Drug Allergies

Question 1

Type A ADR

Answer 1

-dose dependent
-known pharmacological property (orthostatic hypotension)

Question 2

Type B ADR

Answer 2

-unrelated to dose or pharmacologic action
-includes drug allergies, HSR, and idiosyncratic reactions

Question 3

Type 1 reaction - immediate

Answer 3

-IgE mediated
-local to systemic reactions
-examples: urticaria, bronchospasm, angioedema, anaphylaxis

Question 4

Type 2 reaction - Delayed

Answer 4

-Anti-body mediated
-5 to 8 days after exposure
-Examples: hemolytic anemia, thrombocytopenia

Question 5

Type 3 reaction - Delayed

Answer 5

-immune complex reaction
-occurring greater than 1 week post exposure
Example: Serum sickness

Question 6

Type 4 reaction - Delayed

Answer 6

-T-cell mediated
-48 hour to weeks
-Steves-Johnson syndrome

Question 7

Key drugs that cause photosensitivity

Answer 7

-Amiodarone
-Diuretics
-Methotrexate
-Oral and topical retinoids
-Quinolones
-St. John’s Wort
-Sulfa drugs
-Tacrolimus
-Tetracyclines
-Voriconazole

Question 8

Thrombotic Thrombocytopenic purpura (TTP)

Answer 8

-blood disorder when clots form throughout the body
-causes formation of bruises (purpura) and dots (petechiae) on the skin
-treated immediately with plasma exchange

Caused by: clopidogrel, sulfamethoxazole

Question 9

Human Leukocyte Antigen-Associated Hypersensitivity Reactions

Answer 9

-presence of HLA alleles increases the risk of delayed hypersensitivity reactions

Remember HLA-B5701 puts pt at risk for Abacavir hypersensitivity

Question 10

SCARs

Answer 10

Severe cutaneous Adverse Reactions
-SJS
-TEN (toxic epidermal necrolysis)
-DRESS

Question 11

systemic steroids in TEN

Answer 11

CONTRAINDIACTED

Question 12

Key drugs associated with the most severe cutaneous adverse reactions

Answer 12

-allopurinol
-Amoxicillin
-Ampicillin
-Carbamazepine
-Ethosuximide
-lamotrigine
-Nevirapine
-Phenytoin
-Sulfamethoxazole
-Sulfasalazine
-Vancomycin

Question 13

Anaphylaxis treatment

Answer 13

EPI injection
Diphenhydramine
steroids
IV fluids

Question 14

Types of Epi Pens

Answer 14

EpiPen
Auvi-Q (has a 0.1mg dose available)
Symjepi

(0.15mg dose for those 15 - 30 kg)

Question 15

Penicillin allergy but acute otitis media exception

Answer 15

-2nd or 3rd generation cephalsporin recomended in patients with non-severe penicillin allergy

Question 16

Aztreonam

Answer 16

-monobactam
-considered safe in pts with a penicillin allergy

Question 17

Sulfa allergy drugs to avoid

Answer 17

-thiazide and loop diuretics (besides ethacrynic acid)
-sulfonylureas
-acetazolamide
-zonisamide
-celecoxib
-cidofovir and darunavir
-fosamprenavir
-tipranavir

Question 18

Peanut allergy oral immunotherapy

Answer 18

Palforzia

Question 19

Peanuts and soy and egg allergies

Answer 19

-cross reactivity (peanut and soy)
-drugs C/I with soy + egg allergy = clevidipine and propofol

Eggs: yellow fever vaccine and use Flublok and Flucelvax

Question 20

FAERS

Answer 20

FDA Adverse Effect Reporting System
-FDA’s Medwatch program for side effects, allergies and adverse events

Question 21

VAERS

Answer 21

same reporting system as FAERS but only for vaccines

Question 22

Phase IV FDA approved trials

Answer 22

post-marketing safety surveillance programs

Question 23

Are med guides considered part of drug labeling?

Answer 23

Yes