Exam 3 drug induced hypersensitivity reactions

Question 1

what is drug induced hypersensitivity

Answer 1

a low frequency serious adverse drug reaction with an immunological etiology to an otherwise safe and effective therapeutic agent

Question 2

what are the key characteristics of DIHR

Answer 2

rare, unpredictable, complex, potentially fatal

Question 3

what are the determinants for DIHR

Answer 3

pharmacology, chemistry, immunology, patient factors

Question 4

what is immediate hypersensitivity

Answer 4

occurs within 1 hr, type 1 IgE mediated

Question 5

what is delayed hyoersensitivity

Answer 5

occurs more that 1 hr, type IV or III, T cell mediated

Question 6

what is type 1-anaphylaxis

Answer 6

IgE antibodies binding to drug antigen and cross-linkage of adjacent IgE molecules leading to mediator release

Question 7

what is type 2-cytotoxic

Answer 7

IgM or IgG antibodies recognize drug antigens associated with cell membranes causing complement activation

Question 8

what is type 3-immune complex

Answer 8

the formation of antigen antibody complexes

Question 9

what is type 4- delayed hypersensitivity

Answer 9

mediated by sensitized lymphocytes

Question 10

when does immediate hypersensitivity occur

Answer 10

only occurs after prior exposure to the antigen or similar antigen

Question 11

what is the most common drug allergy

Answer 11

penicillin allergy

Question 12

what percent of the population claims to have PCN allergy

Answer 12

10%

Question 13

how many of those that claim to be allergic to PCN can actually tolerate the drug

Answer 13

90%

Question 14

after 5 years how many people lose sensitivity

Answer 14

50%

Question 15

after 10 years how many people lose sensitivity

Answer 15

80

Question 16

what are some PCN sensitivity testings

Answer 16

skin pricking, intradermal and oral challenge

Question 17

when can sensitivity occur

Answer 17

prior exposure ot repeated dosing

Question 18

Tcell proliferation requires what ot stimulate a response

Answer 18

costimulation like B7

Question 19

what is the most common target or DIHR

Answer 19

the skin

Question 20

how many drug eruptions are benign

Answer 20

90%

Question 21

what are the classifications of drug eruptions

Answer 21

exanthemas, urticarial eruptions, fixed drug eruptions, acute generalized exanthematous pustulosis, and erytheme multiforme

Question 22

what is exanthemas

Answer 22

rash over body usually onset 4-14 days after, often caused by virus

Question 23

what does DRESS mean

Answer 23

Drug Reaction with Eosinophilia and Systemic Symptoms

Question 24

what are the characteristics of DRESS

Answer 24

fever, rash, lymphadenopathy, hematological abnormalities, and internal organ involvment

Question 25

what is the mortality rate of DRESS

Answer 25

10%