Cisplatin is one of the most widely used antineoplastic agents in the treatment of solid tumor and hematological malignancies that may cause acute or chronic organ toxicity. Accidental overdose of cisplatin may occur despite all precautions and no general accepted guidelines for the treatment of such cases are available and no specific antidote for cisplatin exists. Here we report a 1-year-old girl who received a massive cisplatin overdose of 500 mg/m2 as an accidental substitution for carboplatin. Although aggressive treatment was given, the patient died because of severe renal failure and cardiac arrest. Our experience remind us to evaluate, establish and implement the best possible and accurate control mechanisms on different levels for …show more content…
The most serious complication is nephrotoxicity, which may result in irreversible renal failure. Key management strategies for a cisplatin overdose involve renal protection and enhancing drug elimination, and consideration of sodium thiosulfate and plasmapheresis. A suggested algorithmic approach for the initial management of a patient with a cisplatin over-dose is presented in figure 2. To our knowledge, patients inadvertently receiving less than 300 mg/ m2 of cisplatin reportedly often recover, whereas overdoses exceeding 400 mg/ m2 frequently result in death. To our knowledge, our case is the youngest one who received a high dose of cisplatin (500 mg/m2) in the absence of intravenous hydration, and nephrotoxicity result in renal failure, hearing loss, visual impairment, severe myelosuppression complicated by life-threatening sepsis were presented in this patient. Although vigorous therapies were given, the patient decreased. As the toxicity of cisplatin is dose-dependent, early elimination of the drug from plasma should be critical in the management. Most of the platinum in the blood plasma is bound to proteins within a few hours after intravenous administration. Binding of cisplatin to proteins and enzymes is generally believed to be the cause of its side effects, especially ototoxicity and …show more content…
heresis has been attributed to the removal of cisplatin-bound plasma proteins, and should nonetheless be strongly considered, regardless of time elapsed, in order to potentially reduce not only renal toxicities but also other
Fifteen year old Lewis Blackman died after a minimally invasive surgery. The cause of death was due to perforated bowel caused by ketorolac, a highly potent non-steroidal anti-inflammatory to treat pain and inflammation and for its potential for stomach ulceration. As I read the case, I noticed the following system failures that lead to this sentinel event. First, ketorolac has a black box warning “not to be used in pediatric patients.” 1 A black box warning is the strictest warning put in the labeling of prescription drugs by the Food and Drug Administration when there is reasonable evidence of an association of a serious hazard with the drug.
Discussion Summaries Brown et al. (2007) developed a clinical pathway using a computer support system in an emergency department. This prospective cohort study was targeted at acute transient ischemic attacks (TIA). The clinical pathway was made with guideline recommendations for antithrombotic therapy.
"Music therapy is a systematic process of intervention wherein the therapist helps the client to promote health, using musical experiences and the relationships that developed through them as dynamic forces of change (Hodges and Sebald pg 284)”. I watched a youtube video called When Meds Fail: A Case for Music Therapy: Tim Ringgold. The video started off with Tim the music therapist singing a song that he wrote for his daughter. As a Music Therapist Tim knows how important music is for an infant in the whom. “Researcher shows using music during childbirth has a significant drop of perception of pain, anxiety and time itself for mom’s
Tylenol tablets with cyanide in them killed seven people in 1982 (Lerner & Learner, 2007). This was a tragic part of history. In downtown Chicago victims bought cyanide injected tylenol bottles at five stores and 2 more bottles were found at another store (Lerner & Learner,
After surgery, radiation, chemotherapy and a marrow transplant, an improperly mixed intravenous solution apparently stopped Brianna Cohen's heart. Hence, this case shows that there is an unintended act either of commission or omission, does not achieve its intended outcome, failure of a planned action to be completed for instance an error of education which was the mixed solution, potassium, which caused the heart rhythm to regulate. Furthermore, there was a wrong plan to achieve an error like an error of planning and deviation from the process of care. Therefore, receiving the incorrect medication, or missing a diagnosis that is evident on a lab test or imaging study is a medical
highlighted that in United States, the dose dumping in general and alcohol induced dose dumping in particular is considered as a serious concern for orally administered prolonged release dosage forms (3). Subjuct to the therapeutic
Lesson 7 Small-Group Discussion. Patient Safety Step 1 In a report by the Institute of Medicine (2006), Titled, Preventing Medication Errors, “The committee concludes that there are at least 1.5 million preventable adverse drug events (ADE’s) that occur in the United States each year.” These numbers are astonishing given the number of adults that are taking prescription medications daily. Most of the errors occur during the prescribing and administering steps and during an average hospital stay, a patient can expect to have one medication error occur every day (Institute of Medicine, 2006).
