Pyrimethamine Desensitization In Cerebral Toxoplasmosis And Aids

González, Exequiel; Henríquez, Alfonso Bravo; Losada, Andrés; Huertas, B.; González, Javier Martı́nez; Berges, P.; Álvarez, E Martín

doi:10.1016/j.jaci.2006.11.285

Cited by 2 publications

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“…Ajustamos el protocolo hasta llegar a una dosis acumulada de 111,95 mcg, tal como fue aconsejado por el equipo de Endocrinología de nuestro hospital. Considerando que los protocolos reportados en la literatura mediante vía endovenosa, que poseen mayor riesgo de producir reacciones sistémicas, fueron administrando dosis cada 15 min 9,11 , fue que decidimos emular el modelo y fuimos incrementando las dosis cada 15 min, sin reacciones adversas, con una respuesta favorable. Posteriormente, la paciente siguió tolerando la dosis completa a diario, con cese de todos los síntomas que le alteraban de forma significativa su calidad de vida.…”

Section: Discussionunclassified

“…La desensibilización medicamentosa está indicada para reacciones de perfil inmediato, anafilácticas, con diferentes grupos de fármacos: antibióticos, antiinflamatorios, suplementos vitamínicos, hormonas, fármacos antineoplásicos, agentes biológicos y otros, y debe ser realizada con el paciente hospitalizado, monitorizado, en un área con personal entrenado en el manejo de reacciones alérgicas severas [8][9][10][11] .…”

Section: Servicio Alergología Hospitalunclassified

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Desensibilización a levotiroxina. Caso clínico

et al. 2018

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We report a 39-year-old female who underwent a total thyroidectomy as treatment for a thyroid papillary cancer. She suffered several episodes of mild angioedema in lips and tongue, after using different commercial Levothyroxine formulations, with and without excipients. Given the need to use this drug, the patient was admitted in our hospital and we proceeded to desensitize her with oral Levothyroxine. The patient fasted throughout the whole procedure, was properly monitored and had an adequate peripheral venous access. On the first day of the procedure, a 15-step protocol was performed, first administering placebo and then, compounded formulations of Levothyroxine starting from 0.01 ug, followed by doubling doses every 15 minutes until the cumulative dose of 111.95 ug was completed, corresponding to the daily dose of Levothyroxine her endocrinologist prescribed (112 ug). The patient was monitored at baseline, between each dose and up to 3 hours after the procedure was completed. There were no incidents such as urticaria, angioedema, or others. On the second day, the patient received a single-full dose of 112 ug on an empty stomach. The medication was successfully tolerated and she was discharged. Thereafter, she tolerates daily Levothyroxine.

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Section: Discussionunclassified

Section: Servicio Alergología Hospitalunclassified

Desensibilización a levotiroxina. Caso clínico

et al. 2018

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Drug hypersensitivity in human immunodeficiency virus-infected patient: challenging diagnosis and management

Yunihastuti

Widhani

Karjadi

2014

Asia Pacific Allergy

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Human immunodeficiency virus (HIV)-infected patients present complex immunological alterations. Multiple drugs that usually prescribed for prevention or treatment of opportunistic infections and antiretroviral pose these patients a higher risk of developing drug hypersensitivity. All antiretroviral agents and drugs to treat opportunistic infections have been reported to cause drug hypersensitivity reactions. Allergic reactions with antiretroviral are not restricted to older agents, although newer drugs usually more tolerated. Cutaneous adverse drug reactions are the most common manifestation of drug hypersensitivity in HIV, typically manifesting as maculopapular rash with or without systemic symptoms in the presence or absence of internal organ involvement. The onset of an allergic reaction is usually delayed. Severe drug hypersensitity reactions as erythema multiforme, Stevens Johnson syndrome and toxic epidermal necrolysis develop more often in HIV-infected patients compared to other populations. Mild to moderate rash without systemic symptom or organ involvement usually do not need drug discontinuation. Appropriate diagnosis and management of drug hypersensitivity reactions are essential, especially in patients with very low CD4+ T-cell count and multiple opportunistic infections. Clinicians should aware of different half-life of each drug when decided to stop the drug. Knowledge of the metabolism, recognition of the risk factors, and the ability to suggest the probability of particular drug as causative are also important points. A step wise rechallenge test or desensitization with the offending drug might be a preferable action and more commonly used in managing drug hypersensitivity in HIV-infected patients. Desensitization protocols have been successfully done for several antiretroviral and opportunistic infection drugs.

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Pyrimethamine Desensitization In Cerebral Toxoplasmosis And Aids

Cited by 2 publications

References 0 publications

Desensibilización a levotiroxina. Caso clínico

Desensibilización a levotiroxina. Caso clínico

Drug hypersensitivity in human immunodeficiency virus-infected patient: challenging diagnosis and management

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