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Drug Allergy
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Drug tolerance is defined as a state in which a patient with a drug allergy will tolerate a drug without experiencing an adverse reaction. Induction of tolerance modifies a patient’s response to a drug temporarily which permits it to be given when it is needed. A procedure for inducing drug tolerance is also referred to as drug desensitization. It is done in situations where an alternate non–cross-reacting medication cannot be used and has been used to treat reactions that are IgE-mediated, non-IgE mediated, pharmacologic and undefined (Caimmi et al. 2019) (Der Groot and Mulder 2010). The procedure has proven to be markedly effective, allowing for successful drug administration in almost any patient with drug hypersensitivity when supervised by experienced clinicians.
In Vitro Tests for Adverse Drug Reactions Based on Cytokine Release
Published in Kirsti Kauppinen, Kristiina Alanko, Matti Hannuksela, Howard Maibach, Skin Reactions to Drugs, 2020
The diagnosis of adverse drug reactions is a real challenge for clinicians. Any drug at any time, in any route of administration, and from any source can cause adverse drug reactions. The clinical evaluation of drug reactions may be difficult due to simultaneous exposure to several drugs, variability in the latent period, as well as variability in the type of reaction. The diagnostic value of in vivo tests, such as skin tests, challenge, and withdrawal tests, is limited. Furthermore, non-drug risk factors, such as recent infections and malignancy, may play a role in drug hypersensitivity reactions.
Orthopaedics and musculoskeletal system
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
14.23. Erythema nodosum can be due tostreptococcal infection.sarcoid.drug hypersensitivity.Crohn's disease (regional ileitis),Yersinia infection.
Antibiotic desensitization as a potential tool in antimicrobial stewardship programs: retrospective data analysis and systematic literature review
Published in Expert Review of Anti-infective Therapy, 2022
Alicia Rodríguez-Alarcón, Jaime Barceló-Vidal, Daniel Echeverría-Esnal, Luisa Sorli, Roberto Güerri-Fernández, Sofía Martina Ramis Fernández, Adela Benitez-Cano, Elena Sendra, Inmaculada López Montesinos, Estela Membrilla-Fernández, Olivia Ferrández, Ramón Adalia, Juan Pablo Horcajada, Fernando Escolano, Silvia Gómez-Zorrilla, Santiago Grau
Drug hypersensitivity is an immunologic response to medication, classified by pathogenesis and time relative to antigen exposure. Type 1 or IgE-mediated hypersensitivity reactions are of greatest clinical concern because they occur immediately and can be severe and life-threatening [15,28]. The drug antigen interacts with IgE bound to receptors on mast cells, triggering degranulation and the release of inflammatory mediators and cytokines [15,29]. Antibodies against penicillin target the beta-lactam ring, a chemical structure common in agents belonging to the penicillin drug class [30]. Although IgE-mediated hypersensitivity reactions can be life-threatening, previous literature has demonstrated that most patients labeled as allergic to penicillin are not truly allergic [1,5,6,9]. Consistent with these studies, only 25% of patients in our cohort were based on a clinical history of high-risk allergy, although none had undergone skin testing to confirm allergy. In 37% of patients, the clinical manifestations of allergy were unknown, 62% did not know when the last allergic reaction occurred and 18% of reactions had occurred more than 10 years previously. AAL is associated with receiving suboptimal treatment using drugs that are less effective and safe [3,4] and every effort should be made to de-label AAL in clinical practice.
Data mining for detecting signals of adverse drug reaction of doxycycline using the Korea adverse event reporting system database
Published in Journal of Dermatological Treatment, 2022
Jae Young Heo, Moon Kyun Cho, Sooyoung Kim
The dermatological AEs associated with doxycycline include photosensitivity, photo-onycholysis, and various skin rashes such as erythematous, maculopapular, and pustular eruptions. The photosensitivity reactions are affected by the dose of doxycycline and the intensity of the ultraviolet (UV) A rays. Although the precise mechanisms of doxycycline phototoxicity are not fully understood, it is proposed that cell membranes, ribosomal protein, and DNA could be the chromophores in the skin and that tetracyclines induce DNA damage by photosensitizing activity (16–18). Among the signals detected in this study, AEs like blisters, erythema, mottled skin, and crusting may appear as clinical manifestations of photosensitivity reactions. In addition, signals such as skin exfoliation, angioedema, mouth edema, dry skin, mucositis, skin ulcers, and fixed eruptions are symptoms of drug hypersensitivity reactions, along with the previously mentioned dermatological symptoms (19).
Dapsone for the treatment of acne vulgaris: do the risks outweigh the benefits?
Published in Cutaneous and Ocular Toxicology, 2022
Selami Aykut Temiz, Munise Daye
Drug hypersensitivity syndrome is a serious idiosyncratic drug reaction determined by the clinical triad of fever, rash, and visceral involvement (most commonly the liver and the hematological system). Dapsone ranks high among drugs that reason drug hypersensitivity syndrome. Dapsone hypersensitivity syndrome (DHS) is the most serious and potentially fatal complication of dapsone. The fatal course is observed in approximately 10% of DHS cases. The severity of hepatocellular damage and previous drug sensitivity can be considered as poor prognostic signs for the outcome of the condition. For the treatment of dapsone hypersensitivity syndrome, early diagnosis, immediate discontinuation of dapsone and minimal use of other drugs should be emphasized. It usually appears on average 4 weeks (1–6 weeks) after the initiation of therapy1,42.