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Flashcards in Side Effects And ADRs Deck (17)

Type I hypersensitivity reaction

Immediate within 15 to 30 minutes of exposure


Type II hypersensitivity reaction

Occurs minutes to hours after exposure


Type III reaction

Immune complex reaction

Example is drug-induced lupus


Type IV reactions

Delayed hypersensitivity reaction that occurs anywhere from 48 hours to several weeks after exposure

Example is a PPD skin test for tuberculosis


Where to report adverse drug reactions

FDA med watch program


Phase 4 post marketing surveillance

Observes the drug in the general population to identify any safety and efficacy issues


What occurs if the FDA determines there are too many side effects associated with a drug already released?

They may ask for the package insert or labeling to be changed

An example was in 2008 the FDA required Tamiflu to change it's pediatric labeling to indicate precautions about hallucinations confusion and other strange behavior


How do you know if the drug was to blame?

Use the naranjo scale with patients

The higher the score the more likely the drug caused the event



Examples of drugs that cause this are sulfa antibiotics, tetracyclines, NSAIDs, topical retinoids ,fluroquinolones, tacrolimus, cyclosporine (immune suppressant drugs)

Patient should avoid sun during high exposure times and should use broad-spectrum sunscreen


Severe skin rashes

SJS (Steven Johnson)/ TEN(toxic epidermal necrosis): sulfamethoxazole, allopurinol, carbamazepine, oxcarbazepine, phenytoin, Plavix

DRESS: ethosuximide, phenytoin, tetracyclines

TTP(thrombotic thrombocytopenic purpura): Plavix, sulfamethoxazole, quinine, ticlopidine


What to do for severe skin rash reaction?

Stop the offending agent as soon as possible

Give fluid, electrolytes, wound care, and pain medication

Corticosteroids can be used and Steven Johnson syndrome but are contraindicated in toxic epidermal necrolysis



Can give antihistamines steroids NSAIDs steroid injections or epinephrine depending on the reaction

Signs and symptoms of anaphylaxis include swelling, bronchoconstriction, lightheadedness or dizziness, nausea vomiting, decrease blood pressure, shock


What should patients carry that have previously had an anaphylactic reaction

Epinephrine diphenhydramine and emergency contact information (epi 0.3mg adults and 0.15mg children)

After an epinephrine injection the area should be rubbed to make the medication enter the skin


Beta-lactam allergy

Avoid all penicillins cephalosporins and carbapenems


Drugs associated with sulfa allergies

Sulfamethoxazole, sulfadiazine, sulfisoxazole, thiazide diuretics, loop diuretics, sulfonylureas Acetazolamide, zonisamide, and celecoxib


Peanut & soy allergy

Caused by food products containing peanuts or soy, propofol (diprivan), progesterone, or clevidipine (cleviprex)


Egg allergy

Concerns with yellow fever vaccination, influenza vaccination, propofol and clevidipine

Flublock is the first seasonal influenza vaccination nation made using recombinant techniques and does not use eggs