated for HER2-positive invasive ductal breast cancer with paclitaxel and trastuzumab as an adjunct to surgery.

Successful Treatment of a Pacemaker Infection with Intraperitoneal Daptomycin.

We investigated the pharmacokinetics of intraperitoneal administration of daptomcyin in a peritoneal dialysis (PD) patient treated for a pacemaker infection with Staphylococcus epidermidis. After initial start of intravenous daptomycin at 9 mg/kg body weight every 48 hours, the therapy was switched to intraperitoneal administration of 5.3 mg/kg body weight in 1 L icodextrin 7.

[Drug-induced sexual dysfunction].

Drugs can affect sexual function through their effects on the central nervous system, the peripheral (autonomic) nervous system or through hormonal effects. As most patients do not spontaneously talk about their sex life, it is important to assess patients with critical medication for possible sexual dysfunction. Critical medication in relation to sexual function include sedative drugs, drugs that affect the central serotonin, dopamine and/ or prolactin signaling pathways as well as certain antihypertensives.

[ Preventing adverse drug events using clinical decision support systems].

Adverse drug events pose a great risk to patients, are an everyday clinical problem and can have potential/ega/ consequences. Computerized physician order entry or computerized provider order entry (CPOE} in combination with clinical decision support systems {CDSS) are popular and aim to reduce prescribing errors as well as identifying potentially harmful drug drug interactions. The quantifiable benejit these systems bring to patients, has however, yet to be definitively proven.

Breakthrough Pain Associated with a Reduction in Serum Buprenorphine Concentration during Dialysis.

Purpose: To describe a case of breakthrough pain associated with a reduction in serum buprenorphine concentration during dialysis.

Methods: Pharmacokinetic sampling of total and free buprenorphine and norbuprenorphine in an 80 year old male undergoing haemodialysis three times per week who received 5760 µg oral and transdermal buprenorphine daily was performed. The patient's serum albumin concentration was 23g/l (reference range: 35-52 g/l).

Acute sirolimus overdose: a multicenter case series.

Background: There are few data relating to sirolimus overdose in the medical literature. Our objectives were to describe all cases of overdose with sirolimus reported to Swiss, German and Austrian Poisons Centres between 2002-2013.

Methods: An observational case-series analysis was performed to determine circumstances, magnitude, management and outcome of sirolimus overdose.

[Fatal agranulocytosis after metamizole reexposure].

We present the case of a 63 year old man who died of severe septic shock in the setting of agranulocytosis induced by dipyrone (metamizole). The patient had previously developed agranulocytosis after dipyrone exposure 18 months prior to this. The case illustrates the seriousness of dipyrone-induced agranulocytosis, highlights the risks associated with re-exposure and underlines the need for excellent communication between treating physicians and their patients.

An open-label study examining the effect of pharmacological treatment on mannitol- and exercise-induced airway hyperresponsiveness in asthmatic children and adolescents with exercise-induced bronchoconstriction.

Background: Mannitol- and exercise bronchial provocation tests are both used to diagnose exercise-induced bronchoconstriction. The study aim was to compare the short-term treatment response to budesonide and montelukast on airway hyperresponsiveness to mannitol challenge test and to exercise challenge test in children and adolescents with exercise-induced bronchoconstriction.

Methods: Patients were recruited from a paediatric asthma rehabilitation clinic located in the Swiss Alps.

A study of the relationship between serum bile acids and propranolol pharmacokinetics and pharmacodynamics in patients with liver cirrhosis and in healthy controls.

The main objectives of the study were to determine the exposure and bioavailability of oral propranolol and to investigate their associations with serum bile acid concentration in patients with liver cirrhosis and in healthy controls. A further objective was to study the pharmacodynamics of propranolol. An open-label crossover study was performed to determine the pharmacokinetics and pharmacodynamics of propranolol after oral (40 mg) and intravenous (1 mg) administration as well as the concentration of total and individual fasting serum bile acids in 15 patients with liver cirrhosis and 5 healthy controls.

Acute mycophenolate overdose: case series and systematic literature analysis.

Background: Literature regarding acute human toxicity of mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS) is limited.

