(British Approved Name, rINN) Drug Nomenclature International Nonproprietary Names (INNs) in main languages (French, Latin, Russian, and Spanish): Synonyms: CenTNF; Infliksimabi; Infliximab; Infliximabum; cA2 BAN: Infliximab INN: Infliximab [rINN (en)] INN: Infliximab [rINN (es)] INN: Infliximab [rINN (fr)] INN: Infliximabum [rINN (la)] INN: Инфликсимаб [rINN (ru)] CAS: 170277-31-3 ATC code: L04AA12 Adverse Effects, Treatment, and Precautions Acute infusion reactions during or within 1 to 2 hours of infusion are common with infliximab, and other TNF inhibitors, particularly with the first or second dose. Symptoms include fever, chills, pruritus, urticaria, dyspnoea, chest pain, and hypertension or hypotension. Mild reactions may respond …
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(British Approved Name, US Adopted Name, rINN) Drug Nomenclature International Nonproprietary Names (INNs) in main languages (French, Latin, Russian, and Spanish): Synonyms: Adalimumab; D2E7; LU-200134 BAN: Adalimumab USAN: Adalimumab INN: Adalimumab [rINN (en)] INN: Adalimumab [rINN (es)] INN: Adalimumab [rINN (fr)] INN: Adalimumabum [rINN (la)] INN: Адалимумаб [rINN (ru)] CAS: 331731-18-1 ATC code: L04AA17 Adverse Effects and Precautions As for Infliximab. Injection site reactions including erythema, itching, pain, and swelling are the most common adverse reactions with adalimumab however, most reactions are mild and do not result in drug withdrawal. Other common reactions include headache, rashes, back pain, hypertension, paraesthesias, increased alkaline phosphate levels, …
[ Continue Reading... ](British Approved Name, US Adopted Name, rINN) Drug Nomenclature International Nonproprietary Names (INNs) in main languages (French, Latin, Russian, and Spanish): Synonyms: BMS-188667; CTLA4-Ig BAN: Abatacept USAN: Abatacept INN: Abatacept [rINN (en)] INN: Abatacept [rINN (es)] INN: Abatacept [rINN (fr)] INN: Abataceptum [rINN (la)] INN: Абатацепт [rINN (ru)] CAS: 332348-12-6 Adverse Effects and Precautions Acute infusion reactions occurring within 1 hour of starting an infusion are common with abatacept use. The most frequently reported infusion events are dizziness, headache, and hypertension hypotension and dyspnoea occur less commonly. Other acute events include nausea, flushing, pruritus, rash, and wheezing. Most events are usually mild to moderate …
[ Continue Reading... ]Other Mechanisms Inducing Hypocalcemia Calcium Complexation: Many agents can induce hypocalcemia by causing complexes to form between the medication and serum calcium.This complexation of calcium is so rapid and massive that maximal PTH secretion is inadequate to compensate for the sudden drop in serum calcium. A classic example of this phenomenon is foscarnet, an antiviral agent often used in immunocompromised patients. Foscarnet chelates with calcium, resulting in a reduction in both total and ionized calcium serum levels. Ethylene glycol has also been identified with this complexation phenomenon. Altered Gastric Acidity: Medications that alter gastric acidity may also impact the absorption of calcium from …
[ Continue Reading... ]Glucocorticoid Therapy and Bone Loss Patients receiving long-term glucocorticoid therapy for conditions such as inflammatory bowel disease and rheumatoid arthritis are also at risk of developing drug-induced bone loss. This effect appears to depend on dose and duration of therapy. Most bone loss has been documented to occur during initiation of treatment, with eventual plateaus achieved within 6 months to 1 year of therapy. Atraumatic fractures involving the vertebrae and ribs are seen in 30% to 50% of patients receiving chronic steroid therapy. There are several mechanisms associated with glucocorticoid-induced bone loss. Steroids decrease bone remodeling by inhibiting osteoblast maturation and subsequent bone formation. …
[ Continue Reading... ]Agents That Impair Absorption of Calcium Medications that impair the absorption of calcium can have a negative impact on serum calcium levels. The malabsorption of calcium has been documented in patients receiving colchicine, mineral oil, or sodium sulfonated polystyrene resin. Similarly, agents known to enhance the renal excretion of calcium — such as loop diuretics — also predispose patients to hypocalcemia. Magnesium Depletion: In addition to medications that directly alter serum calcium levels, agents that deplete the body of magnesium ultimately cause hypocalcemia. In fact, drug-induced hypocalcemia is often due to a depletion of magnesium stores. Magnesium deficiency can induce a transient hypoparathyroidism by reducing the …
[ Continue Reading... ]Agents That Impair Absorption of Vitamin D Older Anticonvulsants: Older anticonvulsants, such as carbamazepine, phenobarbital and phenytoin, have been associated with drug-induced osteomalcia.It has been postulated that these agents increase the degradation of 25(OH)D3, the predominant circulating metabolite. However, many early studies were confounded because they were conducted on institutionalized patients who were predisposed to other risk factors, such as poor dietary vitamin D intake and/or reduced exposure to sunlight. Tolman and colleagues reported a positive correlation between the incidence of osteomalacia and the duration of anticonvulsant therapy; they documented the development of bone disease in over 75% …
[ Continue Reading... ]One of the most prevalent of the degenerative diseases in the United States today, osteoporosis affects over 10 million individuals. An additional 18 million are at risk of osteoporosis due to low bone density. The majority of patients affected are postmenopausal females. The number of cases of osteoporosis is expected to rise substantially in the next several decades, as life expectancy increases and the world population expands. This growing elderly population inevitably will be affected by multiple pathological processes that require drug therapy. Unfortunately, some medications may cause hypocalcemia and accelerate bone loss. Patients who experience these effects can present with osteoporosis, osteopenia, and/or …
[ Continue Reading... ]Calcium plus estrogen leads to stronger bones. By consuming large amounts of calcium, women who are taking estrogen replacement therapy will have denser, stronger bones than women on HRT alone, concludes an analysis of 31 earlier studies. By adding calcium to the diet, the benefits of HRT were doubled. Calcium consumption averaged 1,183 mg per day in women who took supplements, compared to consumption of 563 mg per day in women who did not take supplements. Calcium may have a synergistic effect on estrogen and it also may be more effective than estrogen alone in increasing bone mass in the hip and forearm where estrogen is less effective.
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