Interferon side effects hearing loss,noise in ear from wax gratis,severe hearing loss high frequency,tinnitus different sounds in each ear eclipse - 2016 Feature

Author: admin, 17.05.2015
Interferon alpha therapy is associated with substantial side effects in relation to the neurologic, cutaneous, musculoskeletal, gastrointestinal, cardiovascular, renal, hepatic, and hematologic systems, which may affect the ability to deliver the full course of therapy.
Flu-like symptoms (fever, chills, headache, myalgia, nausea, vomiting) are acute; they last approximately 1to 12 hours after dose administration, and tolerance develops during continued therapy. Mild elevations in hepatic enzymes without clinical symptoms are common in patients who are treated with IFN?2b.
Patients who are treated with interferon may complain of anorexia, weight loss, or early satiety. The most frequently reported IFN?-induced neuropsychiatric side effects are depression and irritability; however, an acute confusional state, anhedonia, fatigue, apathy, weight loss, sleep disturbances, tremor, sexual dysfunction, impaired memory, manic symptoms, cognitive dysfunction, and suicidal ideation also are reported. In 1 series of 44 patients who were treated with IFNs of all types, the most common cardiac events were cardiac arrythmias (primarily in patients with previous disturbances of cardiac pace), dilated cardiomyopathy, and ischemic heart disease. It has been demonstrated that IFN-? precipitates or exacerbates autoimmune endocrine diseases, particularly thyroid disorders.
Erectile dysfunction and a decrease in libido have been described in some men who received IFN. Retinopathy (retinal hemorrhages, cotton wool spots) or optic neuropathy have been reported in <1% of patients who are treated with interferon. Cerebral atrophy (brain size decreases), aseptic meningitis (inflammation of the lining of the brain without evidence of infection), Bell’s palsy or other facial palsy (temporary partial paralysis involving the eyelid and cheek), decreased short term memory, decreased cognitive abilities. Initiation of or worsening of lupus, rheumatoid arthritis, psoriasis, inflammatory bowel disease, Sjogren’s disease (dry mouth and eyes). Depression, anxiety, irritability, lack of concentration, insomnia, mental confusion, hallucinations, mania, bipolar disorders, suicidal thoughts and attempts, homicidal thoughts, psychosis, paranoia, neurosis, disorders of psychomotor activity, vegetative symptoms. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.
In addition to the controversies regarding dose-response, to our knowledge there is no international consensus regarding and little rigorous trial data to support the optimal duration of interferon therapy, which has ranged from 1 month (using intravenous high-dose IFN) to as long as 5 years.

Toxicities can be associated with the individual IFN dose regimen (eg, flu-like symptoms), in which tachyphylaxis describes the phenomenon of improved tolerance with daily versus more intermittent administration. In addition to interferon administration, other potential causes for elevated hepatic enzymes during the course of interferon therapy include alcohol consumption or underlying disease, such as hepatitis B or C.
Causes of fatigue may be endocrine, neuropsychiatric, autoimmune, or cytokine dysregulation.
Treatment of cardiotoxicity consists of discontinuing IFN and employing standard approaches to the management of cardiac failure. Numerous medications are available for the treatment of erectile dysfunction and may be helpful. Other side effects are associated with cumulative IFN dose or with duration of therapy (eg, anorexia and weight loss). Premedication with acetaminophen, antiemetics, or nonsteroidal anti-inflammatory drugs, as well as adequate hydration during therapy, can reduce the intensity of these symptoms.
Individuals most prone to fatigue include those who have a compromised performance status, those who are receiving higher doses of IFN, and those who are older.
The patient and family should be counseled regarding realistic expectations with regard to meal preparation, meal times, and changes in eating habits and food preferences. Hypothyroidism can be an underlying cause of cardiac dysfunction, and can have a variety of effects on the heart, such as ventricular dilation, pericardial effusion, and poor contractility. The ability of IFN to induce autoimmunity reportedly was an independent predictive biomarker of relapse-free survival and overall survival in a Phase II study conducted in patients with high-risk melanoma (E2696). Patients with diabetes and hypertension are at increased risk for developing ocular toxicity. Practical guidelines for the management of interferon-?-2b side effects in patients receiving adjuvant treatment for melanoma. Mechanisms and management of toxicities associated with high-dose interferon alfa-2b therapy.

Longitudinal course of depression, fatigue, and quality of life in patients with high risk melanoma receiving adjuvant interferon. Although treatment with HDI is not precluded in the presence of hepatitis B or C, an increase in the degree of hepatic function surveillance, including liver biopsy and involvement of the hepatology service in management of such cases, is recommended. Patient performance should be assessed before initiating treatment and periodically during therapy.
Ocular toxicity may occur at any time during treatment; a correlation between dose or duration of interferon therapy and ocular toxicity has not been well established. Although interferon side effects also may be characterized as acute or chronic, some may appear to some extent throughout treatment (Fig. In addition, patients should avoid other hepatotoxic agents, including anesthetics, statins, and large quantities of alcohol, during interferon treatment.
Although, in most patients, visual acuity returns to normal when IFN is discontinued, visual loss can be permanent.
Acetaminophen should be used judiciously, and patients should be cautioned regarding the risks of exceeding recommended dosages.
Of concern, in 1 series of 7 patients who developed retinopathy while undergoing treatment with IFN, 6 patients had received concurrent paroxetine. In another series of 20 patients who received paroxetine for depression prophylaxis, 3 patients experienced retinal hemorrhage.

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