Expert opinion on drug safety
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Fentanyl-related deaths have created havoc with public health and safety, especially in the United States. With this increasingly apparent role as a drug of abuse in cases of overdose and death, the drug has acquired the reputation of 'killer fentanyl'. Is this fear justified? ⋯ The opioid drug, fentanyl, is involved in medical cases of complications, toxic effects, addiction, abuse, overdose and death in patients, as well as abuse among healthcare professionals. The increase of fentanyl abuse is a growing public health problem that may evolve into a global problem. However, abuse patterns of legally and illegally produced fentanyl have produced confusion because media reporters and public officials often ignore important differences in the origins of the drug itself and the people who abuse it. In the light of possible fatal and nonfatal side effects, the use of fentanyl should be reconsidered, especially in view of the new opioid drugs that are now available.
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Raloxifene is a benzothiophene, selective estrogen receptor modulator with estrogen-agonist effects in the skeleton and the cardiovascular system but estrogen-antagonist effects in the uterus and the mammary gland. This compound was first approved in different countries for the prevention and treatment of osteoporosis. ⋯ Different placebo-controlled trials indicated that raloxifene is effective in reducing invasive breast cancer risk in postmenopausal women. In a recent comparative study, a similar efficacy between raloxifene and tamoxifen for breast cancer prevention was demonstrated, but raloxifene showed a more favorable safety profile.
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At present, cephalosporins represent one of the most prescribed classes of antibiotics. Although allergic reactions have been estimated to be infrequent, the number of reactions to cephalosporins is increasing due to their wide use. Cross-reactivity with penicillins has mainly been evaluated in patients with penicillin allergy. ⋯ Unlike penicillins, cephalosporin haptens or determinants have not been defined, and therefore the diagnosis is complicated. Nevertheless, skin tests with cephalosporins are useful in the evaluation of several allergic reactions. Although more studies are necessary, a negative result in skin testing to penicillin and cephalosporins with different side chains seems to be a good predictor of tolerance, and could be used in select cases.