Common Drug Reaction Culprits Flashcards
Acneiform lesions
EGFR inhibitors (eg erlotinib, cetuximab, gefitinib)
Acral erythema (erythrodysesthesia)
Doxorubicin, daunorubicin, 5-FU, cytarabine, docetaxel, MTX
Acral sclerosis
bleomycin
AGEP
- beta-lactam antibiotics
- macrolides, CCB, chloroquine, terbinafine
Alopecia
alkylating agents (cyclophosphamide), antrhacyclines (doxorubicin, daunarubicin), taxanes (paclitaxel, docetaxel), vincristine, vinblastine, actinomycin-D, etoposide
Autoimmune hepatitis
Minocycline
Bullous pemphigoid
- Furosemide, PCN, captopril, beta-blockers
- sulfonamides, terbinafine, penicllamine
DM-like eruption
- Hydroxyurea
- penicillamine, statins
Eccrine squamous syringometaplasia
- Cytarabine, paclitaxel, docetaxel
- cyclophosphamide, busulfan, carmustine
Elastosis perforans serpiginosa
D-penicillamine
Erythema nodosum
OCPs, antiobiotics (SULFA, tetracycline), NSAIDs
Extravasation reaction (ulcer, chemical cellulitis)
Anthracyclines (doxorubicin/daunorubicin)
-actinomycin-D, docetaxel, paclitaxel, vinblastine, vincristine, etoposide, 5-FU
Fixed drug eruption
NSAIDs, sulfonamides, TCNs, phenolphthalein, pseudoephedrine (non-pigmenting variant)
-acetaminophen, ASA, OCP, barbituates
Flag sign (of chemo)
MTX (horizontal hyperpigmented bands of hair alternating with normal color)
Gingival hyperplasia
Phenytoin, cyclosporine, CCBs
Hyperpigmentation
antimalarials, clofazamine (violet-brown to blue in lesional skin), imipramine, amiodarone (blue-gray), phenothiazines (chlorpromaine, promethaine, prochlorperazine), chemotherapeutics, and minocycline
Minocycline hyperpigmentation
Type 1: blue-black color within scars, +iron (hemosiderin) with Perls stain
Type 2: blue-gray color on shins, +melanin (Fontana-Masson stain), +iron (Perls stain)
Type 3: generalized “muddy brown” hyperpigmentation in sun-exposed sites (increased melanin within epidermis, no iron deposition)
Hypersensitivity syndrome
aromatic anticonvulsants (phenytoin, phenobarbital, carbamazepine, lamotrigine, oxcarbazepine), sulfonamides, allopurinol, dapsone, gold, olanzapine, saquinavir
Hypertrichosis
cyclosporine, phenytoin, minoxidil, danazol, anabolic steroids
Inflamed ADs
5-FU
-Capecitabine, pentostatin
Inflamed SCC
fludarabine
Inflamed SKs
cytarabine, docetaxel
Leg ulcers
hydroxyurea
Leukocytoclastic vascultitis
Abx (especially beta-lactam)
-NSAIDs, diuretics
Lichenoid eruption
- HCTZ, beta-blockers, antimalarials, quinidine
- penicillamine, gold, furosemide, ACEi
Linear IgA bullous dermatosis
- vancomycin, beta-lactam antibiotics, captopril, furosemide
- NSAIDs, phenytoin, sulfonamides, amiodarone, lithium
Flagellate hyperpigmentation
bleomycin
Supravenous serpentine hyperpigmentation
5-FU
Sun-exposed hyperpigmentation
daunorubicin, 5-FU, MTX
Mucosal hyperpigmentation
busulfan, cyclophosphamide, 5-FU, hydroxyurea, doxorubicin
Hyperpigmentation of Occluded areas
thiotepa
-ifosfamide, topical carmustine, docetaxel, cisplatin
Lupus (SCLE)
HCTZ, griseofulvin, terbinafine, CCBx
Lupus (SLE)
hydralazine, procainamide, isoniazid, MCN, phenytoin, penicillamine
Melanonychia
chemo (melphalan, hydroxyurea, bleomycin, capecitabine, doxorubicin), lamuvidine, MCN, idovudine (AZT)
Mucositis
cyclophosphamide, daunorubicin, doxorubicin, MTX (high dose), 5-FU
Neutrophilic eccrine hidradenitis
doxorubicin, daunorubicin, cytarabine, 5-FU, MTX, bleomycin, cyclophosphamide, busulfan, taxanes
Onycholysis
paclitaxel, docetaxel, etoposide, retinoids, doxorubicin, captopril
Photo-onycholysis
TCN, OCPs, fluoroquinolones, psoralens
Orange-red body fluid
Rifampin
Pemphigus vulgaris
Thiol drugs (penicillamine, captropril, lisinopril) -piroxicam, gold, sodium thiomalate, penicillins, cephalosporines, quinolones, rifampicin, phenylbutazone, propranolol, carbamazepine
Penile ulcers
Foscarnet
Photosensitivity (includes allergic and toxic reations)
griseofulvin, NSAIDs, phenothiazines, sulfonamides, thiazides, dapsone, MTX, hypdroxyurea, 5-FU, fluoroquinolones, TCNs, furosemid, diltiaem, isotretinoin, imipramine, chlorpromazine, phenothiazines
Pseudoporphyria
NSAIDs (naproxen, piroxicam), nalidixic acid), furosemide, HCTZ, isotretinoin, TCNs, sulfonamides
Pseudotumor cerebri
TCN, isotretinoin
Pseuodxanthoma elasticum
Penicillamine
Psoriasis (induce/worsen)
terbinafine, NSAIDs, antimalarials, ACEI, lithium, beta-blockers
pulmonary fibrosis
MTX, bleomycin, busulfan, amiodarone, gold, penicillamine
Radiation recall
doxorubicin, daunorubicin, paclitael, docetaxel, MTX, actinomycin-D, capecitabine, gemcitabine, bleomycin
Raynaud’s phenomenon
combination of bleomycin and vinblastine
Sweet’s syndrome
GCSF
-carbamazepine, TMP-SMZ
Toxic epidermal necrolysis (TEN)
allopurinol, PCNs, anticonvulsants (carbamazepine, lamotrigine, phenytoin), sulfonamides, antiretrovirals, barbituates, NSAIDs
Timeline for AGEP
hours to 2 days
Timeline for phototoxic eruption
hours to 7 days
Timeline for urticaria
hours to 6 days
Timeline for lichenoid eruption
30-100 days
Timeline for fixed drug eruption
up to 2 weeks with first exposure (<24h in subsequent exposure)
Timeline for DRESS
2-6 weeks (mean 3-4 weeks)
Timeline for SJS/TEN
7-21 days (first 2 months for anticonvulsants)
Timeline for morbilliform reaction
7-21 days
Timeline for LABD (linear IgA bullous dermatosis)
24h-2 weeks
Timeline for pemphigus vulgaris reaction
several weeks or months