drugeruption藥物疹(參考版)
2025-03-26 00:04本頁(yè)面
【正文】 consider untoward incidents ?Elicit history of allergies [in patients with allergic diseases] ?Rule out drug interactions ?Adopt right technique: Eg slow iv injection of aminophylline ?Carry out appropriate monitoring ?藥疹的病因及發(fā)病機(jī)理 ?變態(tài)反應(yīng)性藥疹的共同點(diǎn) ?臨床分型及表現(xiàn) ?診斷要點(diǎn) ?處理及預(yù)防 ?過(guò)敏性休克的緊急處理 Learning points Vesiculobullous disease 。 sulfamethoxazole/trimethoprim Exanthemas Differential diagnosis (DDx) Viral eruption ? Presentation: Wheals or angioedema. My be part of a more severe anaphylactic reactons with bronchospasm, laryngospasm, or hypotension ? Types: 1. Nonimmunologic – Aspirin and NSADS are the most mon cause. – They alter prostaglandin metabolism, enhancing degranulation of mast cells. 2. Immunologic – Most monly associated with penicillin and related betalactam antibiotics – Skin test: penicillin exposure – Cross reaction with cephalosporins Urticaria DDx Papular urticaria urticaria ?Known plication of the use of ACE inhibitors ?Effect is dose dependent and may resolve with decreased dose. ?ACE users with one episode of angioedema have a 10x risk of a second episode which may be more severe. ?Mechanism :Blocking of kininase II by ACE inhibitors may increase tissue kinin levels? Angioedema Fixed drug eruption ?Unknown pathogenesis ?Variant: Nonpigmented fixed drug eruption –It is characterized by large, tender, often symmetrical erythematous plaques that resolve pletely within weeks, only to recur on reingestion of offending drug –Pseudoephedrine by far most mon. –Baboon syndrome !! ?Unknown pathogenesis ?Present anywhere on body (50% occur on oral and genital mucosa) ?Presentation: –Six or less lesions occur, typically one. –Clinically begin as a red patch that soon evolves to an iris or target lesion identical to EM. –Eventually may blister and erode. 187。Drug
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