Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Drotrecogin alpha (recombinant human activated protein C, rhAPC; Xigris) is an immune modulating treatment principle that has been shown to significantly reduce mortality in patients with severe sepsis. Currently, the identification of patients in intensive care that may benefit from such a treatment is insufficient. The importance of this evidence-based treatment modality is commonly ignored for reasons of increased cost. A medically justified and economically acceptable strategy with a medico-legal backing would be a procedure based on the design and the results of the PROWESS study. This may benefit patients with severe sepsis of not longer than 48 h duration, an APACHE II score of > or =25 or > or =2 failing organs and no exclusion criteria. Extending the indication beyond this group should be discussed as a last resort in patients with a fulminant clinical course, such as in meningitis, and based on data from retrospective subgroup analyses. Patients with severe sepsis following community-acquired pneumonia with progressive organ dysfunction may also benefit from activated protein C treatment in addition to an otherwise best standard of care.
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PMID:[Identification of patients suitable for therapy with activated Protein C]. 1655 81

Severe infectious diseases after liver transplant are associated with high risk of multiorgan failure and mortality. Septic shock is difficult to manage in this setting since it is often unresponsive to conventional aggressive therapy. Adjuvant therapies have been proposed in association with full combination treatment to sustain the failing organs and improve outcomes in severe sepsis. Recombinant human activated protein C drotrecogin alfa, Xigris) has been occasionally administered to treat posttransplant sepsis to modulate and downregulate the complex network of inflammatory and coagulopathic processes. Herein we have reported on a patient who was given drotrecogin alfa 15 days following liver transplant for acute septic shock originating from a nosocomially acquired pneumonia. Recombinant activated drotrecogin alfa, associated with conventional aggressive treatment, was efficacious to revert the life-threatening "slippery slope" of vasoplegia and uncontrolled diffuse inflammation.
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PMID:Activated recombinant protein C in septic shock early after liver transplantation: a case report. 1867 33

Main pharmacovigilance updates in 2011 are reviewed. Dronedarone: Serious cardio-vascular and hepatic adverse reactions for a questionable efficacy. Long-term proton pump inhibitors: A cause of hypomagnesemia. Bisphosphonates: A risk of atypical femoral fractures. Dasatinib: Cases of pulmonary arterial hypertension reported. Lenalidomide: A risk of second primary malignancies. Daptomycine: Cases of eosinophilic pneumonia reported. Tigecycline: Inferior to comparators. Drotrecogin alfa: Market withdrawal due to lack of efficacy. Nimesulide: More hepatotoxic than other NSAIDs. Topiramate: Evidence of teratogenicity (oral clefts). Valproate: Impaired cognitive development in addition to well-known teratogenicity. Antipsychotics in late pregnancy: A risk of neonatal complications.
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PMID:[Pharmacovigilance]. 2318 21