Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

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
Q

What is the classification of Stevens Johnsons Syndrome (SJS) and Toxic Epidermal Necrosis (TEN)?

A

Febrile mucocutaneous drug reactions

26
Q

When do febrile mucocutaneous drug reactions occur?

A
  • 7-21 days after first exposure
  • About 2 days with additional exposure
27
Q

How do febrile mucocutaneous drug reactions present?

A
  • 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
Q

How is SJS arbitrarily defined?

A
  • Involving at least 2 mucous membranes
  • Having up to 10% BSA involved
29
Q

How is TEN arbitrarily defined?

A

More severe cutaneous and mucosal manifestations - worse than SJS!

30
Q

Which drugs can cause SJS and TEN?

A
  • 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
Q

True/false: the drug suspected for causing SJS/TEN should be discontinued.

A

True

32
Q

What constitutes supportive care for SJS and TEN?

A
  • Burn unit preferred if >20% BSA affected
  • Rehydration and prevent infections
33
Q

What medications can be used to treat SJS and TEN?

A
  • Cyclosporine
  • Etanercept
  • Corticosteroids
  • IV immune globulin (IVIG)
34
Q

How common is fixed drug eruption?

A

Less common

35
Q

When does fixed drug eruption appear?

A

1-21 days after starting Rx

36
Q

How does fixed drug eruption present?

A
  • 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
Q

Which antibiotics can cause fixed drug eruption?

A
  • Sulfonamides
  • Tetracyclines
  • Metronidazole
  • Beta-lactams
38
Q

Which anticonvulsant can cause fixed drug eruption?

A

Carbamazepine

39
Q

Which OTCs can cause fixed drug eruption?

A
  • APAP
  • ASA/NSAIDs
40
Q

How long will it take for fixed drug eruption to resolve?

A

Self-limiting, resolves weeks after discontinuing Rx

41
Q

What are the symptoms of fixed drug eruption?

A

Minor symptoms! Pruritus that can be treated with H1 antihistamines or topical steroids. Pain that can be treated with analgesics

42
Q

What is the process of phototoxic eruption?

A
  1. Photosensitive medication administered
  2. UVA exposure
  3. Medication absorbs radiation
  4. Inflammatory reaction
  5. Direct cellular damage
  6. Sunburn
43
Q

What is the process of photoallergic eruption?

A
  1. Photosensitive medication administered
  2. UVA exposure
  3. Photoactivation, creates antigen
  4. Immune reaction
  5. Direct cellular damage
  6. Dermatitis
44
Q

What is the incidence of phototoxic reactions?

A

High

45
Q

What is the incidence of photoallergic reactions?

A

Low

46
Q

What is the administration route of phototoxic reactions?

A

Systemic

47
Q

What is the administration route of photoallergic reactions?

A

Usually topical

48
Q

What is the amount of agent required for photosensitivity with phototoxic reactions?

A

Large (dose-related)

49
Q

What is the amount of agent required for photosensitivity with photoallergic reactions?

A

Small (not dose-related)

50
Q

What is the onset of reaction after exposure to agent and light in phototoxic reactions?

A

Minutes to hours

51
Q

What is the onset of reaction after exposure to agent and light in photoallergic reactions?

A

24-72 hours

52
Q

Is more than one exposure to agent required in phototoxic reactions?

A

No

53
Q

Is more than one exposure to agent required in photoallergic reactions?

A

Yes

54
Q

What is the distribution of phototoxic reactions?

A

Sun-exposed skin only

55
Q

What is the distribution of photoallergic reactions?

A

Sun-exposed skin, may spread to unexposed areas

56
Q

What are the clinical characteristics of phototoxic reactions?

A

Exaggerated sunburn

57
Q

What are the clinical characteristics of photoallergic reactions?

A

Dermatitis

58
Q

What drugs are common causes of photosensitivity reactions?

A
  • Antibiotics (FQs, tetracyclines, sulfonamides)
  • NSAIDS
  • Sunscreens
  • Phenothiazines
  • Sulfonylureas
  • Diuretics
  • Amiodarone
59
Q

How can phototoxic eruptions be managed?

A
  • Minimize sun exposure, wear protective sunscreen
  • Symptomatic relief (aloe, analgesics)
60
Q

How can photoallergic eruptions be managed?

A
  • Minimize sun exposure, wear protective sunscreen
  • Topical steroids
61
Q

What medication can cause hyperpigmentation?

A

Amiodarone

62
Q

What are the characteristics of amiodarone hyperpigmentation?

A
  • 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.
© 2024 Bold Learning Solutions. Terms and Conditions