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Related Concept Videos

Drug Toxicity: Allergic Reactions01:30

Drug Toxicity: Allergic Reactions

206
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...
206
Allergic Drug Reactions01:27

Allergic Drug Reactions

1.6K
Allergic reactions related to drugs are hypersensitivity responses driven by the immune system and bear no connection to the drug's therapeutic action. While drugs in isolation do not trigger an immune response, they can interact with endogenous proteins to form antigens. These antigens stimulate lymphocytes to produce antibodies. IgE-type antibodies attach themselves to mast cells. Upon subsequent exposure to the same stimulus, the antigen-antibody interaction is initiated, unleashing...
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Drug toxicity: Idiosyncratic Reactions01:16

Drug toxicity: Idiosyncratic Reactions

219
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...
219
Drug Excretion: Miscellaneous Routes01:10

Drug Excretion: Miscellaneous Routes

508
Drug excretion involves various organs, including the liver, intestines, skin, and eyes. In the case of drugs or toxins, they can be actively secreted into bile by transporters in the hepatocyte's canalicular membrane. These substances enter the GI tract during digestion and may be reabsorbed into the body from the intestine. This process, known as enterohepatic recycling, can significantly prolong the presence and effects of a substance in the body. To interrupt this cycle, specific...
508
Drug toxicity: Drug–Drug Interaction01:30

Drug toxicity: Drug–Drug Interaction

422
Drug–drug interactions can precipitate toxicity through multiple mechanisms. Absorption interactions alter how drugs enter the body, exemplified when ranitidine increases the absorption of basic drugs, while cholestyramine decreases the levels of propranolol. Protein binding interactions occur when drugs share the same binding sites on plasma proteins. Drugs like aspirin and warfarin, when bound in excess, can lead to increased free drug concentrations, enhancing the potential for...
422
Allergic Reactions: Anaphylaxis01:30

Allergic Reactions: Anaphylaxis

277
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,...
277

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Acute methemoglobinemia with hemolytic anemia following bio-organic plant nutrient compound exposure: Two case reports.

Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine·2014
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Minimal Erythema Dose MED Testing
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Fixed drug eruption due to clarithromycin.

Santoshi Balkrishna Malkarnekar1, L Naveen1

  • 1Department of Medicine, Sri Devaraj Urs Medical College, Kolar, Karnataka, India.

Journal of Research in Pharmacy Practice
|July 4, 2014
PubMed
Summary

Fixed drug eruption (FDE) is a rare adverse drug reaction. This case highlights clarithromycin-induced FDE, often misdiagnosed, emphasizing physician awareness for preventing patient discomfort.

Keywords:
Clarithromycinfixed drug eruptionoral provocation test

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Area of Science:

  • Dermatology
  • Pharmacology
  • Clinical Medicine

Background:

  • Fixed drug eruption (FDE) is an uncommon adverse drug reaction.
  • Antibiotics, particularly clarithromycin, can trigger FDE.
  • Accurate diagnosis is crucial for patient management.

Observation:

  • A 30-year-old male presented with recurrent, itchy, red lesions on the lip, hand, and thigh.
  • Lesions initially misdiagnosed as lichen planus and treated with topical steroids.
  • Lesions recurred at the same sites, fading in two weeks with violaceous pigmentation.

Findings:

  • Oral provocation test confirmed clarithromycin as the causative agent for FDE.
  • The case underscores the rarity and diagnostic challenges of drug-induced FDE.
  • Delayed diagnosis can lead to prolonged patient suffering and misdirected treatment.

Implications:

  • Physicians must consider FDE in patients with recurrent cutaneous lesions after drug exposure.
  • Increased awareness of drug-induced FDE can prevent misdiagnosis and unnecessary treatments.
  • Prompt identification and drug cessation are key to managing FDE and preventing recurrence.