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23 Cards in this Set
- Front
- Back
What Rx cause Fixed drug eruption? |
Tetracycline, sulfanamides, barbituates |
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What Rx cause Pigmentation? |
Minocycline, antimalarials, bleomycin |
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__________ Rxn: -photodistributed erythema, scaly annular eruption, psoriasiform eruption that appears about 7 weeks after starting medication -+ ANA |
Subacute Lupus-like Rxn |
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What Rx cause subacute lupus-like sx?
(sx will improve 6-12 wks after removing agent) |
antihypertensives (Hydrochlorothorothiazide, ACE I, Ca blockers), Terbinafine, HMC CoA reductase I, INF-alpha |
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_______________Rxn: -fever, musculoskeletal sx, pleuropulmonary involvement, & weight loss that may occur > 1 yr after starting medication -+ ANA (may persist up to yr after removing offending agent)
(NO cutaneous involvement)* |
Systemic Lupus-like Rxn |
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What Rx cause systemic lupus-like sx?
(sx will resolve 4-6 wks after removing agents) |
procainamide, hydralazine, minocycline, isoniazid, penicillamine |
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What Rx cause serum sickness-like sx? |
cefaclor, minocycline |
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What Rx cause Pemphigus-like sx? |
Captopril, penicillamine |
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What Rx cause Photosensitivity? |
doxycycline, thiazide, sulfonylureas |
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MC drug hypersensitivity rxn
-acute, puritic, lasts weeks even after stopping drug -diffuse papular erythemic rash (looks like measles)
Tx? |
Morbilliform eruption
Tx: systemically |
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What Rx cause Morbilliform eruption? |
antibiotics & calcium channel blockers (amoxicillin, codeine, opiates)
(starts on trunk & spreads to limbs & neck symmetrically) |
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Patient started a new drug 2-6 weeks ago & presents w/ flu-like sx, fever, widespread rash (exanthema) & exfoliative dermatitis (erythroderma), & edema. Dx? Tx? |
Drug Hypersensitivity Syndrome
Tx: remove offending agent** |
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Erythroderma or exfoliative dermatitis is also characteristic of ________________, an inflammatory skin disease w/ erythema & scaling |
Red man syndrome |
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What systemic features would you expect to see in a pt w Drug hypersensitivity syndrome? |
cervical lymphadenopathy/pharyngitis atypical lymphocytosis w/ eosinophila hepatotoxicity (abnormal LFTs) |
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What drugs are the MC agents responsible for Drug hypersensitivity syndrome? |
aromatic anticonvulsants (phenytoin, phenobarbital, carbamazipine) sulfonamide antibiotics (thiazides, furosemide, sulfonylureas) minocycline |
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What drug causes Blue Lunula? |
Minocycline
(Minocycline-induced hyperpigmentation--> causes slate/blue pigmentation & brown hyperpigmentation (esp on ant legs)) |
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A pt presents w/ high fever, "toxic" appearance, widespread erythema, & non-follicular small sterile pustules a few days after starting a new drug. Dx? What could the drug be? |
Acute Generalized Exanthematous Pustulosis
Rx: beta-lactam antibiotics, Terbinafine, Itraconazole, Macrolide |
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Erythema multiforme major Steven-Johnson Syndrome Toxic Epidermal Necrolysis
All cause what? |
Severe cutaneous adverse reactions (SCAR)
(usually w/i a month of onset of therapy) |
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_____________ is characterized by target lesions on the distal extremities. Lesions reoccur w/ recurrent HSV infections. Pts are put on chronic acyclovir or valcyclovir. |
Erythema Multiforme Major (if minor- less severe usually not d/t drugs) |
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_________ is a severe form of Erythema multiforme. Skin starts to slough & pt develops mucosal, ocular, & genital erosions (very severe). May be caused by TMP-SMX (bactrim). |
Steven-Johnson Syndrome (SJS) |
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________ is a severe form of SJS, characterized by mucosal erosions, more diffuse areas of sloughing & upper respiratory prodrome (fever, pharyngitis, conjunctivitis) These pts must go to burn center!
What is the MC drug to cause this? |
Toxic Epidermal Necrolysis (TEN)
MC d/t Sulfonamides |
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In addition to aggressive supportive (Burn Unit) care, TEN patients also need to be put on what meds? |
systemic corticosteroids plasmaphoresis IV Immunoglobulins (IVIG)
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What are some of the potential adverse effects of systemic corticosteroids? |
-increased BP (usually mild) -Osteonecrosis (in long-term, 2 months +) -peptic ulcer dz (if dose is 1g +) |