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PHAR154 > Drug Allergies > Flashcards

Drug Allergies Flashcards

1
Q

What are examples of rashes induced by drugs?

A

morbilliform
hives
photo-sensitive reactions
SJS/TEN
DRESS
toxic epid necrolysis

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2
Q

What is the most common form of drug eruption?

A

morbilliform

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3
Q

What is another word for measles-like?

A

morbilliform

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4
Q

What kind of rash is morbilliform?

A

maculopapular rash

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5
Q

What is the most common drug group to induce morbilliform?

A

antibiotics

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6
Q

What percentage of new prescriptions cause a drug eruption?

A

2%

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7
Q

When starting a drug, what is the most common time frame for a drug eruption to present?

A

1-2 weeks after starting the drug

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8
Q

True or false: it is very common for a drug that has been taken for months or years to cause a morbilliform drug eruption

A

false

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9
Q

Where do morbilliform drug eruptions tend to first appear? Where will they spread?

A

trunk
spreads to the limbs and neck

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10
Q

What other symptoms might morbilliform be associated with?

A

itch
mild fever

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11
Q

What is the most important treatment for morbilliform drug eruptions?

A

stop the drug
try identify the causative drug

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12
Q

True or false: antihistamines are helpful for morbilliform

A

false

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13
Q

If the causative drug of morbilliform is stopped, how long can you expect the rash to improve?

A

improvement in 48 hours and clears in 1-2 weeks

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14
Q

What is itchier; hives or morbilliform?

A

hives

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15
Q

When should you be really worried about a morbilliform drug eruption?

A

the presence of blisters and pus-filled lesions

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16
Q

What is the second most common form of drug rash?

A

hives

17
Q

What do the vast majority of pharmacists do in most cases of drug rashes?

A

recommend patients stop the drug and contact their MD

18
Q

What is the difference between phototoxic reactions and photoallergic reactions?

A

phototoxic:
-resembles sunburn
-drug activated by sunlight
-fast onset
-clears upon drug clearance from body
photoallergic:
-resembles eczema
-UV rays create an allergen
-longer lasting
-can occur even upon drug clearance

19
Q

What are the most common drugs that cause SJS?

A

allopurinol (gout medications)
acetaminophen, ibuprofen, naproxen
sulfa antibiotics
medication for seizures or mental illness

20
Q

True or false: toxic epidermal necrolysis is far more common than SJS

A

false

21
Q

When does SJS start to present itself?

A

4-30 days following first exposure
-within 8 weeks

22
Q

What are the symptoms of SJS?

A

skin pain (most common)
flu-like
usually not itchy
blisters and open wounds

23
Q

When should you seek an MD for drug rashes?

A

covering the entire body
high temperature
very painful
blisters or open sores
difficulty breathing or throat tightens

24
Q

True or false: drug rashes only appear after the first dose

A

false
can appear after many doses

25
Q

What can be seen as drug rashes start to resolve?

A

mild skin peeling

26
Q

What might it be smart to start indicating on a patient profile when they have a drug rash?

A

“rash potentially via drug” rather than “drug allergy”

27
Q

What could happen upon next exposure to a drug that someone previously got a rash from?

A

no reaction (one off)
same reaction (for a few days)
worse reaction=very RARE

28
Q

What is the number difference between rashes to ibuprofen compared to allergies to ibuprofen?

A

10x more rashes
-5% of people get rashes
-0.5% of people are allergic

29
Q

Describe rash that results from amoxicillin.

A

morbilliform, erythematous, hives
may occur after 3-14 days of therapy, this rash is not a true allergy
starts on trunk and can spread to the periphery
subsides after 1-2 weeks with continued therapy or 7 days if dc

30
Q

When is amoxicillin rash more common?

A

during viral illness (should not be considerd an allergy)

31
Q

True or false: penicillin allergies can resolve over time

A

true

32
Q

Which drug is the poster-boy for SJS?

A

sulfas

33
Q

What are key things to keep in mind with a patient who got a rash from a newly started drug?

A

IF due to drug, most likely morbilliform appearance
IF person was also sick, sickness could be cause of rash
most likely d/c the agent

34
Q

What are causes of morbilliform rashes?

A

infectious: measles, 6th disease, strep
drugs: antibiotics, NSAIDs, etc

PHAR154 (18 decks)

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