Term
| What is the most common iatrogenic illness? |
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Definition
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Term
| What are some drug factors that increase risk of drug allergies? (5) |
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Definition
1) higher molecular weight
2) ability to bind to proteins
3) higher dose
4) parental usage
5) repeated exposure |
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Term
| What are some host factors that increase the risk of drug allergies? (4) |
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Definition
1) adult
2) Male
3) concurrent infections
4) HIV infection |
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Term
| What are the 4 classifications of drug reactions? |
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Definition
1) anaphylactic - cross links IgE - antibiotics
2) cytotoxicity - cell destruction between IgG or IgM - heparin mediated thrombocytopenia
3) immune complex - drug combines with antibodies to form complexes
4) delayed hypersenstivity - sensitized CD4 T cells - allergic contact dermatitis |
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Term
| What are some clinical presentations of dermatologic drug reactions? (4) |
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Definition
1) within days of use
2) symmetrical
3) truncal
4) pruritus
5) fever
*sometimes have esoinophila |
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Term
| What are the two mechanisms of photosensitive drug rashes? |
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Definition
1) phototoxic - first exposure to drug - sunburn w/in 4-8 hours of light exposure
2) photoallergic - eczematous reactions after months of drug use |
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Term
| What are the 3 testing techniques for drug allergies? |
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Definition
1) skin testing - IgE mediated
2) RAST - b-lactams and anesthetics
3) Drug Challenge |
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Term
| When are non-immunologic reactions commonly seen with penicllins? |
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Definition
| with ampicillin and amoxicillin patients with concomitant viral infections |
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Term
| What are most immune reactions to penicillin direct at? |
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Definition
| B-lactam core, often severe |
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Term
| What test is 90% accurate for diagnosing allergies to penicillin? |
|
Definition
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Term
| What symptom is common with sulfa drug allergies? What group of people have higher sulfa allergies? |
|
Definition
1) Drug exanthems
2) HIV patients (50%) |
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Term
| What is red man syndrome associated with vancomycin allergies? |
|
Definition
| hypotension, flushing, erythema, pruritus, urticaria, pain/muscle spasms on chest and back |
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Term
| What is the aspirin triad? |
|
Definition
1) asthma
2) nasal polyps
3) aspirin sensitivity |
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Term
| anesthetic agent rxns are most commonly from what? (4) |
|
Definition
1) toxic response
2) overdose
3) rapid absorption
4) anxiety |
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Term
| direct mast cell and complement activation are seen with what allergy? |
|
Definition
| Radiographic contrast media |
|
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Term
| How is desensitization achieved with drug allergies? |
|
Definition
| administer drug in increasing doses and continue use |
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Term
| Most food allergies are mediated by what? |
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Definition
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Term
| Oral allergy syndrome defined as rapid onset prurits, angioedema of lips, tongue, and throat are most common from ingestion of what? |
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Definition
| fresh fruits and vegetables |
|
|
Term
| what skin reactions are most common with food allergies? |
|
Definition
| acute urticaria and angioedema |
|
|
Term
| What is a chronic skin condition affecting children with food allergies? |
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Definition
|
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Term
| total villous atrophy and extensive cellular infiltrate are associated with what disease? |
|
Definition
| Celiac disease (non-IgE hypersensitivity to gluten |
|
|
Term
| What genetic predisposition exists with celiac disease? |
|
Definition
-90% are HLA-B8 positive
-80% have HLA DW3 antigen |
|
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Term
| What is the gold standard lab for food allergies? |
|
Definition
| double-blind placebo controlled food challenge |
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Term
| Fatal reactions from hymenoptera occurs most commonly in whom and what do they have? |
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Definition
| adults >45yo, hymenoptera venom-specific IgE antibodies |
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Term
| children usually have what clinical manifestation with hymenoptera reactions? |
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Definition
|
|
Term
| how are hymeoptera allergic reactions confirmed? |
|
Definition
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|
Term
| How do you treat hymenoptera reactions? |
|
Definition
| epinephrine and corticosteroids |
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