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At least 19 recordsLinked to original sources
PubMed1975

Hydroxychloroquine sulfate in prevention of thromboembolic phenomena in surgical patients.

Hydroxychloroquine sulfate appears to be a safe drug with no apparent hemorrhagic or other complications when used pre- and postoperatively in the manner described. With the criteria for thromboembolism of abnormal impedance plethysmography and confirmatory clinical signs, protection seems to have been afforded by hydroxychloroquine sulfate. Since these studies support prior extremely favorable results, further clinical trial with parenteral hydroxychloroquine sulfate seems indicated.

Hematocrit↗
PubMed1976

Prevention of venous thromboembolism by administration of hydroxychloroquine. A preliminary report.

A placebo or the antimalarial agent hydroxychloroquine (Plaquenil), which inhibits platelet adhesiveness, and, to a lesser extent, platelet aggregation, was given to 100 patients between forty and ninety-five years old (average age, seventy-four years) who had either fractures or orthopaedic operations involving the skeleton between the knee and the pelvis. Medication was started at the time of admission in a blind, randomized way, fifty patients receiving hydroxychloroquine (200 milligrams three times a day) and fifty, a placebo. No untoward bleeding complications were noted in the treated group. Eight instances of thromboembolism were encountered in the control group as compared with one in the hydroxychloroquine-treated group, a statistically significant difference at the 1.5 per cent level.

Adult↗
PubMed1975

[Lupus nephropathy. Treatment with the indomethacin-hydroxychloroquine combination and comparison with corticoids].

The authors report their comparative experience of the treatment of proliferative lupus glomerulonephritis using prednisone (16 patients) or the indomethacin-hydroxychloroquine association (12 patients). Prednisone in high dosage was associated in this series with 9 deaths and in 6 patients, with renal failure or an extra-renal complication. By contrast, the indomethacin-hydroxychloroquine association proved to be highly effective, without side-effect. In the endocapillary glomerulonephritis group (8 cases) the authors obtained 7 durable remissions (36.3 months on average) and 1 temporary remission of 24 months, with an average length of treatment of 45.8 months. In the extracapillary glomerulonephritis group (4 cases) the authors obtained 1 remission, 2 improvements and I death, with an average length of treatment of 16.8 months. This combination has a highly significant anti-proteinuric and anti-haematuric action, with a constant efficiency on renal function and on the extra-renal signs of lupus. Its effect is less constant on the immunological disorders. Study of iterative renal biopsies confirms this favourable impression. According to these results, the authors propose a provisional scheme of management of proliferative lupus glomerulonephritis.

Adolescent↗
PubMed1979

Ophthalmologic safety of long-term hydroxychloroquine treatment.

Ocular toxicity of long-term hydroxychloroquine treatment was assessed by regular ophthalmologic examinations in 99 patients. No patient developed significant loss of vision or visual field constriction to a white test object. Three patients had evidence of toxicity, but the medication had to be permanently discontinued in only one who subsequently had regression of all abnormalities except visual field constriction to a red test object. Neither duration of treatment nor the diagnosis of systemic lupus erythematosus predisposed patients to toxicity.

Accommodation, Ocular↗
PubMed1976

Hydroxychloroquine sulphate in prevention of deep venous thrombosis following fracture of the hip, pelvis, or thoracolumbar spine.

One hundred and fifty-three patients, forty-eight to ninety-seven years old, were included in a double-blind placebo-controlled investigation of the usefulness of hydroxychloroquine sulphate for the prevention of deep venous thrombosis in patients with fractures of the hip, pelvis, or thoracolumbar spine. The results indicated that this drug can reduce the number of thrombeombolic complications significantly (p less than 0.005), a finding that corresponds to the results obtained with other drugs such as coumarin derivatives or dextran 70.

Aged↗
PubMed1977

Failure of orally administered hydroxychloroquine sulphate to prevent venous thromboembolism following elective hip operations.

In a double-blind, randomized trial of orally administered hydroxychloroquine sulphate in the prevention of venous thromboembolism after elective surgery on the hip, the drug or a placebo was given to fifty consecutive patients. Therapy was commenced on the day before the operation and continued for fourteen days. The diagnosis of deep venous thrombosis was made by daily thermographic scanning of the legs and confirmed by phlebography. The diagnosis of pulmonary embolism was made by perfusion lung scanning. No significant difference in the incidence of thromboembolism was found between treated and control groups. The results provide evidence that substances which reduce the incidence of thromboembolism in general surgery may not be effective in operations on the hip.

Administration, Oral↗
PubMed1977

Prophylaxis of deep venous thrombosis by hydroxychloroquine sulfate and heparin.

A double blind study of 134 patients was undertaken to compare the effectiveness of hydroxychloroquine sulfate, Plaquenil, and heparin in the prophylaxis of deep venous thrombosis. By the 125I fibrinogen scanning technique, deep venous thrombosis was detected in six patients in the placebo group, in one patient in the Plaquenil group and none in the heparin group. These results indicate that both heparin and Plaquenil do diminish the incidence of thrombosis.

Adult↗
PubMed1979

Hydroxychloroquine in prophylaxis of pulmonary embolism following hip arthroplasty.

Two thousand one hundred and forty four patients received Plaquenil (hydroxychloroquine sulphate) prior to total hip arthroplasty; the drug was continued until the patient was fully mobile. Fatal emboli (confirmed by postmortem) occurred in 0.28% and non-fatal emboli (diagnosed clinically) occurred in 4.15%. This was a statistically significant improvement over the overall results of all previous prophylactic measures used in this unit. The results of Plaquenil are significantly better than the most effective agent previously used in this unit, namely, Dindevan (phenindione). There were no deaths and no serious gastrointestinal or genitourinary bleeding. Allergic rashes occurred in 18 patients (0.8%), temporary blurring of vision in 6 (0.3%), and minor gastrointestinal upsets, including nausea, vomiting and minor bleeding in 12 (0.6%).

Dextrans↗
PubMed1992

Long-term second-line treatment: a prospective drug survival study.

The long-term use of second-line antirheumatic drugs was prospectively studied in a consecutive sample of 245 patients with recently diagnosed rheumatoid arthritis. A survival analysis was done in which treatment termination due to side-effects and to insufficient therapeutic effect were used as index causes. Cumulative drug 'survival' of aurothioglucose with treatment termination due to toxicity was significantly less compared with hydroxychloroquine. With regard to lack of efficacy as index cause, the administration time of hydroxychloroquine was significantly less than that of either aurothioglucose or sulphasalazine. Treatment termination due to lack of efficacy or combined insufficient therapeutic response and toxicity proved to be influenced by the initial disease activity and by the rank order of prescription.

Arthritis, Rheumatoid↗
PubMedDate not supplied

A study of 100 high risk lupus pregnancies.

Certain subgroups of lupus patients and those with circulating antiphospholipid antibodies (aPL) in particular, suffer a high rate of fetal loss. Over the past 4 years, we have prospectively studied 100 pregnancies in patients with systemic lupus erythematosus (SLE) and primary antiphospholipid syndrome. In addition to conventional methods of monitoring SLE and fetal development, we have also used Doppler flow assessment of placental perfusion from the 14th wk of pregnancy onward. Patients with the antiphospholipid syndrome and previous history of thrombotic events were treated with daily heparin (10,000 IU) and low-dose aspirin (75 mg). Those without a history of thrombosis were treated with low-dose prednisolone, azathioprine, or hydroxychloroquine. Pregnancy loss was reduced from 81.3% in 101 previous pregnancies to 36.8% in 100 pregnancies managed by us. None of the patients who received hydroxychloroquine throughout the pregnancy presented fetal malformations. Careful management and close monitoring of the lupus pregnancy has substantially improved fetal outcome.

Abortion, Spontaneous↗
PubMed1979

Antiplatelet drugs: clinical pharmacology and therapeutic use.

Because platelets are so important in thrombus formation, drugs which inhibit platelet function (the 'antiplatelet drugs') have considerable potential as antithrombotic agents. Among the antiplatelet drugs, only aspirin, sulphinpyrazone, dipyridamole, hydroxychloroquine, and clofibrate have had wide clinical trial. Their effects on platelet metabolism differ. Aspirin prevents platelet prostaglandin synthesis by acetylating and irreversibly inactivating platelet prostaglandin synthetase, while sulphinpyrazone is a reversible inhibitor of the same enzyme. Both aspirin and sulphinpyrazone impair the platelet release reaction and reduce platelet aggregation, but neither prevents platelet adhesion to the subendothelium or to foreign surfaces. On the other hand, dipyridamole reduces platelet adhesion as well as aggregation, probably by inhibiting phosphodiesterase and so raising platelet cyclic AMP levels. The effects of hydroxychloroquine and clofibrate have been less well defined. As the antiplatelet drugs form a diverse group of substances with differing effects on platelet function, it is hardly surprising that every potential clinical application of each antiplatelet drug or drug combination has had to be tested separately, and that these drugs have not proved to be equally effective. One or more antiplatelet drugs have now been evaluated in each of the following situations.

Blood Platelets↗
PubMed1992

Ocular side effects of selected systemic drugs.

