Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Endocrine > Drug-Induced Skin Disorders > Flashcards

Drug-Induced Skin Disorders Flashcards

1
Q

True/false: All dermatological reactions happen very soon after administration.

A

False. Not all. First exposure, may take weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some risk factors for derm drug reactions?

A
  • Previous reaction history
  • Concurrent illness
  • Dosage forms (topical>SQ>IM>PO>IV)
  • Genetic factors (HLA-B alleles)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the meaning of maculopapular eruptions exanthematous?

A

“To blossom”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the most common cutaneous drug eruption?

A

Maculopapular eruptions exanthematous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the presentation of maculopapular eruptions exanthematous?

A

“Measles-like”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where can maculopapular eruptions exanthematous occur?

A
  • Abdomen, trunk, upper extremities
  • Symmetrical!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

True or false: the mucus membrane is involved in maculopapular eruptions exanthematous.

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How long does it take for maculopapular eruptions exanthematous to occur?

A
  • 1-2 weeks after Rx (previously unexposed) - delayed T cell hypersensitivity reaction
  • 12-24 hours after Rx (previously exposed)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What antibiotics can cause exanthematous drug eruptions?

A
  • Beta-lactam (penicillins, cephalosporins, carbapenems, monobactams)
  • Sulfonamides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What aromatic amine anticonvulsants can cause exanthematous drug eruptions?

A
  • Phenytoin
  • Carbamazepine
  • Lamotrigine
  • Phenobarbital
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What other drugs can cause exanthematous drug eruptions?

A
  • Allopurinol
  • Cardiovascular (furosemide, thiazides, captopril)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When do exanthematous drug eruptions resolve?

A

Self-limiting, resolve in 1-2 weeks after discontinuing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the symptoms of exanthematous drug eruptions?

A

Minor! Pruritis that can be resolved with antihistamines or topical (not systemic) steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does DRESS stand for?

A

Drug Reaction with Eosinophilia and Systemic Symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How common is DRESS?

A

Less common, but more severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does DRESS present?

A
  • Drug eruption (face, trunk, extremities) - >50% of body surface area!
  • Fever
  • Facial edema
  • Hematologic abnormalities
  • End-organ involvement (hepatic, renal - hepatitis!)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When does DRESS occur?

A

2-8 weeks after first exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the most common causes of DRESS?

A
  • Aromatic amine anticonvulsants (phenytoin, lamotrigine, phenobarbital, carbamazepine)
  • Allopurinol
  • Sulfonamides
  • Minocycline
  • Vancomycin
  • Antituberculosis agents
  • NSAIDs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

In DRESS, what is the pharmacogenomic risk with abacavir?

A
  • HLA-B*5701
  • All patient populations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

In DRESS, what is the pharmacogenomic risk with allopurinol?

A
  • HLA-B*5801
  • Han Chinese, Thai, Korean
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

In DRESS, what is the pharmacogenomic risk with carbamazepine?

A

HLA-B1502
* Han Chinese, Japanese

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How is DRESS handled without severe organ involvement?

A
  • Oral antihistamines
  • Topical steroids - high potency (betamethasone dipropionate, clobetasol propionate, halobetasol propionate)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How is DRESS handled with severe organ impairment?

A
  • Systemic steroids (prednisone 0.5 to 2 mg/kg/day or equivalent - taper over 3-6 months)
  • Cyclosporin
  • IV immune globulin (IVIG)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How long does it take for DRESS to resolve?

