Drug-Induced Encephalopathy

Hansen, Niels Ebbe

doi:10.5772/31172

Cited by 10 publications

(7 citation statements)

References 103 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It should, however, be noted that a deferred diagnosis of a fivefold and greater transaminases elevation or a threefold and greater elevation with symptoms is associated with high mortality risk (mainly due to hepatic failure) that may exceed 50%, unless liver transplantation is performed . Signs and symptoms of hepatotoxicity, liver failure, and eventually hepatic encephalopathy usually present late, making it harder for earlier detection of organ damage, especially if routine laboratory monitoring is not in place …”

Section: Discussionmentioning

confidence: 99%

Serious hepatotoxicity following use of isoniazid preventive therapy in HIV patients in Eritrea

Russom

Debesai

Zeregabr

et al. 2018

Pharmacology Res & Perspec

View full text Add to dashboard Cite

WHO information note indicates that isoniazid preventive therapy (IPT) is generally safe with little risk of hepatotoxicity. However, when the policy of IPT for HIV patients was introduced in Eritrea, frequent IPT‐associated hepatotoxicity and fatality have been reported to the Pharmacovigilance Centre. The aim of the study is to assess the causal association of IPT and hepatotoxicity and identify possible risk factors in patients on Highly Active Anti‐retroviral Therapy (HAART). This is a case series assessment of spontaneously reported cases to the Eritrean Pharmacovigilance Centre. Data extracted from VigiFlow (reported between 2014 and 2016) were exported to excel spread sheet for descriptive and qualitative analysis. Naranjo probability scale and Austin Bradford‐Hill criteria were used to assess causality. The P‐Method was used to assess preventability. A total of 31 of cases of hepatotoxicity related to IPT were retrieved. Majority (80.6%) of the cases were marked as “serious” due to life‐threatening situation (n = 15), hospitalization (n = 6), and death (n = 4). Baseline liver function test was normal in 61.3% and hepatitis B and C infections were ruled out in 77.4%. IPT was discontinued in 26 cases and reaction abated in 22 of them. Causality assessment using Austin Bradford‐Hill criteria found that the association was strong, consistent and specific with a plausible temporal relationship and biological mechanism. IPT‐associated hepatotoxicity that led to treatment interruption and death was observed in patients on HAART in Eritrea. Hence, close laboratory monitoring of patients is recommended to minimize the risk.

show abstract

Section: Discussionmentioning

confidence: 99%

Serious hepatotoxicity following use of isoniazid preventive therapy in HIV patients in Eritrea

Russom

Debesai

Zeregabr

et al. 2018

Pharmacology Res & Perspec

View full text Add to dashboard Cite

show abstract

“…Given that neuropsychiatric effects were evident in mefloquine's safety profile early in its history [ 14 , 16 ] and that concerns over veterans' exposure to neurotoxicants including medicines became prominent in the 1990s [ 42 – 44 ], the literature search then included the discipline of neurotoxicology. This literature describes the manifestation, symptomology, and evidentiary basis of toxic encephalopathies [ 45 – 48 ], neurotoxicity syndromes [ 49 , 50 ], methods for neurotoxicity testing [ 51 – 53 ], and risk assessment [ 54 – 57 ]. This section of the review provided a general frame of reference within which the search and analysis of literature relating specifically to mefloquine toxicity is refined.…”

Section: Methodsmentioning

confidence: 99%

Malaria Prevention, Mefloquine Neurotoxicity, Neuropsychiatric Illness, and Risk-Benefit Analysis in the Australian Defence Force

McCarthy¹

2015

Journal of Parasitology Research

View full text Add to dashboard Cite

The Australian Defence Force (ADF) has used mefloquine for malaria chemoprophylaxis since 1990. Mefloquine has been found to be a plausible cause of a chronic central nervous system toxicity syndrome and a confounding factor in the diagnosis of existing neuropsychiatric illnesses prevalent in the ADF such as posttraumatic stress disorder and traumatic brain injury. Overall health risks appear to have been mitigated by restricting the drug's use; however serious risks were realised when significant numbers of ADF personnel were subjected to clinical trials involving the drug. The full extent of the exposure, health impacts for affected individuals, and consequences for ADF health management including mental health are not yet known, but mefloquine may have caused or aggravated neuropsychiatric illness in large numbers of patients who were subsequently misdiagnosed and mistreated or otherwise failed to receive proper care. Findings in relation to chronic mefloquine neurotoxicity were foreseeable, but this eventuality appears not to have been considered during risk-benefit analyses. Thorough analysis by the ADF would have identified this long-term risk as well as other qualitative risk factors. Historical exposure of ADF personnel to mefloquine neurotoxicity now also necessitates ongoing risk monitoring and management in the overall context of broader health policies.

show abstract

“…What both terms have in common is that they refer to disturbances in the brain’s function. However, delirium is clinical, usually more acute disease entity that requires a rapid clinical response, whereas the disease entity encephalopathy, as is its nature, tends to develop slowly and sometimes only reveals subtle abnormalities, as in hepatic encephalopathy ( Wijdicks, 2016 ; Karanfilian et al, 2020 ) or drug-induced encephalopathy ( Hansen, 2012 ) including antiepileptic-drug-induced encephalopathy ( Hansen et al, 2010 ). Moreover, encephalopathies can also designate chronic brain states such as epileptic encephalopathies (for review, see Palmer et al, 2021 ) often sharing a genetic cause and encompassing a broad spectrum of developmental electroclinical syndromes characterized by subtle seizures and intellectual disabilities (like those caused by epileptic encephalopathies associated with KCNT1 mutations) ( Ohba et al, 2015 ; Hansen et al, 2017 ).…”

Section: Functionality Of the Locus Coeruleus In Deliriummentioning

confidence: 99%

The Locus Coeruleus Noradrenaline System in Delirium

Hansen

Rediske

2021

Front. Aging Neurosci.

Self Cite

View full text Add to dashboard Cite

Delirium is a brain state involving severe brain dysfunction affecting cognitive and attentional capacities. Our opinion statement review aims to elucidate the relationship between abnormal arousal and locus coeruleus (LC) activity in cognitive dysfunction and inattention in delirium states. We propose (1) that enhanced noradrenaline release caused by altered arousal in hyperactive delirium states leads to increased noradrenergic transmission within the LC and subcortical and cortical brain regions including the prefrontal cortex and hippocampus, thus affecting how attention and cognition function. In hypoactive delirium states, however, we are presuming (2) that less arousal will cause the release of noradrenaline to diminish in the LC, followed by reduced noradrenergic transmission in cortical and subcortical brain areas concentrated within the prefrontal cortex and hippocampus, leading to deficient attention and cognitive processing. Studies addressing the measurement of noradrenaline and its derivatives in biomaterial probes regarding delirium are also covered in this article. In conclusion, the LC-NA system plays a crucial role in generating delirium. Yet there have been no large-scale studies investigating biomarkers of noradrenaline to help us draw conclusions for improving delirium’s diagnosis, treatment, and prognosis, and to better understand its pathogenesis.

show abstract

Drug-Induced Encephalopathy

Cited by 10 publications

References 103 publications

Serious hepatotoxicity following use of isoniazid preventive therapy in HIV patients in Eritrea

Serious hepatotoxicity following use of isoniazid preventive therapy in HIV patients in Eritrea

Malaria Prevention, Mefloquine Neurotoxicity, Neuropsychiatric Illness, and Risk-Benefit Analysis in the Australian Defence Force

The Locus Coeruleus Noradrenaline System in Delirium

Contact Info

Product

Resources

About