Various health websites had informed me that Tylenol overdose causes liver failure, which can be fatal if not treated immediately. Apparently it is fairly common and is one of the most lethal overdoses, as far as over-the-counter drugs go. Shoving the bottle in my pocket, I told myself that I would only use it as a last resort, but a part of me knew from the time I had started working on this plan that it would only be a matter of time
When David Servan-Schreiber, a dedicated scientist and doctor, was diagnosed with brain cancer, his life changed. Confronting what medicine knows about the illness and the little-known workings of his body 's natural cancer fighting capacities, and marshaling his own will to live, Servan-Schreiber found himself on a fifteen-year journey from disease and relapse into scientific exploration and, finally, to health. Combining memoir, concise explanation of what makes cancer cells thrive and what inhibits them, and drawing on both conventional and alternative ways to slow and prevent cancer, Anticancer is revolutionary. It is a moving story of a doctor 's inner and outer search for balance; radical in its discussion of the environment,
One study by Arnold et al. (2010) directly compared the two drugs in question for this project and provided credible information to the development of an evidenced-based answer to the problem (Arnold et al., 2010). A second systematic review by Akl et al. (2014) researched the effects of the two drugs in question in the thromboprophylaxis treatment of patients (Akl et al.,
Medication use is potentially dangerous. Polypharmacy is increasing, and makes it harder to keep track of side effects and interactions and of potentially inappropriate drug combinations. “The risk of serious consequences, hospitalization, and death due to medication errors increases with patients’ age and number of medications (Scand J Prim Health Care, 2012)”. For example, the GP is supposed to monitor the patient's regular medication, but does not always do so. Lack of monitoring and keeping track of patients’ medication use is a main cause when a patient is given inappropriate drugs.
When interpreting concentration measurements, factors that need to be considered include the sampling time in relation to drug dose, dosage history, patient response, and the desired medicinal targets. The goal of therapeutic drug monitoring is to use suitable concentrations of difficult-to-manage medications to optimize clinical outcomes in patients in various clinical situations. Keywords: Drug monitoring, therapeutic; Pharmacokinetics Introduction Therapeutic drug monitoring is generally defined as the measurement of specific drugs at timed intervals in order to maintain a relatively constant concentration of the medication in the bloodstream. Monitored drugs tend to have a narrow therapeutic index, that is a ratio between the toxic and therapeutic doses of medications.
This is the hospital’s negligence of not inspecting their devices routinely. Ketorolac is an NSAID medication that should not be used more than one dose for patient under 16 years old. Prolonged use of this medication may cause bleeding. Pharmacy should also be questioned, as medications are their expertise, especially that it was given around the clock for several days. This signifies lack of teamwork.
Background The situation that was presented to us occurred in September of 1982, where seven people in the Chicago area were killed when they ingested Tylenol, a painkiller produced by Johnson and Johnson. The Tylenol that ended up killing the seven had been laced with cyanide, but the extent of the damage and whether it was internal or external was not known for several weeks. However, upon investigating it was found to have been an external sabotage.
Chemotherapy can work wonders on people with cancer. Even though Chemotherapy has been through many struggles it has showed superior strength in fighting cancer. Even with competition, the medicine has outshone the odds of curing cancer. With many pros and cons of the medicine it has helped science and technology in many ways. Will Chemotherapy keep working its wondrous medicine for decades to come or will an alternative take over?