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Drug-induced Peripheral Neuropathy

Peripheral Neuropathy Secondary to Drugs or Chemicals


Presentation

  • Among the 18 patients in the overall group who were eligible to be surveyed (those present for a clinic visit within the past year), 14 reported BIPN, and of these, 10 reported ongoing symptoms at the median follow-up of 24 months.[curetoday.com]
  • Patients usually present with muscle weakness, myalgias, and difficulty in walking.[clinicalgate.com]
  • Chemotherapy can cause degeneration of peripheral sensory and motor nerves and cause patients to present with sensory disturbances, balance problems or weakness.[hopkinsmedicine.org]
  • My Response Presentation/Physical Findings The patient’s presentation is typical of chemotherapy-induced peripheral neuropathy (CIPN) that is characterized by tingling (71%), numbness (58%), and paresthesias or dysesthesias (45%), or spontaneous burning[hematology.org]
  • […] or blood pressure medications Amiodarone Hydralazine Perhexiline Infection fighting drugs Metronidazole (Flagyl ) Nitrofurantoin Thalidomide INH (Isoniazid) Skin condition treatment drugs Dapsone SYMPTOMS AND SIGNS (Not all symptoms and signs may be present[peripheralneuropathycenter.uchicago.edu]
Intravenous Administration
  • Subcutaneous versus intravenous administration of bortezomib in patients with relapsed multiple myeloma: a randomised, phase 3, non-inferiority study. Lancet Oncol 2011; 12: 431-440. 40.[geneesmiddelenbulletin.com]
Hodgkin's Disease
  • Cancer types with higher risk of neuropathy include: l ung, breast, ovarian, myeloma, lymphoma and Hodgkin's disease and testicular. Life factors that may increase the chances of developing neuropathy: Advanced age.[livestrong.org]
Swelling
  • 09-26-2012, 04:35 PM #1 Distinguished Community Member Peripheral Neuropathy, medication caused Peripheral Neuropathy, a numbness,tightness, pain, swelling and/or tingling nerves in the hands in feet, is known in Diabetics, in those with HIV AIDS,in Alchoholics[braintalkcommunities.org]
Suggestibility
  • In this MiniReview, the term 'drug-induced peripheral neuropathy' (DIPN) is used with the suggested definition: Damage to nerves of the peripheral nervous system caused by a chemical substance used in the treatment, cure, prevention or diagnosis of a[ncbi.nlm.nih.gov]
  • Ask your health care team to provide suggestions and special equipment to make daily tasks safe and easier to manage. The suggestions may include night lights, grab bars and other home safety measures to help reduce the risk of falling.[livestrong.org]
  • Or some other kind of treatment, such as radiotherapy, may be suggested. It is extremely important not to stop treatment without talking to your cancer specialist first.[macmillan.org.uk]
  • Reducing CEP72 expression in human neurons and leukemia cells increased their sensitivity to vincristine, suggesting a potential basis for safer dosing.[healio.com]
  • Vitamin B12: Studies suggest that vitamin B12 may alleviate neuropathy (not specifically CIPN). Clinical trials are underway to determine if vitamin B12 is effective in preventing CIPN.[integrativeoncology-essentials.com]
Peripheral Neuropathy
  • Peripheral neuropathy can be caused by medication, and various descriptions have been applied for this condition.[ncbi.nlm.nih.gov]
  • Abstract When symptoms of peripheral neuropathy appear, the possibility that they have been induced by drugs should be considered.[ncbi.nlm.nih.gov]
  • Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common side effects of modern chemotherapy.[ncbi.nlm.nih.gov]
  • TY - JOUR T1 - Drug-induced peripheral neuropathy in a patient with psoriatic arthritis.[unboundmedicine.com]
  • A patient with psoriatic arthritis developed a peripheral neuropathy while taking hydroxychloroquine and naproxen.[scholars.northwestern.edu]
Dysesthesia
  • Patients can present with symmetric, distal, length-dependent, “stocking-glove” distribution of painful paresthesia, dysesthesia, cold sensitivity, allodynia, tingling, and numbness.[clinicalgate.com]
  • My Response Presentation/Physical Findings The patient’s presentation is typical of chemotherapy-induced peripheral neuropathy (CIPN) that is characterized by tingling (71%), numbness (58%), and paresthesias or dysesthesias (45%), or spontaneous burning[hematology.org]

