Pharmacology Flashcards
Examples of Type I Cutaneous Drug Eruption Reactions (3)
Angioedema
Anaphylaxis
Urticaria
Example of Type II Cutaneous Drug Eruption Reactions
Blistering Reactions - Pemphigus and Pemphigoid
Examples of Type III Cutaneous Drug Eruption Reactions (3)
Purpura
Vasculitis
Rash
Examples of Type IV Cutaneous Drug Eruption Reactions (2)
Erythema
Rash
Immunologically-mediated Drug reactions are not dependent on what?
Dose
Examples of non-immunological skin reactions (6)
Eczema
Drug-induced alopecia
Phototoxicity
Skin erosions
Atrophy
Psoriasis
Example of a drug that can cause drug-induced alopecia
Tamoxifen
Example of a drug that can cause skin erosion
Topical 5-Fluorouracil
Example of a drug that can cause atrophy
Topical corticosteroids
Example of drugs that can cause xerosis (2)
Statins
Retinoids
Which gender is at a greater risk to cutaneous drug eruptions?
Females
What concomitant diseases increase the risk of cutaneous drug eruptions? (2)
Cystic Fibrosis
Viral Infections - HIV, EBV and CMV
Which types of drugs increase the risk of cutaneous drug eruptions? (4)
Beta lactam compounds
NSAIDs
High molecular weight drugs
Hapten-forming drugs
What type of drug administration route increases the risk of cutaneous drug eruptions?
Topical drugs
Most common drug-associated skin reaction
Exanthematous drug eruptions
Exanthematous Drug Eruptions: What type of reaction is this?
Type IV Reaction - Idiosyncratic T-cell mediated delayed type hypersensitivity reaction
Exanthematous Drug Eruptions: Spread
Widespread symmetrically distributed rash
Exanthematous Drug Eruptions: Location
Mucous membranes - eyes and mouth spared
Exanthematous Drug Eruptions: Onset
4-21 days after first taking the drug
Exanthematous Drug Eruptions: Examples of associated drugs (6)
Penicillins
Sulphonamides
Erythromycin or Streptomycin
Anti-epileptics
NSAIDs
Chloramphenicol
Exanthematous Drug Eruptions: Ulceration occurs where?
Mouth
Lips
Genitals
Exanthematous Drug Eruptions: Presentation of rash
Erythema
Oedema
Exanthematous Drug Eruptions: General symptoms
Fever - >38.5 degrees
Lymphadenopathy
Shortness of breath
Urticarial Drug Eruptions: Most common mechanism
Immediate IgE-mediated hypersensitivity reaction after a re-challenge with a drug
Urticarial Drug Eruptions: Examples of drugs inducing IgE reactions (3)
Beta Lactams
Antibiotics
Carbamazepine
Urticarial Drug Eruptions: Classic presentation
Wheals
Urticarial Drug Eruptions: Time period
Presents within minutes or hours
Urticarial Drug Eruptions: Impact on the face
Lip swelling
Facial swelling
Urticarial Drug Eruptions: Why does angioedema occur?
Intense histamine release
Urticarial Drug Eruptions: What presentation indicates vasculitic skin rashes?
Purpura with non-blanching
Urticarial Drug Eruptions: Warfarin can be associated with what feature?
Necrosis
Urticarial Drug Eruptions: Less common mechanism of action
Direct release of inflammatory mediators from mast cells on first exposure
Urticarial Drug Eruptions: Examples of drugs that cause this by causing the direct release of the inflammatory mediators? (6)
Aspirin
Opiates
NSAIDs
Muscle relaxants
Vancomycin
Quinolones
Pustular or Bullous Drug Reactions: Examples of drugs that induce acneiform reactions (5)
Glucocorticoids
Androgens
Lithium
Isoniazid
Phenytoin
Pustular or Bullous Drug Reactions: Description of Acneiform reaction
Monomorphic lumps with no comodones
Pustular or Bullous Drug Reactions: What does AGEP stand for?
Acute generalised exanthematous pustulosis
Pustular or Bullous Drug Reactions: Examples of drugs that cause AGEP (3)
Antibiotics
Calcium Channel Blockers
Anti-malaria drugs
Pustular or Bullous Drug Reactions: How does AGEP present?