Numerous systemic drugs produce adverse effects that involve the eye. Pigmentary inclusions of the lids or conjunctivae or both may be caused by a variety of drugs, including amiodarone, chlorpromazine, and gold salts, while conjunctivitis and blepharoconjunctivitis have been associated with isotretinoin, sulfonamides, salicylates, and antineoplastic agents. Dry eye complaints may be caused by antihistamines, beta-receptor blocking agents prescribed for cardiovascular problems, antianxiety agents, and tricyclic antidepressants. Several drugs have been well documented as causes of keratopathies and/or lenticular deposits, including chloroquine and hydroxychloroquine, chlorpromazine, gold salts, systemic corticosteroids, nonsteroidal antiinflammatory drugs, and the antiarrhythmic agent amiodarone. Visual acuity may be decreased by transient changes in refractive error caused by sulfonamides, the antifungal agent metronidazole, thiazide diuretics, and carbonic anhydrase inhibitors. Dilation of the pupil may be caused by anticholinergic drugs, antihistamines, antidepressant agents, and central nervous system stimulants such as cocaine, methylphenidate, and amphetamines. Nystagmus, diplopia, and extraocular muscle palsies have been associated with central nervous system depressants, antihistamines, barbiturates, and elevated blood ethanol concentrations. Intraocular pressure can be elevated in susceptible individuals by long-term use of topical or systemic corticosteroids. Numerous drugs have been associated with retinal toxicity, including chloroquine and hydroxychloroquine, thioridazine, tamoxifen, and talc, which may embolize to the retinal circulation when administered by long-term drug abusers. The antituberculosis agents ethambutol and isoniazid have been implicated as causes of reduced acuity, visual field defects, and disturbances of color vision. Optic neuritis and retrobulbar neuritis may result from the use of chloramphenicol. This paper describes these and other adverse ocular effects that may be encountered when examining patients who are taking systemic drugs.

Amiodarone↗
PubMed1975

Ocular manifestations of juvenile rheumatoid arthritis.

We followed 210 cases of juvenile rheumatoid arthritis closely for eleven years. Thirty-six of the 210 patients (17.2%) developed iridocyclitis. Iridocyclitis was seen most frequently in young female patients (0 to 4 years) with the monoarticular or pauciatricular form of the arthritis. However, 30% of the patients developed uveitis after 16 years of age. Although 61% of patients had a noncontributory ocular history on entry, 42% had active uveitis on entry. Our approach was effective in detecting uveitis in new cases and exacerbations of uveitis in established cases. Forty-four percent of patients with uveitis had one or more identifiable signs or symptoms, such as red eye, ocular pain, decreased visual acuity, or photophobia, in order of decreasing frequency. Even after early detection and prompt treatment, 41% of cases of uveitis did not respond to more than six months of intensive topical treatment with corticosteroids and mydriatics. Despite this, there was a dramatic decrease in the 50% incidence of blinding complications of uveitis cited in earlier studies. Cataract and band keratopathy occurred in only 22 and 13% of our group, respectively. We used chloroquine or hydroxychloroquine in 173 of 210 cases and found only one case of chorioretinopathy attributable to these drugs. Systemically administered corticosteroids were used in 75 of 210 cases; a significant number of posterior subcapsular cataracts was found. Typical keratoconjunctivitis sicca developed in three of the uveitis cases. This association with uveitis and JRA was not noted previously. Surgical treatment of cataracts, band keratopathy, and glaucoma achieved uniformly discouraging results.

Adolescent↗
PubMed1979

Long-term course of chloroquine retinopathy after cessation of medication.

Seven patients with chloroquine retinopathy were examined ten years after their therapy with chloroquine or hydroxychloroquine, or both, had been discontinued and an additional five patients with chloroquine retinopathy were similarly examined from two to eight years after their therapy had been discontinued. Visual acuity, visual fields, and ophthalmoscopic examinations were compared to those performed at the time therapy was discontinued. These long-term observations confirmed the previously published observations based on short-term studies that chloroquine retinopathy tends to remain stable after therapy is discontinued, although a few patients in the early stages of retinopathy may show regression and occasionally a patient with a more advanced stage of the disease may show progression.

Adult↗
PubMed1977

Prevention of postoperative thrombosis by aspirin.

In a random double-blind trial monitored by 125I-fibrinogen leg scan, impedance plethysmography, and contrast phleobograms if impedance became abnormal, hydroxycholoroquine was shown to be no more effective than placebo for prevention of venous thrombosis after total hip replacement. Subsequently, the combination of hydroxychloroquine with aspirin was shown to be not significantly better than aspirin alone. Although the two parts of the trial were performed in an identical manner, comparison of the two sequential parts of this investigation, which provided a significant tread favoring aspirin, must be interpreted with caution. Further study including concurrent controls is needed.

Aspirin↗