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Generic intravenous (IV) drugs are considered bioequivalent to their branded counterparts due to their 100% bioavailability upon administration. However, variations in stability among different drug products can significantly influence their therapeutic performance, even if they are pharmaceutically equivalent.Cefuroxime, a prophylactic antimicrobial, is often used as a single-dose IV injection for patients undergoing coronary artery bypass grafting surgery. A 3 g dose typically provides...
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Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial...
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Anaphylaxis is a severe, life-threatening hypersensitivity reaction mediated by Immunoglobulin E (IgE) antibodies. When IgE binds to allergens, it triggers the release of mediators– histamine, leukotrienes, and prostaglandins from mast cells and basophils. These mediators cause vasodilation, edema, and inflammation, leading to various symptoms.The primary allergens causing anaphylaxis include food items (e.g., peanuts, shellfish), drugs (e.g., penicillin, asparaginase, corticotropin,...
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Type II hypersensitivity involves IgG and IgM antibodies targeting cell surface antigens, leading to cell destruction. This can occur through complement activation, antibody-dependent cell-mediated cytotoxicity (ADCC), or acting as opsonins for phagocytosis. When excessive, these reactions cause significant tissue damage.Drug-induced hemolytic anemia is a common example, where drugs like penicillin or cephalosporins bind to red blood cells, forming drug-protein complexes. These complexes...
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Type III hypersensitivity reactions occur when antigen–antibody complexes form and activate the complement system. Normally, these complexes help the clearance of antigens by phagocytes and red blood cells. However, when large numbers of immune complexes are present, they can deposit in tissues—particularly in the walls of blood vessels—leading to inflammation and tissue injury. These deposits trigger complement activation and neutrophil recruitment, resulting in serum...
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Related Experiment Video

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Cecal Ligation Puncture Procedure
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Serum sickness-like reaction associated with cefazolin.

Michael Brucculeri1, Marian Charlton2, David Serur2

  • 1Division of Nephrology and Hypertension, New York Presbyterian Hospital - Weill Medical College of Cornell University, 525 East 68th Street, New York, NY 10021, USA.

BMC Clinical Pharmacology
|March 1, 2006
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Summary

Serum sickness-like reactions are rare adverse drug events. A case report suggests cefazolin, a common antibiotic, may cause these reactions, highlighting the need for vigilance.

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Area of Science:

  • Pharmacology
  • Clinical Medicine
  • Adverse Drug Reactions

Background:

  • Serum sickness-like reactions (SSLRs) are uncommon adverse events associated with various medications.
  • Cefazolin, a first-generation cephalosporin, is widely used and generally considered safe.
  • Previously, no SSLRs have been linked to cefazolin administration.

Observation:

  • A 23-year-old male developed fever, arthralgia, and a rash 10 days post-discharge after a single dose of intravenous cefazolin.
  • The patient had undergone a laparoscopic donor nephrectomy.
  • Clinical presentation was consistent with a serum sickness-like reaction, with no signs of systemic vasculitis.

Findings:

  • The patient's symptoms resolved completely following treatment with corticosteroids and antihistamines.
  • The Naranjo probability scale indicated a probable link between cefazolin and the adverse event.
  • This case represents a probable serum sickness-like reaction following cefazolin therapy.

Implications:

  • This case suggests a potential association between cefazolin and serum sickness-like reactions.
  • Clinicians should consider cefazolin as a possible cause of SSLRs in patients presenting with characteristic symptoms.
  • Further pharmacovigilance may be warranted to confirm this association.