Drug allergies page 118

vitohuxo's version from 2016-02-18 01:09


Question Answer
type Apredictable. dose dependent and can occur in any patient
type Bnot dose dependent typically and not related to pharmacologic action of the drugs. patient specific susc patterns. drug intolerance, allergy, steven johnson, or pseudoallergic
type 1 drug allergy=immediate (15-30 mins of exposure) IgE immune response....hives, bronchospasm, anaphylaxis, etc.minor inconvenience to death
type 2 allergy=minutes to hours after exposure. anemia and thrombocytopenia.
type 4 allergy=delayed....48 hours to severel weeks after exposure. (PPD skin test for tuberculosis response peak 48-72 hours)
scale that helps determine if drug causes the ADRnaranjo scale
side effects, ADRs, and allergies should be reported to the (also biologics, cosmetics, medical devices)FDA's medwatch program (FAERS)=fda adverse even reporting system. reporting voluntary but should be done.
FDA conducts phase ___ post marketing safety survellience program on approved drugsphase 4
the drug manufacterur can also receive ADRS or allergies and they are required to report to FDA
if nausea more of anintolerance
opiods and mild rashcan cause non allergic release of histamine from mast cells in skin causing itching and rash. if not severe can pre-treat with benadryl
photosensitivitywhen sunlight reacts with drug in the skin and causes tissue damage that looks like severe sunburn. red, itchy rashy that can spread to areas not exposed.
drugs most commonly associated with photosensitivitycyclosporine, oral and topical retinoids, quinolones, st johns wort, sulfa antibiotics, tacrolimus, voriconazole
steven johnson syndromegenerally occur 1-3 weeks after drug administration and almost always more than 72 hours after admin. best treatment is to STOP although may continue worsen for bit even after stopping
systemic steroids may be used in ___ but CI in ____TEN (toxic epidermal necrolysis) CI in steven johnson.
drugs commonly associated with severe skin reactionsallopurinol, lamotrigine, penicillins, sulfamethazole, piroxicam, phenytoin, clopidogrol, ticlopidine,
to be a true drug allergry must have been exposed before....initial exposure cause type 1 resulting igE production then next time take body releases tons histamine BUT can get anaphylaxis first exposure
patients emergency kit should includebenadryl 25mgx2 and epi pen (0.3mg or 0.15 mg pens)
if someone allergic to any beta lactam....on exam shouldavoid using beta lactam unless no other alternative.
sulfamethoxazole allergy avoid....sulfapyridine, sulfadiazine, and sulfisoxazole.
sulfamethoxazole allergy then usually no cross reaction but possible with...."non-arylamine sulfonamides" thiazide diuretics, loops, sulfonylureas, acetazolamide, zonisamide, and celebrex.
sulfite or sulfate allergies do not cross react with"non-arylamine" sulfonamides. sulfites= rotigotine patch, orphenadrine injection, rowasa mesalamine enema, some dobutamine formulations, and some eye drops
opiods that cross react=morphine, oxymorphone, codeine, hydrocodone, hydromorphone, oxycodone, nalbuphine, buprenorphine, butorphanol, levorphanol, naloxone, and heroin
opiod allergy caution withtramadol and tapentadol.
known morphine allergy choosefentanyl, meperidine, methadone, tramadol, or tapentadol.
fentanyl and _________ are cross reactivemeperidine
peanut allergy cross reactivity with
penaut or soy allergy avoid....clevidipine, propofol, progesterone in prometrum capsules.
patient has hives from eggs flu shot....inactivated IM done by healthcare proffesional can sit and watch for 30 mins
patient who has CV changes from egges flu shot...refer to allergist
flu vaccine uses no eggs at all=flublok
2 drug classes cause most allergiespenicillins and sulfonamides
penicillin skin test predictsIgE response (type 1 sensitivity)