Ponte 2017
Category
Primary disease or symptom
Prescribing cascades routes
Alimentary tract and metabolism
Nausea
Metoclopramide→sustained dystonia→lorazepam → excessive sedation→trihexyphenidyl
Antineoplastic and immunomodulating agents
Acute myeloid leukemia
Chemotherapy→febrile neutropenia→imipenem→chills and high fever→NSAIDs
Alimentary tract and metabolism
Nausea
Metoclopramide→generalized tonicclonic seizure→antiepileptic agents
Antiinfectives for systemic use
Abdominal symptoms
Imipenem→generalized tonicclonic seizure→lorazepam and phenytoin→ meropenem→generalized tonicclonic seizure
Antiinfectives for systemic use
Urinary tract infection
Imipenem→central nervous system symptoms exacerbation→valproic acid→hyperammonemia→levetiracetam
Cardiovascular system
Atrial fibrillation
Amiodarone→hypothyroidism→levothyroxine
Alimentary tract and metabolism
Epigastric pain and nausea
Metoclopramide→diarrhea→loperamide
Antineoplastic and immunomodulating agents
Breast cancer
Lapatinib→hypertriglyceridemia→Bate lipid-lowering agents→nausea and vomit →metoclopramide
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処方カスケードの判定
Existence of ADR, either expected or unknown:
Doubtful 0
Yes 1
Yes, but misunderstood 2
Action followed against the ADR:
Treatment discontinuation 0
Continued with dose reduction 1
Continued unchanged or with another drug of the 2
same group
Existence of a second drug treatment for the ADR:
No 0
Yes 1
Overall result of this new treatment:
Patient improves 0
Patient worsens or remains unchanged 1
A new ADR appears 2
The new ADR requires a third drug treatment 3
Sum (minimum required is 4)