Drug hypersensitivity

Control of severe or incapacitating allergic conditions not controlled by other methods, bronchial asthma (including status asthmaticus), contact dermatitis, atopic dermatitis, serum sickness, drug hypersensitivity reactions... 

RCM-related T-cell activity may be assessed in vitro by lymphocyte transformation test [19, 24]. In addition, CD69 upregulation (lymphocyte activation test) was observed in patients with a positive lymphocyte transformation test [24, 39]. These tests appear to be a promising tool to identify drug-reactive T cells in the peripheral blood of patients with RCM-induced drug-hypersensitivity reactions. However, the sensitivity and specificity remain unknown and, therefore, these tests cannot be recommended for routine use yet, but further research on the specificity and sensitivity is indicated. 

Beeler A, Zaccaria L, Kawabata T, et al CD69 upregulation on T cells as an in vitro marker for delayed-type drug hypersensitivity. Allergy 2008 63 181-188. 

Pichler WJ Delayed drug hypersensitivity reactions. Ann Intern Med 2003 139 683-693. 

Association of pyrazolone drug hypersensitivity with HLA-DQ and DR antigens. Clin Exp Allergy 1998 28 1153-1158. 

Aberer W. Bircher A, Romano A, et al Drug provocation testing in the diagnosis of drug hypersensitivity reactions general considerations. Allergy 2003 58 854-863. 

Anon. Part 1 Executive summary of disease management of drug hypersensitivity a practice parameter. Ann Allergy Asthma Immunol 1999 83 665-700. 

Pichler WJ. Immune mechanism of drug hypersensitivity. Immunol Allergy Clin North Am 2004 24 373-397. 

Evaluate for the presence of adverse drug reactions, drug hypersensitivity, and drug interactions. 

Demoly, P. and Rebelo Gomes, E., Drug hypersensitivities definition, epidemiology and risk factors, Eur. Ann. Allergy Clin, Immunol., 37, 202, 2005. 

Kenna, J.G. et al., Metabolic basis for a drug hypersensitivity Antibodies in sera from patients with halothane hepatitis recognize liver neoantigens that contain the trifluoroacetyl group derived from halothane, J. Pharmacol. Exptl. Therap., 245, 1103, 1988. 

Uetrecht, J., Role of drug metabolism for breaking tolerance and the localization of drug hypersensitivity, Toxicology, 209, 113, 2005. 

Adkinson, Jr., N.F. et al., Task force report future research needs for the prevention and management of immune-mediated drug hypersensitivity reactions, J. Allergy Clin. Immunol., 109, S461, 2002. 

Allergic states Control of severe or incapacitating allergic conditions intractable to conventional treatment in serum sickness and drug hypersensitivity reactions. Parenteral therapy is indicated for urticarial transfusion reactions and acute noninfectious laryngeal edema (epinephrine is the drug of first choice). 

Hypersensitivity to the drug hypersensitivity to dihydropyridine calcium channel blockers (nisodipine) sick sinus syndrome or second- or third-degree AV block... 

HLA). Hence, in vitro assays for drug hypersensitivity testing are limited and genotyping of patients prior to drug administration seems to be the way forward. 

Patients with preexisting second- or third-degree A-V block, cardiogenic shock, or drug hypersensitivity should not be treated with moricizine. 

Contraindications Concurrent use of other ototoxic or nephrotoxic drugs, hypersensitivity to capreomycin... 

Hepatotoxicity with jaundice due to drug hypersensitivity may occur. 

Contraindications Acute alcohol intoxication concurrent use of centrally acting analgesics, hypnotics, opioids, or psychotropic drugs hypersensitivity to opioids... 

A severe type I hypersensitivity reaction such as systemic anaphylaxis (eg, from insect envenomation, ingestion of certain foods, or drug hypersensitivity) requires immediate medical intervention. 

Immune vasculitis can also be induced by drugs. The sulfonamides, penicillin, thiouracil, anticonvulsants, and iodides have all been implicated in the initiation of hypersensitivity angiitis. Erythema multiforme is a relatively mild vasculitic skin disorder that may be secondary to drug hypersensitivity. Stevens-Johnson syndrome is probably a more severe form of this hypersensitivity reaction and consists of erythema multiforme, arthritis, nephritis, central nervous system abnormalities, and myocarditis. It has frequently been associated with sulfonamide therapy. Administration of nonhuman monoclonal or polyclonal antibodies such as rattlesnake antivenin may cause serum sickness. 

Martin E etal Drug hypersensitivity Insights into pathomechanisms. Allerg Immunol (Paris) 2005 37 207. [PMID 16156398]... 

Pohl LR, Satoh H, Christ DD, et al. The immunologic and metabolic basis of drug hypersensitivities. Ann Rev Pharmacol Toxicol 28 367 1988. 

A syndrome of drug hypersensitivity has been described in patients receiving NNRTIs as well as in those receiving amprenavir or abacavir. Serious rashes, including Stevens-Johnson syndrome, have occurred. 

Moser R, Quesniaux V, Ryffel B. Use of transgenic animals to investigate drug hypersensitivity. Toxicology 2001 158 75-83. 

Nierkens S, Pieters R. Murine models of drug hypersensitivity. Curr Opin Allergy... 

Rare multi-organ failure associated with Stevens Johnson syndrome, toxic epidermal necrolysis or drug hypersensitivity syndrome... 

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