Objectives: Our objectives were to describe all cases of overdose with MMF or EC-MPS reported to the Swiss Toxicological Information Centre (STIC) or in the literature between 1995 and 2013. Therefore, we performed an observational case-series and systematic literature search to determine circumstances, magnitude, management and outcome of overdose with MMF or EC-MPS.

Acute thiopurine overdose: analysis of reports to a National Poison Centre 1995-2013.

Literature regarding acute human toxicity of thiopurines is limited to a handful of case reports. Our objectives were to describe all cases of overdose with thiopurines reported to the Swiss Toxicological Information Centre between 1995-2013. A retrospective analysis was performed to determine circumstances, magnitude, management and outcome of overdose with these substances.

AMP deaminase 1 gene polymorphism and heart disease-a genetic association that highlights new treatment.

Nucleotide metabolism and signalling is directly linked to myocardial function. Therefore analysis how diversity of genes coding nucleotide metabolism related proteins affects clinical progress of heart disease could provide valuable information for development of new treatments. Several studies identified that polymorphism of AMP deaminase 1 gene (AMPD1), in particular the common C34T variant of this gene was found to benefit patients with heart failure and ischemic heart disease.

Bronchial hyperresponsiveness testing in athletes of the Swiss Paralympic team.

Background: The aim of this study was to assess airway hyperresponsiveness to eucapnic voluntary hyperventilation and dry powder mannitol challenge in athletes aiming to participate at the Paralympic Games 2008 in Beijing, especially in athletes with spinal cord injury.

Methods: Forty-four athletes with a disability (27 with paraplegia (group 1), 3 with tetraplegia (group 2) and 14 with other disabilities such as blindness or single limb amputations (group 3) performed spirometry, skin prick testing, measurement of exhaled nitric oxide, eucapnic voluntary hyperventilation challenge test (EVH) and mannitol challenge test (MCT). A fall in FEV1 of ≥10% in either challenge test was deemed positive for exercise-induced bronchoconstriction.

Roflumilast--a phosphodiesterase-4 inhibitor licensed for add-on therapy in severe COPD.

Roflumilast is a selective phosphodiesterase 4 inhibitor which has been licensed in the European Union since 2010 and in Switzerland since November 2011 as an add-on treatment for patients with chronic obstructive pulmonary disease (COPD) in GOLD (Global Initiative for Chronic Obstructive Lung Disease) stages 3 and 4 (FEV(1) <50% predicted after bronchodilatation) and frequent exacerbations despite correctly-dosed therapy with a long-acting bronchodilator. Roflumilast is designed to target both the systemic and pulmonary inflammation associated with COPD. In this review roflumilast's chemistry, pharmacodynamics, pharmacokinetics, clinical efficacy, safety and tolerability and the current ongoing clinical trials involving roflumilast are outlined.

Drug-related problems and factors influencing acceptance of clinical pharmacologists` alerts in a large cohort of neurology inpatients.

Questions Under Study/principles: Data regarding the prevalence and types of drug-related problems (DRPs) among neurology inpatients is sparse. The objective of this study was to characterise the types of DRPs seen among neurology inpatients and furthermore to study factors affecting the acceptance of clinical pharmacologists' and pharmacists' recommendations for improving drug safety.

Methods: 1,263 consecutive inpatient cases in a Swiss university hospital neurology unit were assessed for the presence of DRPs over 12 months.

Toxicity of clopidogrel and ticlopidine on human myeloid progenitor cells: importance of metabolites.

Ticlopidine and clopidogrel are thienopyridine derivatives used for inhibition of platelet aggregation. Not only hepatotoxicity, but also bone marrow toxicity may limit their use. Aims of the study were to find out whether non-metabolized drug and/or metabolites are responsible for myelotoxicity and whether the inactive clopidogrel metabolite clopidogrel carboxylate contributes to myelotoxicity.

Response to add-on inhaled corticosteroids in COPD based on airway hyperresponsiveness to mannitol.

Background: The use of inhaled corticosteroids in mild to moderate COPD is controversial. The aim of this study was to determine whether airway hyperresponsiveness to mannitol might identify patients who are likely to respond to add-on inhaled corticosteroids.

Methods: Ninety subjects with mild to moderate COPD were recruited and 68 subsequently randomized in a double-blind manner to receive inhaled budesonide (1,600 μg/d, n = 31) or placebo (n = 37) for 3 months.