Multiple drug hypersensitivity

The term multiple drug hypersensitivity is used for different forms of side effects to various drugs. Some use it to characterize patients with multiple drug intolerance ( pseudoallergy to various NSAID, etc.), others reserve this term for well-documented, repeated, and clearly immune-mediated reactions to structurally... 

Anaphylaxis Anaphylaxis to streptomycin (12/284) and to INH (1/284) was reported from a retrospective chart review of patients managed for spinal TB in southwest China [ll ]. Multiple drug hypersensitivity (MDH) has been observed to both first- and second-line ATDs. Itch, oedema, eosinophilia and fever are the most common features of MDH. Streptomycin and ofloxacin are associated with the most serious reactions [42 ]. 

Adverse hypersensitivity may start 1 to 8 weeks after start of drug use and clinically display as anaphylaxis, fever, rash and various cutaneous reactions (exanthema s, bullous responses, etc.), blood dyscrasias and involve multiple internal organs, including liver, kidney and lungs (Sullivan and Shear, 2001 Gomes and Demoly, 2005). Occasionally drug hypersensitivity results in very serious and life-threatening conditions, such as Steven Johnsons Syndrome (SJS) and toxic epidermal necrolysis (TEN). 

If the patient received multiple drug therapy, the last dmg administered to the patient may have caused hypersensitivity and skin eruptions. Drug-induced dermatitis may take a few minutes, several hours, or a day for urticaria (hives) to appear. Certain drugs such as penicillin are known to cause hypersensitivity. 

Venne, A., Li, S., Mandeville, R., Kabanov, A. V. Alakhov, V. (1996). Hypersensitizing effect of pluronic L61 on cytotoxic activity, transport, and subcellular distribution of doxorubicin in multiple drug-resistant cells. Cancer Res, 56,3626-3629. 

Brown RJ, Rother KI, Artman H, Mercuric MG, Wang R, Looney RJ, Cowen EW. Minocycline-induced drug hypersensitivity syndrome followed by multiple autoimmune sequelae. Arch Dermatol 2009 145(1) 63-6. 

Lehloenya RJ, WaUace J, Todd G, Dheda K. Multiple dmg hypersensitivity reactions to anti-tuberculosis drugs five cases in HIV-infected patients. Int J Tuberc Lung Dis 2012 16(9) 1260--4. 

Hypersensitivity to the drug conditions that might predispose patients to priapism (eg, sickle cell anemia or trait, multiple myeloma, leukemia) patients with anatomical deformation of the penis patients with penile implants (intracavernosal) use in women, children, or newborns use in men for whom sexual activity is inadvisable or contraindicated for sexual intercourse with a pregnant woman unless the couple uses a condom barrier. 

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