Drug Allergies, ADRs And ADR reporting Flashcards
List types of drug allergies or Hypersentivity rxns
Type 1
Type 2
Type 3
Type 4
What’s Type I rxn? (Drug allergies or Hypersentivity rxns)
Immediate (within 15-30 mins of exposure)
Severity can range from minor inconvenience to death
What’s Type II rxn? (Drug allergies or Hypersentivity rxns)
Mins to hours after exposure
E.g. Hemolytic anemia and Thrombocytopenia
What’s Type III rxn? (Drug allergies or Hypersentivity rxns)
Immune-complex rxns.
Occurs 3-10 hrs after exposure
E.g. Drug-induced lupus and serum sickness
What’s Type IV rxn? (Drug allergies or Hypersentivity rxns)
Delayed hypersensitivity rxns
Can occur 48 hrs to several weeks after exposure
E.g. PPD skin test for TB, which peaks at 48 hrs
What’s the most common drug rxn xterized as? What does it mean?
Type A = dose-dependent and predictable
E.g. Doxazosin is slowly titrated up to reduce severity of SE
What’s a type B drug rxn?
Idiosyncratic - means a particular pt has an independent peculiar rxn (or hypersensitivity) to the drug
Where should SEs, adverse events and allergies be reported to?
FDA’s MedWatch program
Are vaccine SE, ADRs and allergies reported to MedWatch program?
No!
Report to vaccine adverse drug rxns called VAERS
T/F? FDA conducts phase IV (post-marketing safety surveillance programs)?
True
T/F? Community-based adverse event reporting is critical?
True
Is reporting voluntary?
Yes
What’s a Naranjo Scale?
Validated causality assessment scale that can help pharmacists determine the likelihood that a drug caused by ADR
Characterizing an ADR?
What rxn occurred (mild rash, severe rash with blisters, trouble breathing)
When did it occur (about how old were you)
Can u use similar drugs in the same class (e.g. If they report allergy to penicillin, have they ever used Keflex)
Ask and include any food allergies and latex allergies in the pt record
How would u classify stomach upset/nausea?
Not a drug allergy
Better categorized as INTOLERANCE
How do deal with Photosensitivity?
Limit sun exposure
Use sunscreen that block UVA (causes aging, skin cancer) and UVB (causes sunburn)
What’s a broad-spectrum sunscreen?
Covers both UVA and UVB
List drugs most commonly associated with photosensitivity
Sulfa antibiotics
Tetracyclines
NSAIDs Amiodarone Chloroquine, Coal Tar, Cyclosporine Oral and topical retinoids Phenothiazines, Psoralens Quinidine Fluoroquinolones Tacrolimus, Topical fluorouracil Diuretics, thiazides and loops Metronidazole St. John's wort PDE-5 inhibitors
List drugs that are associated with severe skin rashes in SJS/TEN
Sulfamethoxazole Allopurinol CBZ, Oxcarbazepine Phenobarbital Ethosuximide Lamotrigine Phenytoin Clopidogrel Ticlopidine Quinine Abacavir Nevirapine Letrozole Hydroxychloroquine Piroxicam Tetracyclines
List drugs that are associated with severe skin rashes in DRESS (drug rxn with eosinophilia and systemic sx)
Ethosuximide
Phenytoin
Tetracyclines
List drugs that are associated with severe skin rashes in TTP (Thrombotic Thrombocytopenic Purpura)
Clopidogrel
Sulfamethoxazole
Quinine
What’s the best way to treat SJS/TEN?
Stop offending agent ASAP
Pts should receive fluid/electrolyte replacement, wound care and pain meds
What med can be used in SJS, but contraindicated in TEN?
Corticosteroids
Whats DRESS?
Can include a variety of skin eruptions as well as systemic sx (fever, hepatic dysfxn, renal dysfxn, lymphadenopathy)
