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Adverse effects may be caused by the immunizing agent or by foreign protein incorporated with the immunizing agent (eg buy 500mg ilosone with amex, egg protein in viral vaccines grown in chick embryos) buy 500mg ilosone free shipping. General reactions (1) Pain, tenderness, redness at injection sites Local tissue irritation may occur with injected immunizing agents. It is a edema, urticaria, angioneurotic edema, severe respiratory medical emergency that requires immediate treatment with SC epi- distress) nephrine (0. Anaphy- laxis is most likely to occur within 30 min after immunizing agents are injected. Symptoms are usually relieved by acetaminophen, antihistamines, and corticosteroids. With DtaP (1) Soreness, erythema, edema at injection sites These effects are common (2) Anorexia, nausea (3) Severe fever, encephalopathy, seizures These are rare adverse reactions and less likely to occur with the acellular pertussis component now used. If they occur, they are thought to be caused by the pertussis antigen, and further admin- istration of pertussis vaccine or DTP may be contraindicated. With Haemophilus influenzae b vaccine—pain and erythema These effects occur in about 25% of recipients but are usually mild at injection sites and resolve within 24 hours. With hepatitis B vaccine (1) Injection site soreness, erythema, induration Soreness and fever commonly occur and can be relieved by acet- aminophen or ibuprofen. With influenza vaccine (1) Pain, induration, and erythema at injection sites Adverse effects can be minimized by administering acetaminophen at the time of immunization and at 4, 8 and 12 h later. Recipients who are allergic to eggs should be observed for 90 min after the vaccine is injected. MMR vaccine should be given only in a setting where personnel and equipment are available to treat anaphylaxis. With pneumococcal vaccine (1) Local effects—soreness, induration, and erythema at Local effects occur in 40–90% of recipients; systemic effects occur injection sites less frequently.

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In addition safe 250mg ilosone, a significant per- Tolerance and cross-tolerance are usually attributed to acti- centage of women with arthritis ilosone 250mg on line, asthma, depression, diabetes vation of drug-metabolizing enzymes in the liver, which accel- mellitus, epilepsy, and migraine experience increased symp- erates drug metabolism and excretion. The increased symptoms may indicate to decreased sensitivity or numbers of receptor sites. Women with clinical depression, for example, may need higher doses of antidepressant medications premenstrually, if ADVERSE EFFECTS OF DRUGS symptoms exacerbate, and lower doses during the rest of the menstrual cycle. As used in this book, the term adverse effects refers to any un- Another example is that women with schizophrenia re- desired responses to drug administration, as opposed to ther- quire lower dosages of antipsychotic medications than men. Most drugs If given the higher doses required by men, women are likely produce a mixture of therapeutic and adverse effects; all drugs to have adverse drug reactions. Adverse effects may produce es- CHAPTER 2 BASIC CONCEPTS AND PROCESSES 21 TABLE 2–1 Effects of Pathologic Conditions on Drug Pharmacokinetics Pathologic Conditions Pharmacokinetic Consequences Cardiovascular disorders that impair the Absorption of oral, subcutaneous, intramuscular, and topical drugs is erratic because of pumping ability of the heart, decrease car- decreased blood flow to sites of drug administration. Central nervous system (CNS) disorders that CNS impairment may alter pharmacokinetics indirectly by causing hypo- or hyperventilation alter respiration or circulation (eg, brain and acid–base imbalances. Also, cerebral irritation may occur with head injuries and lead trauma or injury, brain ischemia from in- to stimulation of the sympathetic nervous system and increased cardiac output. Increased adequate cerebral blood flow, drugs that blood flow may accelerate all pharmacokinetic processes. With faster absorption and dis- depress or stimulate brain function) tribution, drug action may be more rapid, but faster metabolism and excretion may shorten duration of action. Gastrointestinal (GI) disorders that interfere Symptoms of impaired GI function commonly occur with both GI and non-GI disorders. As a with GI function or blood flow (eg, trauma or result, many patients cannot take oral medications. Those who are able to take oral drugs surgery of the GI tract, abdominal infection, may experience impaired absorption because of: paralytic ileus, pancreatitis) Vomiting or diarrhea. Concurrent administration of drugs that raise the pH of gastric fluids (eg, antacids, histamine-2 blockers, proton pump inhibitors). Concurrent administration of foods or tube feeding solutions that decrease drug absorption. It may be increased because GI hypermotility rapidly deliv- disease, ulcerative colitis) ers drug molecules to sites of absorption in the small intestine and the drugs tend to be absorbed more rapidly from inflamed tissue.

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