Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ranitidine was first marketed in 1981; since then many patients have been treated such that much experience has been accumulated on the safety of this histamine H2-receptor antagonist in the treatment of gastroduodenal disease. A wide array of ranitidine-associated side effects has been described, but infrequently. As so much information is now available, the aim of this review is to assess the weight of evidence for a causal link between ranitidine and the reported side effects. Overall, ranitidine is well tolerated. The incidence of general side effects at less than 2% is very similar to placebo. Headaches, tiredness, dizziness and mild gastrointestinal disturbance (e.g. diarrhoea, constipation and nausea) are among the most frequent complaints, but have very seldom resulted in stopping treatment. Cardiovascular side effects are extremely rare and unpredictable with the usual doses of oral ranitidine (at most 1 in 1 million patients). They mostly comprise sinusal bradycardia and atrioventricular blockade, especially after rapid intravenous administration, receding after cessation of the drug. Clinical studies, however, have not shown a significant pharmacological effect of ranitidine on the cardiovascular system via H2-receptors, even though individual sensitivities cannot be ruled out in a few isolated reports. Ranitidine is unlikely to be directly hepatotoxic: a transient change in liver function tests has been noted in only 1 in 100 to 1 in 1000 patients. Several cases of mixed hepatitis have been reported, but very few were fully documented. The incidence of ranitidine-associated acute hepatitis has been estimated to be less than 1 in 100,000 patients. Neuropsychiatric complications may be less common and clinically quite similar to those reported with cimetidine, i.e. confusion, disorientation, hallucinations, delirium. These side effects have occurred especially in critically ill and multiple-therapy patients, or patients with chronic renal or hepatic failure, so that the direct causal link with ranitidine treatment was often difficult to ascertain. Even though an H2-receptor-mediated effect is an attractive hypothesis (since similar complications were noted with other H2-receptor antagonists), other mechanisms have been suggested to play a role, e.g. cholinergic or histaminic effects. The overall incidence of neuropsychiatric complications is probably markedly less than 1%. White cell injury (i.e. agranulocytosis) appears to be the most frequent haematological complication, even though case reports are very few and poorly documented.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Side effects of ranitidine. 204 87

General anesthesia offers greater comfort for both the abortion patient and the operator. The combination of diazepam and ketamine which is rapidly reversible and offers a moderately deep anesthesia was used in 127 voluntary abortions and 3 therapeutic abortions. Patients ranged in age from 14-40 years and averaged 26, with 58% under 26. Patient weights ranged from 40-82 kg and averaged 56 kg. 43% were primaparas and average parity was 2.5. The average duration of the prenancy was 8.1 weeks. 10 patients were obese, 1 was asthmatic, 1 was a controlled hypertensive, 3 had cardiopathies, and 4 each had hepatitis and meningitis. 1 had treated epilepsy and 2 had serious depressive syndromes. 3 women had previously had voluntary abortions, 9 had had miscarriages, and 1 had had an extrauterine pregnancy. 17% had no fear or anxiety before the procedure, 56% had moderate levels, 28% had significant levels, and 19% had very high levels. 94% of the procedures were done by aspiration and in most cases a preliminary insertion of laminaria was done. The average duration of the procedure was 5 minutes, with extremes of 2 and 25 minutes. Patients were premedicated 1 hour before the procedure with intramuscular injections of 10 mg diazepam and 1/4 mg of atropine. For the induction, a butterfly needle with an antireturn system was used to inject 10 mg of diazepam and 1/4 mg of atropine diluted in 20 ml of distilled water. The patient was placed in the gynecological position and, if necessary, 5 mg of diazepam were added. Between .5-1 mg/kg of ketamine were injected in 10-15 seconds. The same dose was reinjected if the anesthesia was insufficient or the procedure was prolonged. A mixture of 40% oxygen and 60% nitrous oxide was administered if necessary. Patients remained in bed for 6 hours after awakening. 85% of patients received total doses of ketamine of .70mg/kg or less. Average duration of anesthesia was 9.2 minutes, with durations of less than 15 minutes in 94% of cases. On awakening 5% of patients had nausea and vomiting. 16% had minor psychic disturbances or disorientation, 8% had moderate problems with vocalization, and 2% had hallucinatory delirium with agitation. Overall, 20% of patients experienced headaches, 11% nausea, and 9% dizziness. It was concluded that the combination of diazepam .2 mg/kg and ketamine .5-.7 mg/kg provides well tolerated light anesthesia utilizable for outpatient abortions.
 ...
PMID:[Diazepam and ketamine for voluntary interruptions of pregnancy]. 692 72

