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Drug Toxicity: Allergic Reactions

Drug Toxicity: Allergic Reactions

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 exposure to a...

Hypersensitivity Reactions: Cytolytic Reactions

Hypersensitivity Reactions: Cytolytic Reactions

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...

Drug toxicity: Idiosyncratic Reactions

Drug toxicity: Idiosyncratic Reactions

Idiosyncratic drug reactions represent abnormal chemical responses that vary significantly among individuals, ranging from extreme sensitivity to low doses to insensitivity to high doses. These reactions often occur due to the drug's covalent binding with serum proteins, forming a foreign hapten that triggers an immunotoxicological response. The variability in drug reactions has a strong pharmacogenetic foundation, with genetic differences crucial in how individuals metabolize drugs. For...

Hypersensitivity Reactions: Delayed Hypersensitivity Reactions

Hypersensitivity Reactions: Delayed Hypersensitivity Reactions

Delayed-Type Hypersensitivity (DTH), or Type IV hypersensitivity, is a cell-mediated immune response. It occurs when T cells, rather than antibodies, mediate a reaction to specific antigens. It is characterized by a delayed onset (1-2 days) and involves the recruitment of macrophages to the inflammation site.The initiation of a DTH response begins with the sensitization of T cells. During this phase, which lasts at least 1-2 weeks, antigen-specific T cells are activated, clonally expanded, and...

Hypersensitivities

Hypersensitivities

Hypersensitivity, also known as a hypersensitivity reaction or allergic reaction, is a condition where the body's immune system reacts abnormally to a foreign substance. Such substances, that cause hypersensitivity are referred to as an allergen, could be something typically harmless to most people, like pollen or certain foods.
Types of Hypersensitivities
Hypersensitivity reactions are categorized into four types: Type 1, Type 2, Type 3, and Type 4. Each type has a distinct mechanism...

Hypersensitivity Reactions: Immune-Complex Reactions

Hypersensitivity Reactions: Immune-Complex Reactions

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 sickness, a systemic...

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MEDUSA for Identifying Death Regulatory Genes in Chemo-genetic Profiling Data

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Published on: February 7, 2025

Hypersensitivity reactions to etoposide phosphate.

Khrishanthne Sambasivan¹, Sarah Mahmoud, Arwa Kokache

¹Department of Medical Oncology, Charing Cross Hospital, London, UK.

Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners

|June 7, 2013

Summary

Etoposide phosphate is a prodrug for etoposide-allergic patients. However, some patients may experience allergic reactions to both etoposide and etoposide phosphate, requiring careful medical supervision.

Keywords:

Hypersensitivity allergy etoposide phosphate germ cell tumour

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Area of Science:

Oncology
Pharmacology
Clinical Medicine

Background:

Etoposide phosphate is a prodrug of etoposide, often used in patients with hypersensitivity to etoposide.
Previous studies indicated successful treatment of etoposide-hypersensitive patients with etoposide phosphate.

Observation:

This study presents two cases of patients experiencing allergic reactions to both etoposide and etoposide phosphate.
These cases highlight a subset of patients who may react to both the parent drug and its prodrug.

Findings:

While most etoposide-hypersensitive patients tolerate etoposide phosphate, a small proportion are at risk of cross-reactivity.
Allergic reactions can occur with both intravenous etoposide and its prodrug, etoposide phosphate.

Implications:

Patients with a history of etoposide allergy require careful monitoring when initiating etoposide phosphate treatment.
The first dose of etoposide phosphate in patients with prior etoposide allergy should be administered under close medical supervision.
Further investigation is warranted to identify risk factors for cross-reactivity between etoposide and etoposide phosphate.