Therapie
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Comparative Study
[Adverse drug effect notifications by nurses and comparison with cases reported by physicians].
The aim of the present study was to investigate the characteristics of adverse drug reactions reported by hospital doctors and nurses from Toulouse University Hospital between 1992 and 1993. During these two years, doctors and nurses reported 1498 and 164 adverse drug reactions respectively. Nurses reported significantly more cutaneous side effects than doctors (50 vs 24 per cent). ⋯ The more frequently suspected drugs were antiinfectious agents (35 per cent) and analgesics (7 per cent) for nurses, and neurotropic drugs (23 per cent) for doctors. Side effects reported by nurses were mainly observed after parenteral administration (48 per cent) whereas doctors reported mostly side effects seen after oral route (66 per cent). This study underlines the characteristics of adverse drug reactions which can be reported by nurses.
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Letter Case Reports
[Risk of intracerebral hematoma and profibrinolytic activity of isotretinoin].
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Colchicine has been widely used in the treatment of gout and familial mediterranean fever. Overdose is rare mostly in childhood. ⋯ The mechanism of colchicine upon the microtubules, provides a better understanding of the pharmacology and also of the multiorgan involvement. We report the case of a ten year old child who ingested 0.6 mg/kg colchicine with a good outcome.
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Cancer pain in general responds in a predictable way to analgesic drugs and drug therapy is the mainstay of treatment, successfully controlling pain in 70 to 90% of patients. Some pains do not respond so well but can usually be ameliorated by the judicious use of adjuvant analgesics, non-drug measures and the active involvement of the multi-disciplinary team.
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It is commonly recognized than opioids analgesics have an major place in the treatment of pain. In spite of guidelines, opioids drugs remain underutilized in chronic cancer pain and acute severe pain. Among the possible factors, involved in the insufficient use of opioids drugs, is the fear (opiophoby) of physicians, nurses, patients and family to induce or to maintain an addiction. ⋯ We will examined the place of morphine-like drugs in the treatment of severe acute pain and chronic cancer pain, the definition of dependency in pain patients, the assessment of the dependency potential in patients treated for pain. Available studies indicate that iatrogenic addiction is quite scarce and that the risk for a major tolerance is very small. Further studies will be necessary, since opioids analgesics may also be useful in some non-cancer chronic pain.