L9 - ADR

Question 1

CDR?

Answer 1

Drug induced cutaneous reactions

Can mimic disease, important to diffrentiate

Question 2

What do when svere CDR suspected?

Answer 2

Immediate withdrwal of all potential offending agents

Question 3

Topical CDR ovbious to spot, oral is not..

ONSET:
Acute:
Sub acute:
Latent:

Answer 3

ONSET:
Acute: < 60mins
Sub acute: < 1-24hrs
Latent: > 2 days

Differnt drugs = different onsent of symptoms, can be quick or slow

Question 4

Serious vs severity CDR

Answer 4

Severity: intensity e.g minor, mild, moderate or severe

Serious: death/hopsitlisation/signifacnt disablity

Question 5

Skin irritation can be single exposure, cummulative e.g ____ or deyalyed (results in____)

Answer 5

SJS

hyperproliferatoin, hyperkeratosis

Question 6

Mechinims for irritatoin: damaging skin barrier for benzoyl peroxide

Answer 6

Damage to SC:

1. Removal of lipids by solvents/detergents
2. protien denatruation by acids
3. ROS frmo bleach

leads to water loss and greater pentration of irritatnts to deep layer

Question 7

RETINOIDS - adverse?

Topical = trans

Systemic = cis

Answer 7

Topical = trans: for acne, can cause irritation esp on eczema

Systemic = cis, widespread rash, pruitis, care with cosmetic products = too much retanoic acid

Question 8

Drug induced photosens?

what drugs?

Answer 8

Drug + lught = reaction, phototoxic

can be used theraputicly = controlled phototoxic reactions

Antibiotics, NSAID, retinoids

Question 9

Hand foot syndrome

Mild to modereate:
Severe:

Answer 9

Mild to modereate: redness, swelling, tingling or burning

Severe: cracked, flaking, peeling, blisters, sores, difficutly walking

Question 10

Non pharmacological mechniism of ADR due to _______senstivity

Answer 10

hypersenitivity

Question 11

4 classes of Hypersentivity reactions

Answer 11

1. Anaphylactic: IgE degranulation
2. cytotoxic: antibodiy/antigen, complement actiavtion = cell damage
3. Immune complex: Drug + cell = forign complex = autoimunity
4. Delayed = T cells, cytokines, monocyte infiltration

Question 12

DILE vs SLE

Answer 12

Confusing if due to disease or drug?

Lupus: whiskers on face, pain in joints, big lymph nodes

Question 13

Erythema Multiforme, Stevens-Johnson syndrome (SJS) & toxic epidermal necrolysis (TEN)

SUBJECTIVE SCALE OF RESULTS

Use SCARS? what is scars.

Answer 13

Severe cutaneous adverse reactions
- general reports of EM, SJS & TEN

lots of medicine related reports

Question 14

Toxicity may involve direct toxiity as well as immune medaited reactions

Answer 14

Issue is may involve immune system, may be due to drug/toxicity, hard to classify