A

Resolves in weeks to months after discontinuing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the classification of Stevens Johnsons Syndrome (SJS) and Toxic Epidermal Necrosis (TEN)?
Febrile mucocutaneous drug reactions
26
When do febrile mucocutaneous drug reactions occur?
* 7-21 days after first exposure * About 2 days with additional exposure
27
How do febrile mucocutaneous drug reactions present?
* Fever, HA, rhinitis, and malaise can precede mucocutaneous reaction * Affects face, trunk, and extremities - percent of body surface area determines the classification * Extensive necrosis and detachment of skin and mucosal surfaces
28
How is SJS arbitrarily defined?
* Involving at least 2 mucous membranes * Having up to 10% BSA involved
29
How is TEN arbitrarily defined?
More severe cutaneous and mucosal manifestations - worse than SJS!
30
Which drugs can cause SJS and TEN?
* Sulfonamide antibiotics * Tetracyclines * Quinolones * Cephalosporins * Abacavir (HLA-B*5701) * Allopurinol (drug most associated; HLA-B*5801) * Carbamazepine (HLA-B*1502) * Phenobarbital * Phenytoin * Valproic acid * Lamotrigine * Oxicam NSAIDs (meloxicam, piroxicam)
31
True/false: the drug suspected for causing SJS/TEN should be discontinued.
True
32
What constitutes supportive care for SJS and TEN?
* Burn unit preferred if >20% BSA affected * Rehydration and prevent infections
33
What medications can be used to treat SJS and TEN?
* Cyclosporine * Etanercept * Corticosteroids * IV immune globulin (IVIG)
34
How common is fixed drug eruption?
Less common
35
When does fixed drug eruption appear?
1-21 days after starting Rx
36
How does fixed drug eruption present?
* Round or oval lesion * Can have one lesion or multiple * Commonly seen in hands, feet, lips, genitalia - occurs in same place but appears faster when rechallenged * Asymptomatic or may have pain, itch, or burn
37
Which antibiotics can cause fixed drug eruption?
* Sulfonamides * Tetracyclines * Metronidazole * Beta-lactams
38
Which anticonvulsant can cause fixed drug eruption?
Carbamazepine
39
Which OTCs can cause fixed drug eruption?
* APAP * ASA/NSAIDs
40
How long will it take for fixed drug eruption to resolve?
Self-limiting, resolves weeks after discontinuing Rx
41
What are the symptoms of fixed drug eruption?
Minor symptoms! Pruritus that can be treated with H1 antihistamines or topical steroids. Pain that can be treated with analgesics
42
What is the process of phototoxic eruption?
1. Photosensitive medication administered 2. UVA exposure 3. Medication absorbs radiation 4. Inflammatory reaction 5. Direct cellular damage 6. Sunburn
43
What is the process of photoallergic eruption?
1. Photosensitive medication administered 2. UVA exposure 3. Photoactivation, creates antigen 4. Immune reaction 5. Direct cellular damage 6. Dermatitis
44
What is the incidence of phototoxic reactions?
High
45
What is the incidence of photoallergic reactions?
Low
46
What is the administration route of phototoxic reactions?
Systemic
47
What is the administration route of photoallergic reactions?
Usually topical
48
What is the amount of agent required for photosensitivity with phototoxic reactions?
Large (dose-related)
49
What is the amount of agent required for photosensitivity with photoallergic reactions?
Small (not dose-related)
50
What is the onset of reaction after exposure to agent and light in phototoxic reactions?
Minutes to hours
51
What is the onset of reaction after exposure to agent and light in photoallergic reactions?
24-72 hours
52
Is more than one exposure to agent required in phototoxic reactions?
No
53
Is more than one exposure to agent required in photoallergic reactions?
Yes
54
What is the distribution of phototoxic reactions?
Sun-exposed skin only
55
What is the distribution of photoallergic reactions?
Sun-exposed skin, may spread to unexposed areas
56
What are the clinical characteristics of phototoxic reactions?
Exaggerated sunburn
57
What are the clinical characteristics of photoallergic reactions?
Dermatitis
58
What drugs are common causes of photosensitivity reactions?
* Antibiotics (FQs, tetracyclines, sulfonamides) * NSAIDS * Sunscreens * Phenothiazines * Sulfonylureas * Diuretics * Amiodarone
59
How can phototoxic eruptions be managed?
* Minimize sun exposure, wear protective sunscreen * Symptomatic relief (aloe, analgesics)
60
How can photoallergic eruptions be managed?
* Minimize sun exposure, wear protective sunscreen * Topical steroids
61
What medication can cause hyperpigmentation?
Amiodarone
62
What are the characteristics of amiodarone hyperpigmentation?
* Blue-gray coloration * Occurs in sun exposed areas * Not immediate (average 20 months of treatment, minimal cumulative dose of 160 gm) * Slow recovery

Endocrine (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions