drugeruption藥物疹(已修改)
2025-04-04 00:04 本頁面
【正文】 Drug Eruption Liangchun Wang Department of Dermatology, the Second Affiliated Hospital, Sun YatSen University What is drug eruption The adverse drug reactions of the skin Why do we have to know? ?Over 2 MILLION serious ADRs yearly ?100,000 DEATHS yearly ?ADRs 4th leading cause of death ahead of pulmonary disease, diabetes, AIDS, pneumonia, accidents and automobile deaths ?Nursing home patients ADR rate—350,000 yearly Why do we have to know? Gastrointestinal tract events % Electrolyte/renal % Hemorrhagic % Metabolic/endocrine % Dermatologic (skin) /allergic % Causes of drug eruption INGESTANTS: substances that enter the body by mouth INHALANTS: the allergen is breathed in through the nose or mouth CONTACT ALLERGIES: enter the body through the skin INJECTED: enter the body through puncture Pathogenesis ?In most patterns pathogenesis is UNKOWN1! ?Possible mechanisms ?Immunologic mechanism unpredictable ?Nonimmunologic mechanisms sometimes predictable ?Idiosyncratic with a possible immunologic mechanismunpredictable ?Immunologic mechanism unpredictable ?Nonimmunologic mechanisms sometimes predictable ?Idiosyncratic with a possible immunologic mechanismunpredictable ?Response by the patients to the drug or its metabolite ?Four types of hypersensitivity Type I hypersensitivity (1) Type I hypersensitivity (2) Systemic Anaphylaxis (Allergic shock) Anaphylactic shock ? drug allergy, . penicillin ? toxin from bee, seafood Localized Anaphylaxis: ? Breathe tract allergy: allergic rhinitis, allergic asthma ? Digest tract allergy (food) ? Skin allergy: urticaria, angioedema Type II hypersensitivity (1) Red cells: Penicillin, chloropromazine, phenacetin Granulocytes: Quinidine, amidopyrine Platelets: sulphonamides, thiazides Type II hypersensitivity (2) Infusion
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