Week 7 - Drug Reactions Flashcards Preview

Dermatology Diploma > Week 7 - Drug Reactions > Flashcards

Flashcards in Week 7 - Drug Reactions Deck (47)
Loading flashcards...
1

Who is most at risk of developing a cutaneous drug reaction?

  • The Eldery
  • Polypharmacy patients
  • HIV

2

Which drugs are most likely to cause cutaneous reactions?

  • Antibiotics
  • Analgesics
  • NSAIDS
  • Thiazide diuretics
  • Anticonvulsants

3

What are the two types of adverse drug reactions?

  • Immunological (Drug Allergy)
  • Non-Immunological (Drug Intolerance) -90% of reactions are this.

4

What are the most common types of drug eruptions?

  • Pruritus
  • Maculopapular Exanthems
  • Urticaria
  • Angio-Oedema
  • Photoallergic reactions
  • Fixed Drug Reactions

5

When do drug reactions usually occur?

7-10 days

6

How can you tell the difference between a viral rash and a drug induced rash?

  • Viral rashes start on the face and acral sites then spread to the trunk.
  • Viral rashes have associated symptoms like sore throat, GI symptoms, Cough, Conjunctivitis.
  • Drug induced reactions are usually itchy.

7

What are the drugs associated with exanthem reactions?

  • Ampicillin and penicillin
  • Carbamazepine
  • Sulphonamides
  • Phenytoin
  • NSAIDs
  • Allopurinol

8

What type of drug reaction is this?

Morbilliform Exanthem (aka maculopapular reaction) - the most common

9

What is the second most common type of reaction?

Urticaria/anaphylaxis

10

What drugs are associated with urticarial/anaphylactic reactions?

  • Aspirin
  • NSAIDS
  • Beta lactam antibiotics, including penicillins

11

What drugs can cause pruritus?

  • Opioids
  • Statins
  • ACE-inhibitors
  • NSAIDS

12

What type of drug reaction is this?

Symmetrical drug-related intertriginous and flexural exanthem

13

What drugs are associated with symmeterical intertriginous and flexural exanthem?

  • Penicillins
  • Cephalosporins
  • Erythromycin
  • NSAIDS

14

In what 2 patterns can lichenoid drug eruptions occur?

Lichen plaus or Lupus

15

How long after exposure do Lichenoid drug eruptions usually occur?

Months

16

What drugs are commonly associated with drug-induced lichen planus?

  • Antimalarials
  • Gold
  • NSAIDS
  • Mercury amalgam
  • Penicillamine
  • Thiazide diuretics

17

What drugs are commonly associated with drug-induced Lupus Erythematosus?

  • ACE-inhibitors
  • Beta blockers
  • Calcium channel blockers (eg. diltiazem)
  • Statins
  • Thiazide diuretics

18

What is this?

A Drug-Induced Lichenoid reaction

19

What is a fixed drug eruption?

A recurrent well-defined lesion that occurs in the same place each time the drug is taken.Typically causes an oval plaque that starts red and oedmatous and evolves to become dusky, violaceous and occasionally bullous. Onset 30 minutes to 8 hours after exposure.

20

What drugs cause a fixed drug eruption?

  • NSAIDs
  • Paracetamol
  • Tetracyclines
  • Co-trimoxazole

21

What drugs are responsible for a drug-induced photosensitivity reaction?

  • NSAIDS
  • Tetracyclines
  • Isotretinoin
  • Statins
  • Frusemide
  • Thiazide diuretics

22

What drugs are responsibl for Drug-Induced Acneform Eruptions?

  • Corticosteroids
  • Androgens and anabolic steroids
  • Hormonal contraceptives
  • Lithium
  • Phenytoin
  • Valproate
  • Ciclosporin

23

When do Drug-induced acneform eruptions usually occur?

1-2 weeks after taking the drug

24

How can you tell if an acneform eruption is different from acne?

Acneform eruptions often lack comedonees or cysts.

25

What are the commonest causes for EM?

  • Herpes simplex (90%)
  • Mycoplasma Pneumonia
  • Prior EM

26

What are some other infections that cause Erythema Multiforme (EM)?

  • CMV infection
  • EBV infection
  • HIV infection
  • Lymphoma
  • Histoplasmosis
  • Hepatitis B vaccine
  • Syphilis
  • Orf virus

27

What are some medications that cuase Erytheme Multiforme?

  • NSAIDS
  • Penicillins
  • Sulphonamides
  • Barbiturates
  • Anticonvulsants
  • Phenothiazines

28

What is the typical disease course for EM?

  • Acroal targetoid lesions - Bull's eye lesions start at the beginning
  • An eruption over the rest of the body occurs
  • Resolves in 2-3 weeks.

29

What is the treatment for Erythema Multiforme?

  • Symptomatic relief.
  • Opthalmological advise if eye involvement.
  • Topical steroids
  • Oral aciclovir if severe (EM Major)
  • Oral steroids is controversial but may shorten disease duration.

30

What is DRESS?

Drug Rash with Eosinophilia & Systemic Symptoms

 

  • Fever, lymphadenopathy and a rash.
  • Facial oedema commonlyoccurs.
  • Eosinophila & abnormal LFTs.
  • Occurs 1-6 weeks after drug ingested.