Four Cases of Severe Hepatotoxicity Associated With Pemoline: Possible Autoimmune Pathogenesis

Rosh, Joel R.; Dellert, Susan F.; Narkewicz, Michael R.; Birnbaum, Adrienne; Whitington, Gene L.

doi:10.1542/peds.101.5.921

Cited by 33 publications

(8 citation statements)

References 15 publications

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“…The first case of serious hepatic abnormality ascribed to pemoline was reported in 1989 [190]. Since then, awareness on pemoline-related side effects has increased and several cases of liver failure have been linked to this agent [1,181]. Hence, the Food and Drug Administration concluded that the risk of hepatotoxicity associated with this drug outweighs its potential benefits and this led to its definitive withdrawal from the market in May 2005 [242].…”

Section: Pemolinementioning

confidence: 99%

Fatigue in multiple sclerosis – Insights into evaluation and management

Ayache

Chalah

2017

Neurophysiologie Clinique/Clinical Neurophysiology

129

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Section: Pemolinementioning

confidence: 99%

Fatigue in multiple sclerosis – Insights into evaluation and management

Ayache

Chalah

2017

Neurophysiologie Clinique/Clinical Neurophysiology

129

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“…Certain drugs, including oxyphenisatin, methyldopa, nitrofurantoin, diclofenac, interferon, infliximab, pemoline, minocycline, atorvastatin, and rosuvastatin can induce hepatocellular injury that mimics autoimmune hepatitis (1)(2)(3)(4)(5). It has also been suggested that herbal agents such as Dai-saiko-to and black cohosh might trigger autoimmune hepatitis (6).…”

mentioning

confidence: 99%

Ornidazole-induced autoimmune hepatitis

Ersöz¹,

Vardar²,

Akarca³

et al. 2011

Turk J Gastroenterol

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“…However, hepatotoxicity is an associated risk. 161,162 In summary, there are few data on the role of psychostimulants to counteract opioid-induced sedation, and further controlled trials are needed. Although psychostimulants have been proposed as a potential treatment for hypoactive-hypoalert delirium, 163 there is clearly concern regarding the potential for aggravation of perceptual disturbance, which is not an uncommon occurrence in hypoactive delirium.…”

Section: Table 8 Proposed Management Approach To Patients Presenting mentioning

confidence: 99%

The panorama of opioid‐related cognitive dysfunction in patients with cancer

Lawlor

2002

Cancer

104

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BACKGROUNDOpioids have an essential role in the management of pain in cancer patients, particularly those with advanced disease. Cognitive dysfunction is a recognized complication of opioid use. However, misconceptions and controversy surround the nature and prevalence of its occurrence. A projected increase in the aging cancer population highlights the need for a better understanding of this phenomenon.METHODSA critical appraisal of the literature evidence in relation to the pattern, pathophysiology, assessment, impact, and management of cognitive dysfunction due to opioid use in cancer pain management is given.RESULTSStudies in cancer patients with less advanced disease reveal subtle evidence of cognitive impairment, largely related to initial dosing or dose increases. In advanced cancer, opioid‐induced cognitive dysfunction usually occurs in the form of delirium, a multifactorial syndrome. The presence of both cognitive impairment and delirium frequently is misdiagnosed or missed. Potential risk factors include neuropathic and incidental pain, opioid tolerance, somatization of psychologic distress, and a history of drug or alcohol abuse. Elevation of opioid metabolites with renal impairment may contribute to cognitive dysfunction. Recognition of opioid‐related cognitive dysfunction is improved by objective screening. Successful management requires either dose reduction or a change of opioid, in addition to addressing other reversible precipitants such as dehydration or volume depletion.CONCLUSIONSOpioid‐related cognitive dysfunction tends to be subtle in the earlier stages of cancer, whereas delirium, a more florid form with behavioral disturbance is likely to be present in the advanced cancer population. In patients with advanced disease, an optimal management approach requires careful clinical assessment, identification of risk factors, objective monitoring of cognition, maintenance of adequate hydration, and either dose reduction or switching to a different opioid. Cancer 2002;94:1836–53. © 2002 American Cancer Society.DOI 10.1002/cncr.10389

show abstract

Four Cases of Severe Hepatotoxicity Associated With Pemoline: Possible Autoimmune Pathogenesis

Cited by 33 publications

References 15 publications

Fatigue in multiple sclerosis – Insights into evaluation and management

Fatigue in multiple sclerosis – Insights into evaluation and management

Ornidazole-induced autoimmune hepatitis

The panorama of opioid‐related cognitive dysfunction in patients with cancer

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