allergic drug eruption treatment

8/11/2019 Allergic Drug Eruption Treatment

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ALLERGIC DRUG ERUPTION :

TREATMENT AND MEDICATIONElda Oncossya P (106 105 0134)


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ALLERGIC DRUG ERUPTION

General term for eruptions in the skin and

mucosa induced by a drug or its metabolites


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Classification of Drug Eruptions by Pathogenesis


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GOAL ?

Discontinue the offending mechanism and

allergic reactions to a certain drugs

Dx : Medical History & PEAssessment of Drug

Reactions


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Guidelines for Assessment of Possible

Adverse Drug Reactions :

Exclude alternative causes

Examine interval between drug introduction and

onset of reaction

Note any improvement after drug withdrawal

Determine whether similar reactions have been

associated with same compound

Note any different reaction on readministration of

the drug(s)


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ALLERGIC DRUG ERUPTIONS :

1. Urticaria Major drugs involved: antibiotics, (penicillins,

cephalosporins, sulfonamides, tetracyclines), NSAIDS,

contrast media

Treatment: Self-limiting disease

Withdraw causative agent, avoid in future

Primarily treated with H1 antihistamines


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2. Angioedema

Associated with urticaria in 50% of cases.

ACE inhibitor induced angioedema (onset: few minutes to

years), penicillins, NSAIDs, contrast media

Treatment:

Withdraw offending drug and avoid in future

H1 antihistamines.

If severe or breathing/swallowing difficulties, systemiccorticosteroids, subcutaneous adrenalin/epinephrine


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3. Xanthematous Drug Eruption

Synonyms: Morbilliform eruption or maculopapular drug

eruption

Most common drug reactions affecting skin, start 7-14days of starting new drug

Drugs involved: Penicillins, Carbamazepine, Allopurinol,

Sulfonamides

Treatment: Discontinue offending agent.

Largely supportive, topical steroids

Antihistamines may alleviate pruritus.


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Spesific Types of Drug-Induced Skin Reactions :

Fixed Drug Eruptions (FDE)

Eruptions that reccur at the same site each time

the same drug is administered.(most causative drugs : NSAIDs, Tetracyclines, Sulfa, Food Additives)


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Red/ purple patches Multiple patches

D = 1cm10cm

Itching & pain

TREATMENT

Oral Antihistamine Causative drug should be discontinued


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Sources :

1. Gruchalla Rebecca S, MD, PhD.Journal of Allergy and Clinical

Immunology : Drug metabolism, danger signals, and drug-

induced hypersensitivity. Volume 108, Issue 4. Pages 475-

488, October 2011

2. Jonathan E Blume, MD . Drug Eruption: Medication.Clinical

Dermatology, Columbia University College of Physicians and

Surgeons. 8 April 2013

3. Rasad Asri, MSc. Ilmu Penyakit Kulit dan Kelamin : Erupsi

Obat Alergik. Jakarta : FKUI. 154-158.

allergic drug eruption treatment

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