Drug Hypersensitivity and Anaphylaxis

Question 1

When do hypersensitivity reactions to drugs usually occur?

Answer 1

on first dose of subsequent course having been previously tolerant

Question 2

What are the usual symptoms of IgE mediated drug hypersensitivity reactions?

Answer 2

urticaria, angioedema, bronchospasm, anaphylaxis

Question 3

What are the usual symptoms of T cell mediated drug hypersensitivity reactions?

Answer 3

maculopapular exanthems

Question 4

Which drugs can cause direct mass cell activation without IgE?

Answer 4

radiocontrast, vancomycin

Question 5

What is a type I hypersensitivity reaction?

Answer 5

IgE mediated

Question 6

Can you use skin testing for allergic drug reactions?

Answer 6

only for a limited group of IgE mediated reactions - not validated for most allergic drug reactions

Question 7

Can you use RAST/ELISA testing for allergic drug reactions?

Answer 7

only available for some betalactam antibiotics

Question 8

What is more specific and what is more sensitive out of skin tests vs RAST/ELISA?

Answer 8

RAST/ELISA - specific

skin test - sensitive

Question 9

What is the lymphocyte transformation test?

Answer 9

detects drug specific T cells involved in some delayed allergic hypersensitivity reactions

Question 10

What is the most specific test for diagnosis anaphylaxis?

Answer 10

a serum tryptase taken within 2 hours of an event