Workup

Human Papillomavirus
  • Monitoring the safety of quadrivalent human papillomavirus vaccine: findings from the Vaccine Safety Datalink. Vaccine 2011; 29: 8279-8284. *The literature refers to the Dutch text[geneesmiddelenbulletin.com]

Treatment

  • Neuropathy is a universal and dose-limiting factor during treatment with vinca alkaloids, but is otherwise a rare complication of drug therapy.[ncbi.nlm.nih.gov]
  • In this MiniReview, the term 'drug-induced peripheral neuropathy' (DIPN) is used with the suggested definition: Damage to nerves of the peripheral nervous system caused by a chemical substance used in the treatment, cure, prevention or diagnosis of a[ncbi.nlm.nih.gov]
  • Eribulin monotherapy versus treatment of physician’s choice in patients with metastatic breast cancer (EMBRACE): a phase 3 open-label randomised study. Lancet 2011; 377: 914-923. 42.[geneesmiddelenbulletin.com]
  • As the number of cancer survivors continues to grow, awareness of long-term toxicities and impact on quality of life after chemotherapy treatment in cancer survivors has intensified.[ncbi.nlm.nih.gov]
  • Three factors were identified as being associated with BIPN: the number of BV doses, the cumulative dose and treatment response.[curetoday.com]

Prognosis

  • Reversal depends on the severity of the neuropathy, intensity and duration of the treatment and existence of causative cofactors, but generally the prognosis is good.[ncbi.nlm.nih.gov]
  • What is the Prognosis for Drug-Induced Neuropathy? (Outcomes/Resolutions) The prognosis of Drug-Induced Neuropathy is good with adequate treatment and management of the signs and symptoms.[dovemed.com]
  • Cisplatin neurotoxicity in the treatment of metastatic germ cell tumour: time course and prognosis. Br J Cancer. 2001; 85: 823-826. 16. D’Addario G, Pintilie M, Leighl NB, Feld R, Cerny T, Shepherd FA.[geneesmiddelenbulletin.com]

Etiology

  • Use Additional Use Additional Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10data.com]
  • Codes with this note are Etiology codes and must be followed by a Manifestation code or codes.[icd.codes]
  • (Etiology) The cause of Drug-Induced Neuropathy is the use of medications, which can be toxic to the nerves.[dovemed.com]
  • Only 24% of all peripheral neuropathies are thought to be secondary to drugs. 13 A sizable proportion of neuropathies are undiagnosed as to etiology.[now.aapmr.org]

Epidemiology

  • Causation and causal inference in epidemiology. Am J Public Health 95 (Suppl 1): S144–50, 2005. Dalakas MC. Peripheral neuropathy and antiretroviral drugs. J Periph N Syst 6:14-20, 2001. Gaist D, Jeppesen U, Anderson M, et al.[now.aapmr.org]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology of peripheral neuropathic pain: immune cells and molecules. Anesth Analg. 2007;105:838-847. 7. Vilholm OJ, Christensen AA, Zedan AH, Itani M. Drug-induced peripheral neuropathy. Basic Clin Pharmacol Toxicol. 2014;115:185-192. 8.[uspharmacist.com]
  • A better understanding of the pathophysiology of CIPN and genes associated with predisposition ultimately will prove fruitful in the quest to identify predictive or targetable biomarkers for personalized treatment of this prevalent and debilitating symptom[healio.com]

Prevention

  • In this MiniReview, the term 'drug-induced peripheral neuropathy' (DIPN) is used with the suggested definition: Damage to nerves of the peripheral nervous system caused by a chemical substance used in the treatment, cure, prevention or diagnosis of a[ncbi.nlm.nih.gov]
  • Ways to Prevent or Manage Problems Related to Nerve Changes You may be advised to take these steps: Prevent falls. Have someone help you prevent falls around the house. Move rugs out of your path so you will not trip on them.[cancer.gov]
  • How can I prevent associated constipation? Make sure that you are eating foods high in fibre and drink at least 6-8 glasses of water a day to help prevent constipation.[eviq.org.au]

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