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Chapter 77 Drug Allergies & ADRs

front 1

ADRs are categorized into two types:

back 1

predictable (type A) and unpredictable (type B)

front 2

Type A reactions are

back 2

dose-dependent, related to the known pharmacologic properties of the drug can occur in any patient and range from mild to severe

(most common reaction)

front 3

Examples of type A reactions

back 3

orthostatic hypotension with doxazosin

nephrotoxicity with aminoglycosides

front 4

Type B reactions are

back 4

not dose-dependent, are unrelated to the pharmacologic actions of the drug and can be influenced by patient-specific factors (genetics)

front 5

Type B reactions are categorized as

back 5

immediate (occurring within 60 mins after exposure) and delayed (occurring days to months after exposure)

front 6

Define type I reactions- immediate

back 6

IgE- mediated, ranging from minor local reactions to severe systemic reactions

(ex: urticaria, angioedema, anaphylaxis)

front 7

Define type II reactions- delayed

back 7

antibody-mediated, usually occurring 5-8 days after exposure

(ex: hemolytic anemia, thrombocytopenia)

front 8

Define type III reactions- delayed

back 8

immune-complex reactions, occurring ≥ 1 week after exposure

(ex: serum sickness)

front 9

Define type IV reactions- delayed

back 9

T- cell mediated, occurring 48 hours to weeks after exposure

(ex: SJS)

front 10

Define thrombotic thrombocytopenic purpura

back 10

blood disorder in which clots form throughout the body, the clotting process consumes platelets and leads to bleeding under the kin and the formation purpura (bruises) and petechiae (dots) on the skin

front 11

SJS and TENS involve

back 11

epidermal detachment and skin loss that is equivalent to third degree burn (generally occur 1-3 weeks after drug exposure)

front 12

Systemic steroids are contraindicated with

back 12

TEN but may be used for SJS

front 13

Anaphylaxis treatment includes

back 13

epinephrine injection + diphenhydramine +/- steroids +/- IV fluids

front 14

Adult dose for epinephrine

back 14

0.3 mg

front 15

Pediatric dose for epinephrine

back 15

0.15 mg

front 16

beta-lactams should be avoided with a

back 16

stated allergy to another beta-lactam

front 17

What monobactam is considered safe in patients with an immediate-type penicillin allergy

back 17

aztreonam

front 18

Side effects, adverse events and allergies should be reported to the

back 18

FDAs MedWatch program which is called the FDA Adverse Event Reporting System (FAERS)

front 19

The FDA can required ______ for approved drugs and biologics, to collect and analyze ADR reports and better understand a drug's safety profile

back 19

phase IV trials

front 20

A boxed warning indicates

back 20

a risk of death or permanent disability

front 21

Contraindications indicate that

back 21

the drug cannot be used in patient

(the risk will outweigh possible benefit)