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Phar 504 > Drug Allergies > Flashcards

Drug Allergies Flashcards

1
Q

What type of allergy is immediate in onset, delayed

A

Type 1/ type 2,3,4

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2
Q

Which allergic reaction is antibody mediated

A

Type 1

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3
Q

What are clinical features of Type 1 antibody reactions

A

Hives, itching, flusing, angioedema, hypotension, anaphylaxis

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4
Q

T/F: There is not a fever in type 1 allergy reactions

A

True

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5
Q

What is anaphylaxis, goals of therapy

A

acute, life-threatening allergic reaction involing multiple organ systems, anaphylactic shock

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6
Q

How often does Type 1 reactions causes problems for the skin, respiratory tract, GI, CV

A

80-90%, 70%, 40%, 35%

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7
Q

How quick is anaphylaxis

A

within 30 minutes of antigen exposure

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8
Q

T/F: Anigodema is only bilateral

A

False: Angioedema can be unilateral or bilateral

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9
Q

What type of angioedmea is a part of the type 1 allergic reaction

A

Mast-cell mediated

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10
Q

What are the criteria for having a type 1 allergic reaction

A

sudden skin or mucosal symptoms and signs, sudden respiratory symptoms and signs, sudden reduced BP or symptoms of end-organ dysfunction, sudden gastrointestinal symptoms

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11
Q

How many of the criteria is need to diagnose as a type 1 allergic reaction if the antigen is known, unkwown

A

2, 1

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12
Q

T/F; Skin manifestations must be present to be considered a type 1 allergic reaction

A

False: Skin manifestations is absent in 10 to 20% of the cases

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13
Q

Which allergic reaction is a cytotoxic reaction

A

Type 2

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14
Q

What causes a type 2 allergic reaction

A

Drug binds to surfaces of certain cell types and act as antigens

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15
Q

How long does it take for symptoms to occur in type 2 allergic reactions

A

1 week (can begin within hours if previously exposed)

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16
Q

What are clinical features of type 2 allergic reactions

A

hemolytic anemia, thrombocytopenia, leukopenia, neutropenia

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17
Q

What is heparin induced thrombocytopenia (HIT)

A

antibody initiates profound activation of platelets while, at the same time, initaiting their clearance by macrophages

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18
Q

What is a risk of HIT

A

low platelet count, blood clotting

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19
Q

Which allergic reaction is a immune-complex reaction

A

Type 3

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20
Q

What causes a type 3 allergic reaction

A

Free IgG or IgM binds to the drug to form free, soluble, circulating immune complexes that can percipitate into tissue causing an inflammatory response

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21
Q

When would Type 3 allergic reactions take place

A

after high dose, long term, or recurrent drug exposure

22
Q

How long does it take for a type 3 allergic reaction to take place

A

1 week or more

23
Q

What are the clinical features of type 3 drug allergies

A

Drug fever, vasculitits, serum sickness

24
Q

What are differences between drug fever and infectious fever

A

fever will stop upon discontinuation of drug and recur within hours of re-challenge, commonly high: 102-104, patients often do not realize they have a fever

25
What cell type is usually present in only drug fever
Eosinophils
26
Which allergic reaction is cell mediated/delayed
Type 4
27
When do type 4 reactions take place
1-3 weeks
28
What are dangerous diseases that can occur due to type 4 allergic reactions
Stevens-Johnsons syndrome and Toxic Epidermal Necrolysis
29
What are indications of SJS and TENS, which is more dangerous
blistering and skin sloughing, TENS
30
What is Drug Rash with Eosinophilia and Systemic Symptoms
severe drug reaction that involves widespread rash, fever, and single or multi organ failure
31
What are organs affected by DRESS
Liver (80%), kidney, heart, lungs, muscle, pancreas
32
T/F: DRESS has the unique feature of single or multi organ failure and not all cases are associated with eosinophilia
True
33
When does aminopenicillin reaction occur
7 to 14 days after starting antibiotics
34
What is common in lupus but not drug induced lupus
malar rash and discoid lesions, renal involvement, positive double stranded DNA antibodies
35
T/F: A patient with positive anti-ds DNA and positive anti-histone antibodies likely has DILE
False: A patient with negative anti-dsDNA and postive anti-Histone antibodies likely has DILE
36
What drugs cause DILE
slufas, hydralizine, isoniazaid, procainamide, phenytoin
37
What are drugs that are started to be indicated for interstitial nephritis
PPIs
38
Which drugs cause drug induced phototoxicity/photoallergy
tetracyclines, sulfonamides, voriconazole, amiodarone
39
What is the most common cause of allergic drug reactions
Beta lactams
40
T/F: Skin testing for an antibiotic test not the drugbut instead the metabolite
True
41
What drug has cross reactivity to beta lactams
cephalosporins, carbapenam
42
What type of aztreonam could have cross reactivity with beta-lactams
ceftazidime (identical side chain to that aztreonam)
43
What is the drug that causes the 2nd most drug allergies, what part causes this
sulfonamides, arylamine side chain
44
T/F: Beta lactams are the most common causes for SJS and TEN
False: Sulfonamide allergy is the most common cause of Steven-Johnson Syndrome and Toxic Epidermal Necrosis
45
What causes Samter's triad symptoms and cause type 1 reaction
Aspirin
46
What are the sympotms of Samter's triad
hypersensitivity reaction, ashtma exacerbations, and nasal polyps
47
What drugs require HLA testing
Abacavir (all), carbamezapine, allopurinol, phenytoin
48
What drugs can treat the symptoms of urticaria
H1 antihistamines, H2 antihistamines and glucoroticoids (severe or progressing)
49
How is anaphylaxis treated
D/C suspected drug/antigen, IM injection of epinephrine, maintain 02 saturation over 92, lay patient down but keep legs raised, 0.9NaCl
50
Wha drugs treat breathing problems
albuterol, Ipratropium
51
How should corticosteroids be used in an allergic reaction
to prevent or minimize late phase reaction
52
how much epinephrine should be given in anaphylaxis, refractory anaphylaxis
.3mg, 1-4 mcg

Phar 504 (34 decks)

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