Over a period of 2 months an 88-year-old man developed progressively more severe breathing-related pain under the right shoulder blade, loss of appetite, general weakness, depressive mood, sub-febrile temperature and nocturnal sweating. Various inflammation parameters were raised (sedimentation rate 43 mm in the first hour; C-reactive protein 26 mg/dl; white cell count 12,500/microliters). There also were pleural effusion and signs of mild nonspecific hepatitis. Antibiotics were administered because bacterial pneumonia was suspected. But the patient's condition deteriorated and he developed nightly periods of disorientation. There was no evidence for any advanced malignancy. Immunological tests pointed towards older-onset systemic lupus erythematosus: titre for antinuclear antibodies markedly raised to 1:20 480; anti-DNA titre moderately raised to 1:125 IU/ml. The patient's general condition and the pleuritic pain improved within 2 days under treatment with prednisone (50 mg daily); the depression, disorientation and fever receded within a week. The anti-DNA titre fell to 47 IU/ml after 8 weeks. He was able to resume his usual social activities and was kept on a maintenance prednisone dose of 5.0 mg daily.
 ...
PMID:[Lupus erythematosus in old age]. 820 42

1. In animal studies, TPTA was found to be neurotoxic. In humans, variable CNS pictures have been described with or without significant EEG findings. Brain CT does not usually reveal any abnormalities. 2. Our patient presented with intermittent unique spontaneous involuntary movement of hands, facial twitching, silly smile and crying. Diplopia, drowsiness, giddiness, vertigo, bidirectional nystagmus, impairment of calculation ability, as well as disorientation to time, people and place also developed. EEG showed mild cortical dysfunction without seizures. MRI and Tc-99m HMPAO brain SPECT revealed no significant findings. TPTA may cause cellular dysfunction of brain without structural damage, which results in variable CNS clinical presentations. 3. Nadir of leucopenia was noted on the sixth day after consumption of TPTA. Liver impairment occurred on the ninth day. Borderline demyelinated neuropathy developed on the fifty-third day. CNS abnormalities, delayed peripheral neuropathy, hepatitis and leucopenia deserve monitoring for a prolonged period, even when the victim initially presents with GI upset only after consumption of TPTA.
 ...
PMID:Unique cerebral dysfunction following triphenyltin acetate poisoning. 972 37

A 56 year old man was admitted cause he had increasing symptoms as weakness, lethargy, disorientation. The total eosinophil count was 3000/mm3, the serum sodium concentration was 120 mmol per litre. In spite of severe hyponatriemia, urinary sodium excretion was not suppressed and serum osmolality (240 mOsm/Kg was lower than urine osmolality (488 mOsm/Kg). SIADH and Idiopathic Hypereosinophilic Syndrome was diagnosed because we found systemic failure signs due to hypereosinophilia (hepatitis, gastritis, pulmonary hypertension, and encefalopathy). Cortisonic treatment was started with symptoms improving, natriemia, eosynophil count and hepatitis signs normalization. After treatment stopping, reappeared asymptomatic hypereosinophilia, than we choosed Idrossiurea but, non-standing hypereosinophilia disappeared, appeared signs of preexisting adrenal insufficiency, emphasized by stopping cortisone therapy. A RMN showed an hypofiseal adenoma. Many cases of SIADH and Hypereosinophilia hiding adrenocortical insufficiency are reported with severe and unusual hypereosinophilia.
 ...
PMID:[Association of hyponatremia and eosinophilia: correlated idiopathic hypereosinophilic syndrome and SIADH or adrenal insufficiency with secondary eosinophilia]. 1285 64

A 56-year-old man presented with fever, disorientation, and testicular pain. He was receiving azathioprine immunosuppression for autoimmune hepatitis. Orchiectomy identified occlusion of spermatic cord vessels by intravascular large B-cell lymphoma (IVLBL) and ischemic changes in the testis. Tumor cells were positive for CD 10, CD 20, CD 30, and Epstein-Barr virus (EBV) latent membrane protein 1 (LMP-1) and early region RNA (EBER). He was treated with the cessation of azathioprine, chemotherapy, anti-CD 20 immunotherapy, and radiotherapy. Twenty months after diagnosis, he is alive with no evidence of lymphoma or hepatitis. This is the first report of IVLBL presenting with testicular ischemia. It highlights the importance of prompt diagnosis and intervention to achieve durable response. That this lymphoma arose in the setting of immunosuppressive therapy introduces additional complexity relating to pathogenesis, clinical behavior, and treatment.
 ...
PMID:Testicular ischemia due to intravascular large B-cell lymphoma: a novel presentation in an immunosuppressed individual. 1461 32

Although, N-acetylcystein (NAC) has shown benefit in non-acetaminophen related liver failure, it was not well studies in dengue associated severe hepatitis. We report a case of dengue hemorrhagic fever associated severe hepatitis (encephalopathy grade 2-drowsy and intermittent disorientation) treated with NAC resulted in good outcome without hepatic transplantation.
...
PMID:N-acetylcystein in dengue associated severe hepatitis. 2470 Oct 72