Drug Allergies

Question 1

What is a type A reaction?

Answer 1

Dose-dependent related to a know pharmacological reaction

Question 2

What is a type B reaction?

Answer 2

Not dose-dependent that is unrelated to pharmacologic actions and influenced by patient factors

• Drug allergies
• Drug hypersensitivity
• Idiosyncratic reactions

Question 3

What is a type 1 reaction?

Answer 3

IgE-mediated that is immediate (local to systemic)

Question 4

What is a type 2 reacrion

Answer 4

Delayed: Antibody mediated occurring 5-8 days (hemolytic anemia, thrombocytopenia)

Question 5

What is a type 3 reaction

Answer 5

Delayed: Immune complex reaction ≥1 wk after exposure (serum sickness)

Question 6

What is a type 4 reaction?

Answer 6

Delayed: T-cell mediated occurring 48 hr to wks (SJS)

Question 7

Difference between intolerance and allergies?

Answer 7

Intolerance: less serious
Allergy: an immune system response and range from mild to severe

Question 8

Is stomach upset/nausea an allergy or intolrance

Answer 8

Intolerance

Question 9

Importance of broad spectrum sunscreen

Answer 9

Protects against UVA and UVB

Question 10

Drugs that cause photosensitivity?

Answer 10

Amiodarone
Diuretics
Methotrexate
PO and topical retinoids
FQ
St johns wort
sulfa drugs
tacrolimus
tetracyclines
Voriconazole

Question 11

What is TTP

Answer 11

Blood disorder in which clots form throughout the body

Question 12

Drugs that can cause TTP

Answer 12

Clopidogrel and Sulfamethoxazole

Question 13

Difference between papule and macules

Answer 13

Papules: raised
Macules: Flat

Question 14

What is purpura?

Answer 14

Red/purple skin spots due to bleeding under the skin

Question 15

What is petechiae?

Answer 15

Pinpoint in size

Question 16

What is ecchymosis?

Answer 16

Large bruised area

Question 17

What is a hematoma?

Answer 17

Collection of blood under the skin due to trauma to blood vessels

Question 18

What increases abacavir hypersensitivity?

Answer 18

HLA-B*5701

Question 19

Drugs that can cause severe cutaneous ADR?

Answer 19

Allopurinol
Amoxiciillin
Ampicillin
Carbamazepine
Ethosuximide
Lamotrigine
Nevirapine
Phenytoin
Sulfamethoxazole
Sulfasalazine
Vanc

Question 20

What is CI with SJS?

Answer 20

Systemic steroids

Question 21

What is the treatment for anaphylaxis?

Answer 21

Epi injection +/- diphenydramine +/- steroids +/- IV fluids

Question 22

Dosing of EpiPens

Answer 22

EpiPen: 1 mg/mL
Adult dose: 0.3 mg
Pediatric dose: 0.15 mg

Question 23

How to administer EpiPen

Answer 23

1. remove from case
2. Keep fingers away from orange end of device
3. Inect 90 degrees into middle of out thigh
4. Hold for 3 secs
5. Remove and massage area for 10 secs

Question 24

Instructions for Auvi-Q

Answer 24

Follow voice instructions. Hold needle for 5 secs

Question 25

Instructions for Symjepi

Answer 25

Inject and hold for 2 secs → massage for 10 secs

Question 26

What is the Naranojo Scale

Answer 26

Likelihood a drug caused the adverse reaction

Question 27

Where do you report ADRs

Answer 27

FDA Adverse Event Reporting System (FAERS) FDA MedWatch