Monomorphic sheets of pustules
Pustular or Bullous Drug Reactions: Examples of drugs that cause bullous pemphigoid? (3)
ACE Inhibitors
Penicillin
Furosemide
Pustular or Bullous Drug Reactions: Example of a drug that causes linear IgA disease?
Vancomycin
Pustular or Bullous Drug Reactions: Linear IgA Disease presentation
Annular ring forms of blisters
Pustular or Bullous Drug Reactions: Bullous eruptions can be induced by what drug?
Metronidazole
Examples of drugs that cause hyperpigmentation reactions (2)
Hydroxyurea
Minocycline
Fixed Drug Eruptions: Locations (4)
Hands
Genitals
Lips
Oral mucosa
Fixed Drug Eruptions: Presentation
Well demarcated round plaques that are red and painful
Fixed Drug Eruptions: How to resolve this?
Stop the drug - may re-occur if restarted
Fixed Drug Eruptions: Examples of drugs causing these reactions (5)
Tetracycline
Doxycycline
Paracetamol
NSAIDs
Carbamazepine
Severe Cutaneous Adverse Drug Reactions: 4 potential symptoms (4)
Stevens-Johnson Syndrome
Toxic Epidermal Necrolysis
Drug Reaction with Eosinophilia and Systemic symptoms
Acute generalised exanthematous pustolosis
SJS
Stevens Johnson Syndrome
TEN
Toxic Epidermal Necrolysis
DRESS
Drug reaction with Eosinophilia and Systemic Symptoms
AGEP
Acute generalised exanthematous pustulosis
Severe Cutaneous Adverse Drug Reactions: SJS - Associated with what drugs? (3)
Anti-epileptics
Cephalosporin
HIV drugs
Severe Cutaneous Adverse Drug Reactions: SJS - Location
Mucosa - mouth, eyes and lips
Severe Cutaneous Adverse Drug Reactions: SJS - Presentation
Erythema multiforme rash
Severe Cutaneous Adverse Drug Reactions: TEN - Presentation
Fluid-filled blisters
Bullae
Severe Cutaneous Adverse Drug Reactions: TEN - Examples (4)
Sulphonamides
Cephalosporins
Carbamazepine
NSAIDs
Severe Cutaneous Adverse Drug Reactions: DRESS - Presentation
Rash with marked facial involvement and a high temperature
Severe Cutaneous Adverse Drug Reactions: DRESS - Examples of drug that induces this (4)
Sulphonamides
Anti-convulsants
Allopurinol
NSAIDs
Severe Cutaneous Adverse Drug Reactions: AGEP - Presentation
Sheets of pustules that can coalesce or sheet off
Drug-Induced Photosensitivity: These reactions are typically (immunological/non-immunological) phytotoxicity?
Non-immunological
Drug-Induced Photosensitivity: Examples of Acute reactions (3)
Skin toxicity
Systemic Toxicity
Photo-degradation
Drug-Induced Photosensitivity: Examples of Chronic reactions (3)
Pigmentation
Photoageing
Photocarcinogenesis
Phototoxic Cutaneous Drug Reactions
Non-immunological skin reaction due to light activation of a photoreactive drug
Phototoxic Cutaneous Drug Reactions: Increased sensitivity to light can occur through what two physiological states?
Lupus
Immunosuppression
Skin Phototoxicity: Examples of drugs that cause immediate prickling with delayed erythema and pigmentation (2)
Chlorpromazine
Amiodarone
Skin Phototoxicity: Chlorpromazine and Amiodarone cause what reactions?
Immediate prickling with delayed erythema and pigmentation
Skin Phototoxicity: Examples of drugs that induce exaggerated and easy sunburn (3)
Quinine
Thiazide
Demeclocycline
Skin Phototoxicity: Quinine, Thiazides and Demclocycline induce what reactions?
Exaggerated and easy sunburn
Skin Phototoxicity: Calcium channel antagonists induce what?
Telangiectasia
Skin Phototoxicity: Example of a drug that can induce telangiectasia
Calcium channel antagonists
Skin Phototoxicity: What reaction can Psoralens induce?
Delayed (3-5 days) Erythema and pigmentation
Skin Phototoxicity: What drugs can induce a delayed erythema and pigmentation?
Psoralens