Allergic hepatitis

Kojima N, Kumamoto I, Masumoto T, Onji M. A case report of drug-induced allergic hepatitis probably due to the N-methyltetrazolethiol group cephalosporin. Arerugi 1994 43(3) 511-14. 

Fatal hepatotoxicity has also been associated with dacarbazine 500 mg/day for 5 days (5). The cause of this effect is unclear an allergic hepatic vasculitis with thrombosis is possible. 

Drug-induced liver disease occurs as several different clinical presentations idiosyncratic reactions, allergic hepatitis, toxic hepatitis, chronic active toxic hepatitis, toxic cirrhosis, and liver vascular disorders. 

Pohl LR. Drug-induced allergic hepatitis. Semin Liver Dis 1990 10 305-315. 

Castell JV, Castell M (2006) Allergic hepatitis induced by drugs. Curr Opin Allergy Qin Immunol... 

Ahmed Y, Siddiqui W, Enoch CB, Albrecht H, Bookstaver PB. Rare case of rilpivirine-induced severe allergic hepatitis. J Antimicrob Chemother 2013 68(2) 484-6. 

Several types of adverse drug reactions do not easily fit into Cell and Coomb s classification scheme. These include most cutaneous hypersensitivity reactions (such as toxic epidermal necrolysis), immune-allergic hepatitis and hypersensitivity pneumonitis. Another difficulty is that allergic drug reactions can occur via more than one mechanism picryl chloride in mice induces both type 1 and type IV responses. Although other classification schemes have been proposed. Cell and Coomb s system remains the most widely utilized scheme [4-7]. 

The thiazide diuretics are contraindicated in patients with known hypersensitivity to the thiazides or related diuretics, electrolyte imbalances, renal decompensation, hepatic coma, or anuria. A cross-sensitivity reaction may occur with the thiazides and sulfonamides. Some of the thiazide diuretics contain tartrazine, which may cause allergic-type reactions or bronchial asthma in individuals sensitive to tartrazine. 

Plasma proteins are contraindicated in those with a history of allergic reactions to albumin, severe anemia, or cardiac failure in the presence of normal or increased intravascular volume and in patients on cardiopulmonary bypass. Plasma protein fractions are used cautiously in patients who are in shock or dehydrated and in those with congestive cardiac failure or hepatic or renal failure. These solutions are Pregnancy Category C drugp and are used cautiously during pregnancy and lactation. 

Sulfasalazine is associated with various adverse effects, most of which are thought to be due to the sulfapyridine component. Common adverse effects that may be dose related include headache, dyspepsia, nausea, vomiting, and fatigue.19 Idiosyncratic effects include bone marrow suppression, reduction in sperm counts in males, hepatitis, and pulmonitis. Hypersensitivity reactions may occur in patients allergic to sulfonamide-containing medications. 

Every patient receiving antimicrobial therapy for skin and soft tissue infections must be monitored for efficacy and safety. Efficacy typically is manifested by reductions in temperature, white blood cell count, erythema, edema, and pain that begin within 48 to 72 hours. To ensure safety, dose antibiotics according to renal and hepatic function as appropriate, and monitor for and minimize adverse drug reactions, allergic reactions, and drug interactions. 

Hepatitis B HBV C 0.5 mL A 1 mL Intramuscular Allergic reaction to yeast (baking yeast)... 

Disulfiram is used as an adjunct in the management of alcohol dependence. It is contraindicated in patients with a history of cerebrovascular accident, cardiac failure, coronary artery disease, hypertension and psychosis. Side-effects that may be present include initial drowsiness and fatigue, nausea, vomiting, halitosis, reduced libido, psychotic reactions, allergic dermatitis, peripheral neuritis and hepatic cell damage. 

Hypersensitivity reactions While taking -blockers, patients with a history of severe anaphylactic reaction to a variety of allergens may be more reactive to repeated challenge, either accidental, diagnostic, or therapeutic. Such patients may be unresponsive to the usual doses of epinephrine used to treat allergic reaction. Renal/Hepatic function impairment Rarely, use of carvedilol in patients with CHF has resulted in deterioration of renal function. Patients at risk appear to be those with low blood pressure (systolic BP less than 100 mm Hg), ischemic heart disease. 

Adverse reactions may include acneiform eruptions allergic dermatitis arthropathy multiple cases of cholestatic and fulminant hepatitis drowsiness fatigue headache hepatotoxicity resembling viral or alcoholic hepatitis impotence metallic or garlic-like aftertaste peripheral neuropathy polyneuritis optic or retrobulbar neuritis restlessness occasional skin eruptions. 

Uses Allergic Rxns itching Action Phenothiazine antihistamine serotonin antagonist Dose Adults. 4-20 mg PO qSh max 0.5 mg/kg/d Feds. 2-6 y 2 mg bid-tid (max 12 mg/24 h) 7-14 y 4 mg bid-tid in hepatic impair Caution [B, ] BPH Contra Neonates or <2 y NAG BOO acute asthma GI obst Disp Tabs, syrup SE Anticholinergic, drowsiness Interactions T Effects Wf CNS depressants, MAOIs, EtOH X effects OF epi, fluoxetine EMS Use other CNS depressants w/ caution concurrent EtOH use can T CNS depression higher epi doses may be needed if used OD May cause mood changes, Szs, CNS depression, or CNS stimulation symptomatic and supportive... 

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