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Derm > Drug Reactions > Flashcards

Drug Reactions Flashcards

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Dermatology Board Prep flashcards
1
Q

name the five types of drug reactions

A 
exanthematous
fixed drug reaction
stephen johnson syndrome
drug induced hypersensitivity syndrome
or drug related eosnophilia with systemic symptoms
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2
Q

what type of drugs are people with EBV susceptible to reaction with?

A

penicillins

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3
Q

what type of drugs are people with HIV susceptible to reaction with?

A

sulfonamides

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4
Q

describe the exanthematous drug reaction on the skin

A

widespread symmetric erythematous macules and papules

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5
Q

where on body does exanthematous drug reaction occur?

A

trunk and extermities

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6
Q

when does exanthematous drug reaction usually start?

A

usually between 8-11 days after starting drug

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7
Q

what two things to give for treatment of exanthematous drug reaction?

A

topical steroid and antihistamines

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8
Q

describe how fixed drug eruption appears on the skin

A

solitary erthematous patch or plque that often has central bulla

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9
Q

name the four drug classes common for fixed drug eruptions

A

NSAIDs
tetracyclines
metronidazole
sulfonamides

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10
Q

where on body do fixed drug eruptions usually occur?

A

mouth genitals face and acral areas

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11
Q

how does fixed drug eruption look after healing?

A

dark brown macule with violet hue

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12
Q

when do fixed drug eruptions appear? how long after drug?

A

about a day

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13
Q

what is treatment for fixed drug eruption?

A

steroid ointment if not eroded and abx cream if eroded

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14
Q

what three things do patients with drug induced hypersensitivity syndrome present with

A

fever
facial swelling
macular exanthem

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15
Q

what do a high percentage of patiens with drugs induced hypersensitivity syndrome have?

A

eosinophilia

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16
Q

where does rash appear with drugs induced hypersensitivity syndrome?

A

macular rash on trunk and extremities

17
Q

how long after drug do you get drugs induced hypersensitivity syndrome?

A

usually around 3rd week but can be anywhere from 1-12 weeks

18
Q

name the five drugs classes common for drugs induced hypersensitivity syndrome?

A 
allopurinol
abx
NSAIDs
abacavir (HIV)
anticonvulsants
19
Q

what two abx lead to drugs induced hypersensitivity syndrome?

A

penicillin and sulfonamides

20
Q

what other organs can be involved in drugs induced hypersensitivity syndrome?

A

liver

kidney and bone marrow

21
Q

what is treatment for mild drugs induced hypersensitivity syndrome?

A

topical steroids with anti histamines

22
Q

what is treatment for severe drugs induced hypersensitivity syndrome?

A

prolonged systemic steroid with slow taper

23
Q

describe what happens in the skin with stephens johnson syndrome or toxic epidermal necrolysis

A

eryhtematous irregularly shaped dusky red macules that start to coalesce and skin sloughs off

24
Q

name the five drug classes involved in SJS/TEN (SATAN)

A 
sulfonamides
allopurinol
tetracyclines
anticonvulsants
NSAIDs
25
Q

what other symptoms are there in SJS/TEN?

A

fever headache and myalgias

26
Q

what is the Nikolsky sign?

A

skin detaches with lateral pressure in SJS/TEN

27
Q

name three common complications with SJS/TEN

A

corneal damage
bacteremia/sepsis
mucous membrane stenosis/scarring

28
Q

what drug reaction can involve the mucus membranes?

A

SJS/TEN

29
Q

what is treatment for SJS/TEN

A

remove meds consult derm and send to burn

30
Q

when does SJS/TEN onset?

A

within 8 weeks after start of offending drug

31
Q

what is another reaction that commonly is confused with SJS/TEN?

A

erythema multiforme

32
Q

what happens in erythema multiforme?

A

painful erythematous targetoid papules and oral ulcerations

33
Q

where does erythema multiforme occur more? what about SJS/TEN?

A

erythema multiforme more in acral extremities
SJS more in trunk
both in mouth

34
Q

what is erythema multiforme related to ?

A

HSV…may occur in flares

35
Q

how to treat erythema multiforme?

A

topical steroids for mild and systemic for severe

Derm (22 decks)

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