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Drug allergy

Revision as of 17:12, 17 July 2024 by Nikolas (talk | contribs) (Created page with "<section begin="dermatology" />* Classification according to timeline ** Immediate (< 1 hour) *** Urticaria *** Angioedema *** Rhinitis *** Bronchospasm *** Anaphylaxis ** Non-immediate (> 1 hour) *** Delayed urticaria *** Maculopapular exanthema *** Erythroderma *** Vasculitis *** Stevens-Johnson syndrome (SJS) *** Toxic epidermal necrolysis (TEN) *** Drug reaction with eosinophilia and systemic symptoms (DRESS) *** Acute generalized exanthematous pustulosis (AGEP) ***...")
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  • Classification according to timeline
    • Immediate (< 1 hour)
      • Urticaria
      • Angioedema
      • Rhinitis
      • Bronchospasm
      • Anaphylaxis
    • Non-immediate (> 1 hour)
      • Delayed urticaria
      • Maculopapular exanthema
      • Erythroderma
      • Vasculitis
      • Stevens-Johnson syndrome (SJS)
      • Toxic epidermal necrolysis (TEN)
      • Drug reaction with eosinophilia and systemic symptoms (DRESS)
      • Acute generalized exanthematous pustulosis (AGEP)
      • Symmetrical drug-related intertriginous and flexural exanthemas (SDRIFE)
  • Classification according to pathomechanism
    • Type I hypersensitivity
      • IgE-mediated mast cell activation as a reaction to a soluble antigen
      • All immediate drug allergies
      • Treatment
        • Eliminate culprit drug
        • Antihistamines
    • Type III hypersensitivity
      • IgG-mediated complement activation as a reaction to a soluble antigen
      • Vasculitis
      • Serum sickness
    • Type IVa hypersensitivity
      • Cell-mediated macrophage activation as a reaction to a presented antigen
      • Tuberculin reaction
      • Contact dermatitis
    • Type IVb hypersensitivity
      • Cell-mediated eosinophil activation as a reaction to a presented antigen
      • DRESS
      • Maculopapular exanthema
      • Erythroderma
    • Type IVc hypersensitivity
      • Cell-mediated T-cell activation as a reaction to a presented antigen
      • Stevens-Johnsons syndrome
      • Toxic epidermal necrolysis
    • Type IVd hypersensitivity
      • Cell-mediated neutrophils activation as a reaction to a presented antigen
      • AGEP
  • Drug-induced urticaria
    • Drugs
      • Penicillin
      • Aspirin
      • NSAIDs
  • Angioedema/Quincke-oedema
    • Drugs
      • NSAIDs
      • Aspirin
      • ACE-inhibitors (not technically a drug allergy)
    • Clinical features
      • Facial oedema
      • If laryngeal involvement – dyspnoea, inspiratory stridor
    • Treatment
      • Epinephrine
      • Steroids
      • Antihistamines
  • Anaphylaxis
    • Drugs
      • Lidocaine
      • Anaesthetics
      • Aspirin
      • Contrast
      • NSAIDs
    • After minutes – hours
    • Clinical features
      • Hypotension
      • Bronchospasm, laryngeal oedema -> dyspnoea, inspiratory stridor
    • Treatment
      • Epinephrine
      • Steroids
      • Antihistamines
  • Drug-induced vasculitis
    • Drugs
      • Antibiotics
      • Analgesics
    • Clinical features
      • Painful, palpable purpura
      • Urticaria
    • Resolve after drug cessation
  • Serum sickness
    • Drugs
      • NSAIDs
      • Penicillins
    • Clinical features
      • Fever
      • Rash
      • Arthralgia
    • Resolve after drug cessation
  • Maculopapular exanthema
    • On trunk, extremities
    • No eosinophilia
    • No systemic symptoms
    • Resolve after drug cessation
  • Erythroderma
    • Erythema, scaling of the whole body
    • Eosinophilia
    • No systemic symptoms
    • Resolve after drug cessation