Presentation
We present a case of lateral canthal tendon rupture that presented with an acute right lower eyelid ectropion in a young, renal compromised patient in the setting of recent fluoroquinolone use for pneumonia. [ncbi.nlm.nih.gov]
Entire Body System
- Epilepsy
Contraindications Quinolones are contraindicated if a patient has epilepsy, QT prolongation, pre-existing CNS lesions, or CNS inflammation, or the patient has suffered a stroke. They are best avoided in the athlete population. [omicsonline.org]
Contraindications to Fluoroquinolones: Pregnancy and lactation Epilepsy Stroke Severe renal insufficiency QT-prolongation Caution in children: cartilage damage Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z References Auquer u.a. 2002 [urology-textbook.com]
Kontraindikationen der Fluorchinolone: Schwangerschaft, Stillzeit, Kinder (Knorpelschäden), Epilepsie, Schlaganfall, schwere Niereninsuffizienz, QT-Verlängerung. [urologielehrbuch.de]
[…] fluoroquinolones, people with any of these medical problems should make sure their physicians are aware of their conditions: kidney disease liver disease with kidney disease diseases of the brain or spinal cord, including hardening of the arteries in the brain, epilepsy [medical-dictionary.thefreedictionary.com]
[…] should make sure their physicians are aware of their conditions before using fluoroquinolones: kidney disease liver disease together with kidney disease diseases that affect the brain or spinal cord, including hardening of the arteries in the brain; epilepsy [encyclopedia.com]
- Anemia
Diarrhea, leukopenia, anemia, and photosensitivity are uncommon. Rash is uncommon unless gemifloxacin is used for > 1 wk and is more likely to develop in women 40. Nephrotoxicity is rare. [merckmanuals.com]
[…] nitrofurantoin, amoxicillin, or a cephalosporin could be used to treat uncomplicated cystitis based on the results of susceptibility testing, but nitrofurantoin should not be given in the third trimester or during labor because it can cause hemolytic anemia [secure.medicalletter.org]
Fluoroquinolones can cause different adverse effects: neurosensory disorders, dizziness and headache, haematological disorders, leukopenia, thrombopenia, anemia and more particularly tendinitis leading sometimes to the rupture of the tendon of Achilles [pharmacorama.com]
Citation (Review of common and rare complications of fluoroquinolones focusing upon QT prolongation, tendon rupture, diabetes, renal injury, and seizures; liver injury discussed in concept of immune related idiosyncratic reactions such as hemolytic anemia [livertox.nih.gov]
Glucose-6-phosphate dehydrogenase activity defect (problem with an enzyme that your body makes)—If you have this condition and you take a fluoroquinolone, you could have problems with anemia. [drugs.com]
- Difficulty Walking
On examination a week later he had difficulty walking. .. Kent A. Huston, M.D. 4330 Wornall St., Kansas City, MO 64111 [nejm.org]
There are long-term sequelae including difficulty walking, decreased range of motion and pain in up to 10% of patients.6 Risk factors for fluoroquinolone-associated tendinopathy are incompletely defined. [nps.org.au]
After three weeks of taking it, I had severe shortness of breath, ringing in my ears, pain walking and difficulty walking. The pain has never left, only gotten worse. I can only walk or stand for a few minutes at a time before having to sit. [peoplespharmacy.com]
- Weight Loss
Symptoms include fever, weight loss, and coughing up blood. [medical-dictionary.thefreedictionary.com]
Its symptoms include fever, weight loss, and coughing up blood. Urinary tract— The passage through which urine flows from the kidneys to the outside of the body. [encyclopedia.com]
[…] gain; sensation of skin burning; slow or fast heartbeat; skin itching, rash, redness, or swelling; tingling of hands or feet; unusual weight gain or loss Rare Abdominal or stomach cramps and pain (severe); abdominal pain; abdominal tenderness; agitation [drugs.com]
- Toe Pain
pain where the medicine was injected (lasting after the injection) pain in the calves, spreading to the heels swelling of the calves or lower legs swelling of the face or neck swallowing problems rapid heartbeat shortness of breath loss of consciousness [medical-dictionary.thefreedictionary.com]
pain at the injection site that persists after the drug was injected pain in the calves that spreads to the heel area swelling of the calves or lower legs swelling of the face or neck difficulty swallowing rapid heartbeat shortness of breath loss of [encyclopedia.com]
Respiratoric
- Painful Cough
Predicting if or when a rupture will occur is difficult. 7 Symptoms of a thoracic aortic aneurysm may include: Chest tenderness or pain Back pain Cough Shortness of breath Hoarseness 8 Symptoms of an abdominal aortic aneurysm may include: A pulsating [recallcenter.com]
Gastrointestinal
- Abdominal Pain
palpitations) Skin reactions in 29 percent of patients (rashes, hair loss, sweating, intolerance to heat or cold) Gastrointestinal symptoms in 18 percent of patients (nausea, vomiting, diarrhea, abdominal pain) In a letter to his Congressman, he wrote [articles.mercola.com]
Side effects The most common side effects are mild diarrhea, nausea, vomiting, stomach or abdominal pain, dizziness, drowsiness, lightheadedness, nervousness, sleep problems, and headache. [medical-dictionary.thefreedictionary.com]
