Drug Allergies

Question 1

What are examples of rashes induced by drugs?

Answer 1

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

Question 2

What is the most common form of drug eruption?

Answer 2

morbilliform

Question 3

What is another word for measles-like?

Answer 3

morbilliform

Question 4

What kind of rash is morbilliform?

Answer 4

maculopapular rash

Question 5

What is the most common drug group to induce morbilliform?

Answer 5

antibiotics

Question 6

What percentage of new prescriptions cause a drug eruption?

Answer 6

2%

Question 7

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

Answer 7

1-2 weeks after starting the drug

Question 8

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

Answer 8

false

Question 9

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

Answer 9

trunk
spreads to the limbs and neck

Question 10

What other symptoms might morbilliform be associated with?

Answer 10

itch
mild fever

Question 11

What is the most important treatment for morbilliform drug eruptions?

Answer 11

stop the drug
try identify the causative drug

Question 12

True or false: antihistamines are helpful for morbilliform

Answer 12

false

Question 13

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

Answer 13

improvement in 48 hours and clears in 1-2 weeks

Question 14

What is itchier; hives or morbilliform?

Answer 14

hives

Question 15

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

Answer 15

the presence of blisters and pus-filled lesions

Question 16

What is the second most common form of drug rash?

Answer 16

hives

Question 17

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

Answer 17

recommend patients stop the drug and contact their MD

Question 18

What is the difference between phototoxic reactions and photoallergic reactions?

Answer 18

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

Question 19

What are the most common drugs that cause SJS?

Answer 19

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

Question 20

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

Answer 20

false

Question 21

When does SJS start to present itself?

Answer 21

4-30 days following first exposure
-within 8 weeks

Question 22

What are the symptoms of SJS?

Answer 22

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

Question 23

When should you seek an MD for drug rashes?

Answer 23

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

Question 24

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

Answer 24

false
can appear after many doses

Question 25

What can be seen as drug rashes start to resolve?

Answer 25

mild skin peeling

Question 26

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

Answer 26

"rash potentially via drug" rather than "drug allergy"

Question 27

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

Answer 27

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

Question 28

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

Answer 28

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

Question 29

Describe rash that results from amoxicillin.

Answer 29

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

Question 30

When is amoxicillin rash more common?

Answer 30

during viral illness (should not be considerd an allergy)

Question 31

True or false: penicillin allergies can resolve over time

Answer 31

true

Question 32

Which drug is the poster-boy for SJS?

Answer 32

sulfas

Question 33

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

Answer 33

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

Question 34

What are causes of morbilliform rashes?

Answer 34

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