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NAPLEX > Drug Allergies > Flashcards

Drug Allergies Flashcards

1
Q

What is a type-2 reaction

A

Occurs in minutes - days

Examples: hemolytic anemia, thrombocytopenia

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2
Q

Type 3 reaction

A

Immune complex rxn

Ex: drug induced lupus, serum sickness

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3
Q

Type 4 rxn

A

Delayed hypersensitivity (48h-wks after)

Ex: PPD tb skin test

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4
Q

Type A reaction

A

Dose dependent and predictable

Ex: doxazosin 1 mg qhs titrated up to 4 mg to decrease type a rxn of orthostatic hypotension

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5
Q

Type B reaction

A

Idiosyncratic (not predictable) drug rxn

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6
Q

Where should side effects/adverse events/allergies be reported

A

FDA medwatch program (FDA’s adverse event reporting system - FAERS) exception: VACCINES - reported in VAERS

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7
Q

what is used to determine if a drug is the cause of a rxn?

A

The Naranjo Scale

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8
Q

Drugs associated with photosensitivity

A 
SULFA ANTIBIOTICS
TETRACYCLINES
NSAIDs
Amiodarone
Chloroquine
Oral/topical retinoids
Coal tar
Quinine
Fluoroquinolones
Griseofulvin
Tarcolimus
Thiazides and loop diuretics
St. John's wort
Cyclosporine
Tigecycline
Voriconazole
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9
Q

Drugs that can cause Stevens johnsons syndrome or toxic epidermal necrolysis

A 
Sulfamethoxazole
Allopurinol
Carbamazepine
Clindamycin
Oxcarbazepine
Phenobarbital 
Ethosuximide
Lamotrigine
Phenytoin/fosphenytoin
Clopidogrel
Ticlopidine
Quinine
Abacavir
Nevirapine
Letrozole
Hydrochloroquine
Piroxicam
Minocycline/doxycycline
Taigabine
Zonisamide
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10
Q

Common drugs that cause drug rxn with eosinophilia and systemic symptoms (DRESS)

A

Ethosuximide
Carbamazepine
Phenytoin/fosphenytoin
Minocycline/doxycycline

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11
Q

Drugs that can cause thrombotic thrombocytopenic purpura (TTP)

A 
Cloud often
Ticlopidine
Sulfamethoxazole
Quinine
Acyclovir/valacyclovir/famciclovir
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12
Q

Treatment for SJS and TEN

A 
Stop offending agent 
Can use corticosteroids in SJS BUT CONTRAINDICATED IN TEN
ANTIBIOTICS
CONTROL PAIN WITH OPIOIDS
Fluid/lytes
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13
Q

Symptoms/signs of TEN And SJS

A

Severe exposive mucosal erosions
High temp
Damage to organs

SJS can lead to TEN

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14
Q

DRESS symptoms

A

Skin eruptions
Fever, hepatic/renal dysfunction
Lymphadenopathy

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15
Q

DRESS treatment

A

Stop offending agent

Symptoms may worsen for a period of time

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16
Q

TTP symptoms

A

Purpura and petechiae

17
Q

TTP tx

A

Emergent plasma exchange

18
Q

What two drug classes cause most drug allergies

A

Penicillins and sulfonamides

19
Q

Treatments of drug reactions

A

Non breathing difficulty - stopping causative agent (sometimes)

Antihistamines - decrease swelling and rash
Steroids - severe swelling (needs injection)
NSAIDS - decrease swelling
Epinephrine - reverses bronchoconstriction

20
Q

Epi pen instructions

A

Jab into outer thigh at a 90 degree angle (through clothes if necessary)

Count to 5 slowly

Remove injector and rub area

If needle is showing you received the dose, if not inject again

If needed used second pen the opposite outer thigh

Take 2 antihistamine tablets

21
Q

What is a type-1 reaction

A

Immediate

Severity- minor to death

22
Q

Beta lactam allergy - what to avoid

A

Pcns ALL

potential cephalosporin allergy also: cephalosporin and carabapenem

23
Q

Ppl with sulfa allergies should avoid

A 
Sulfamethoxazole
Sulfapyridine
Sulfadiazine
Sulfisoxazole
 Look at book for more info!
24
Q

Side effects of true allergy to NSAIDS

A

Urticaria
Angioedema
+/-anaphylaxis

On exam even avoid COX2 selectives but used clinically

25
Q

Drugs to avoid if have peanut or soy allergy (same family and can have cross reactivity)

A

Clevidipine (cleviprex)
Propofol (diprivan)
Progesterone (prometrium capsules)

26
Q

Pts with egg allergy should avoid

A 
Clevidipine (cleviprex) 
Propofol (diprivan) 
Influenza vaccine (can use fluvox) 
Yellow fever vaccine
Rabies vaccine

NAPLEX (15 decks)

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