[…] or stomach cramps and pain (severe); abdominal pain; abdominal tenderness; agitation; area rash; black, tarry stools; bleeding; blisters on mucous membranes, with fever; blistering, itching, loosening, peeling, or redness of skin; bloody or cloudy urine [drugs.com]
Cardiovascular
- Tachycardia
Musculoskeletal symptoms in 73 percent of patients (tendon ruptures, tendonitis, weakness, joint swelling) Sensory symptoms in 42 percent of patients (tinnitus, altered visual, olfactory, and auditory function) Cardiovascular symptoms in 36 percent of patients (tachycardia [articles.mercola.com]
QTC interval prolongation and polymorphic ventricular tachycardia in association with levofloxacin. Am J Med 1999; 107 (5): 528-9. [ Links ] 25.- Badshah A, Janjua M, Younas F, Halabi A R, Cotant J F. [scielo.cl]
Musculoskeletal
- Muscle Weakness
weakness, peripheral neuropathy, autonomic dysfunction, sleep disorder, cognitive dysfunction and psychiatric disturbance. [ncbi.nlm.nih.gov]
If you have been prescribed a fluoroquinolone antibiotic be sure to seek medical attention if you experience any side effects like unusual joint or tendon pain, muscle weakness, tingling or pricking sensation, numbness in arms or legs, confusion or hallucinations [goodrx.com]
Some signs and symptoms of serious side effects include unusual joint or tendon pain, muscle weakness, a “pins and needles” tingling or pricking sensation, numbness in the arms or legs, confusion, and hallucinations. [fda.gov]
[…] pain, muscle weakness, joint pain, joint swelling, peripheral neuropathy, and central nervous system effects, and to contact their doctor immediately for further advice – sheet for patients do not prescribe fluoroquinolones: for non-severe or self-limiting [gov.uk]
They are left with conditions including peripheral neuropathy, muscle weakness, cognitive dysfunction, new or worsened mental illness, and even paralysis which are all consistent with excitatory neurotoxicity (excitotoxicity) and brain damage. [ 8 ][ [benzoinfo.com]
Skin
- Skin Rash
Quinolone antiobiotic side effects may include: Headaches Skin rash Gastrointestinal problems Allergic reactions 1 Other serious side effects of fluoroquinolone antibiotics may include: Seizures Hallucinations Potential liver damage, kidney damage, or [recallcenter.com]
rashes and other skin reactions; thyroid problems; autoimmune diseases; blood sugar problems; and emotional problems, sometimes severe, among many other symptoms. [slweb.org]
The common side effects of the fluoroquinolones are gastrointestinal disturbances, headaches, skin rash and allergic reactions. [livertox.nih.gov]
problems with memory; problems with speech or speaking; problems with vision or hearing; rash; rash with flat lesions or small raised lesions on the skin; redness; redness of skin; redness, swelling, or soreness of tongue; scarring; seizures; sense [drugs.com]
If any of the following side effects occur, check with a physician immediately: skin rash or other skin problems such as itching, peeling, hives, or redness fever agitation or confusion hallucinations shakiness or tremors seizures or convulsions tingling [medical-dictionary.thefreedictionary.com]
Neurologic
- Seizure
Snapshot A 44-year-old man presents to the emergency department for intractable seizures. He was sedated, intubated, and admitted to the intensive care unit. [medbullets.com]
Hence, it is hardly a surprise that coffee drinkers who are prescribed a benzodiazepine are at an even higher risk for fluoroquinolone-induced seizures and neuropsychiatric disturbances. [benzoinfo.com]
If any of the following side effects occur, check with a physician immediately: skin rash or other skin problems such as itching, peeling, hives, or redness fever agitation or confusion hallucinations shakiness or tremors seizures or convulsions tingling [medical-dictionary.thefreedictionary.com]
I stopped breathing, had numerous convulsions and two grand Mal seizures. [hormonesmatter.com]
Seizures associated with levofloxacin: case presentation and literature review. Eur J Clin Pharmacol 2009; 65 (10): 959-62. [ Links ] 30.- Kushner J M, Peckman H J, Snyder C R. Seizures associated with fluoroquinolones. [scielo.cl]
- Confusion
If you experience side-effects such as joint and muscle pain, numbness, tingling or confusion while taking a fluoroquinolone, consult a health-care professional. [cbc.ca]
Consult a healthcare professional if you experience side effects such as joint and muscle pain, numbness, tingling or confusion while taking a fluoroquinolone. [healthycanadians.gc.ca]
If you have been prescribed a fluoroquinolone antibiotic be sure to seek medical attention if you experience any side effects like unusual joint or tendon pain, muscle weakness, tingling or pricking sensation, numbness in arms or legs, confusion or hallucinations [goodrx.com]
This is because one of the toxic aspects of these drugs is that they do Mitochondrial Damage, which can cause a confusing and diverse array of symptoms that often look like other diseases. [fqresearch.org]
Some signs and symptoms of serious side effects include unusual joint or tendon pain, muscle weakness, a “pins and needles” tingling or pricking sensation, numbness in the arms or legs, confusion, and hallucinations. [fda.gov]
- Agitation
In the past year, FDA has warned about serious psychological effects on attention, memory and agitation. Aortic aneurysm is another very serious side effect. Patients have been sounding the alarm on these drugs for a long time. [peoplespharmacy.com]
The reported adverse reactions include agitation tremor, hallucinations, psychosis and convulsions. [nps.org.au]
The GABA receptor blockade caused by a fluoroquinolone results in a CNS stimulant effect, with neurological manifestations ranging from mild insomnia and agitation to hallucinations and seizures. [ 2 ] Anyone can suffer these side effects, but individuals [benzoinfo.com]
If any of the following side effects occur, check with a physician immediately: skin rash or other skin problems such as itching, peeling, hives, or redness fever agitation or confusion hallucinations shakiness or tremors seizures or convulsions tingling [medical-dictionary.thefreedictionary.com]
If any of the following side effects occur, the patient should consult a physician immediately: skin rash or such other skin problems as itching, peeling, hives, or redness fever agitation or confusion hallucinations shakiness or tremors seizures or convulsions [encyclopedia.com]
- Tremor
The reported adverse reactions include agitation tremor, hallucinations, psychosis and convulsions. [nps.org.au]
Studies have found that benzodiazepine-dependent individuals frequently experience depression, anxiety, psychosis, paranoia, severe insomnia, paraesthesia, tinnitus, hypersensitivity to light and sound, tremors, seizures, and suicidal thoughts upon exposure [benzoinfo.com]
If any of the following side effects occur, check with a physician immediately: skin rash or other skin problems such as itching, peeling, hives, or redness fever agitation or confusion hallucinations shakiness or tremors seizures or convulsions tingling [medical-dictionary.thefreedictionary.com]
Since that day I have suffered with seizures, convulsions, tremors, debilitating fatigue, muscle weakness, vision loss, severe neuropathic pain, vomiting, nausea, lack of appetite, tendon, and vein problems. [hormonesmatter.com]
If any of the following side effects occur, the patient should consult a physician immediately: skin rash or such other skin problems as itching, peeling, hives, or redness fever agitation or confusion hallucinations shakiness or tremors seizures or convulsions [encyclopedia.com]
- Convulsions
I stopped breathing, had numerous convulsions and two grand Mal seizures. [hormonesmatter.com]
The reported adverse reactions include agitation tremor, hallucinations, psychosis and convulsions. [nps.org.au]
If any of the following side effects occur, check with a physician immediately: skin rash or other skin problems such as itching, peeling, hives, or redness fever agitation or confusion hallucinations shakiness or tremors seizures or convulsions tingling [medical-dictionary.thefreedictionary.com]
Antidiabetic drugs serious and sometimes fatal hypoglycemia Phenytoin changes in phenytoin levels, seizure or overdose Methotrexate methotrexate toxicity Drugs that prolong QT interval prolonged QT interval, heart problems Duloxetine duloxetine toxicity NSAIDs convulsions [drugwatch.com]
If any of the following side effects occur, the patient should consult a physician immediately: skin rash or such other skin problems as itching, peeling, hives, or redness fever agitation or confusion hallucinations shakiness or tremors seizures or convulsions [encyclopedia.com]
Workup
Yet extensive medical workups do not find any other cause. Worse, there are no known effective treatments. Thus, these people suffer pain and disability for weeks, months, and years." [articles.mercola.com]
Treatment
Treatment failure with multiple doses of ofloxacin was observed in this case of gonorrhea. [ncbi.nlm.nih.gov]
Prognosis
Single-center experience with drug-induced liver injury from India: causes, outcome, prognosis, and predictors of mortality. Am J Gastroenterol 2010; 105: 2396-404. [livertox.nih.gov]
Etiology
Fluoroquinolone antibiotics (such as olprofloxacin, pefloxacin, ofloxacin, norfloxacin, temafloxacin, etc.) have recently been implicated in the etiology of Achilles tendinitis and subsequent tendon rupture. [ncbi.nlm.nih.gov]
We are more and more being confronted with the advance of multidrug-resistant bacterial etiologies in our patients. [healio.com]
Epidemiology
Epidemiology, University of Pennsylvania, Philadelphia, PA. [ncbi.nlm.nih.gov]
This volume covers their mechanisms of action, resistance mechanisms and epidemiology, pharmacokinetics, safety and clinical applications. [lavoisier.fr]
Pathophysiology
Pathophysiology: Bacterial Resistance Mechanisms Mutations of A Subunits of DNA gyrase Alterations of outer membrane porins Affects organism permeability VIII. [fpnotebook.com]
[…] surveillance data indicating that these medications were associated with subsequent tendonitis and tendon rupture. 4 Several large epidemiological studies have confirmed this association. 5, 6 Secondary cell biology and animal research has elucidated the pathophysiology [bmjopen.bmj.com]
Prevention
Methods: MICs and mutation prevention concentrations were compared among E. coli strain TOP10 and two corresponding transformants harbouring the OqxAB-encoding plasmids. [ncbi.nlm.nih.gov]