Serum-sickness-like

Some types of allergic reaction, for example immediate or delayed-type skin allergies, serum-sickness-like reactions and anaphylactic reactions, may occur in a proportion of patients given penicillin treatment. There is some, but not complete, cross-allergy with cephalosporins. 

The most frequent adverse effects are local reactions at the injection site (pain, tenderness, erythema, swelling, and pruritus), fevers (greater than 37.5°C or 99.5°F), headaches, dizziness, and irritability. Anaphylaxis and hypersensitivity reactions have been reported rarely and occur within a few hours after vaccine administration. In rare instances, a serum sickness-like apparent hypersensitivity syndrome (arthralgia, urticaria, ecchymoses, erythema multiforme, and erythema nodosum) has been... 

These reactions involve a serum sickness like syndrome (e.g., arthralgias, fever, malaise, and urticaria) that usually develops 7 to 14 days after exposure to the causative antigen. 

Serum sickness-like reactions (erythema multiforme or skin rashes accompanied by polyarthritis, arthralgia and, frequently, fever) have been reported these reactions usually occurred following a second course of therapy. Signs and symptoms occur after a few days of therapy and resolve a few days after drug discontinuation with no serious sequelae. 

Misceiianeous Brown-black microscopic discoloration of thyroid glands (prolonged therapy), decreased hearing, fever, lupus-like syndrome, secretion discoloration, serum sickness-like syndrome, tinnitus, tooth discoloration, vulvovaginitis. 

Nausea, serum sickness-like reaction (marked by fever and joint pain usually occurs... 

Nausea, unusual bruising or bleeding, serum sickness-like reaction (marked by fever and joint pain usually occurs after the second course of therapy and resolves after the drug is discontinued)... 

Nausea, unusual bruising/bleeding, serum sickness-like reaction Rare... 

The common side effects are nausea and vomiting. The others are allergic symptoms including drug fever, skin rash, urticaria, eosinophilia, photosensitization reactions, serum sickness like syndrome. Stevens-Johnson syndrome and exfoliative dermatitis are also common with longer acting agents. 

A delayed serum sickness-like reaction may occur 1-2 weeks after anti-TNF therapy in 1% of patients. These reactions consist of myalgia, arthralgia, jaw tightness, fever, rash, urticaria, and edema and usually require discontinuation of that agent. Positive antinuclear antibodies and anti-double-stranded DNA develop in a small number of patients. Development of a lupus-like syndrome is rare and resolves after discontinuation of the drug. 

Piperacillin-Tazobactam (Zesyn) [Anribioric/Extended Spectrum Penicillin, Beta Lactamase Inhibitor] Uses Infxns of skin, bone, resp urinary tract, abd, sepsis Action PCN plus 3-lactamase inhibitor bactericidal i cell wall synth Dose Adults. 3.375-4.5 g IV q6h i in renal insuff Caution [B, M] Contra PCN or 3-lactam sensitivity Disp Powder for inj frozen, premix inj 3.25, 3.375, 4.5 g SE D, HA, insomnia, GI upset, serum sickness-like Rxn, pseudomembranous colitis Interactions T Effects W/ probenecid T effects OF anticoagulants, MTX i effects W/ macrolides, tetracyclines i effects OF OCPs EMS T Effects of anticoagulants monitor for signs of electrolyte disturbances and hypovolemia d/t D such as X- K+ may cause allergic Rxn in pts sensitive to PCN OD May cause N/V/D, resp difficulty, and Szs symptomatic and supportive... 

Amfebutamone has been associated with a variety of generalized sensitivity reactions (SEDA-25, 17 SEDA-27, 28), including urticaria and serum sickness-like reactions. 

Two cases of serum sickness-like reactions have been reported in association with amfebutamone when used as an aid to smoking cessation (15,16). Both patients developed localized swellings of the fingers and hands, urticaria, and arthralgia. In both cases treatment with antihistamines and corticosteroids produced rapid relief of symptoms. 

In three other patients (two women, one man) a serum sickness-like reaction developed 6-21 days after the start... 

McCollom RA, Elbe DH, Ritchie AH. Bupropion-induced serum sickness-like reaction. Ann Pharmacother 2000 34(4) 471-3. 

Peloso PM, Baillie C. Serum sickness-like reaction with bupropion. JAMA 1999 282(19) 1817. 

Tripathi A, Greenberger PA. Bupropion hydrochloride induced serum sickness-like reaction. Ann Allergy Asthma Immunol 1999 83(2) 165-6. 

Waibel KH, Katial RR. Serum sickness- like reaction and bupropion. J Am Acad Child Adolesc 2004 43 509. 

Cefaclor has been associated with a high incidence of adverse joint and skin reactions. This unusual serum sickness-like reaction appears to be due to an inherited defect in the body s handling of cefeclor metaboUc products. 

In three other patients (two women, one man) a serum sickness-like reaction developed 6-21 days after the start of amfebutamone treatment (14). The symptoms, arthralgia, pruritus, and tongue swelling, abated within 2 weeks of treatment with oral corticosteroids. Serum sickness reactions to drugs are rare, and it will be important to find out whether amfebutamone carries an increased risk of this unusual reaction. 

The underlying mechanism of a series of clinical entities associated with beta-lactams, such as maculopapular rash, drug fever, eosinophilia, serum sickness-like disease, vesicular and bullous skin reactions, erythema nodosum, and acute interstitial nephritis, is suspected to be immunological but is still largely unknown. 

It is stiU uncertain whether cefaclor-associated serum sickness-like reactions correspond to true hypersensitivity. It has indeed been suggested that they may result from inherited defects in the metabolism of reactive intermediates and may be a unique adverse reaction requiring biotransformation of the parent drug (187). A lymphocyte-based cytotoxicity assay has shown that cefaclor metabolites, as generated by murine hepatic microsomes, mediated cytotoxicity among patients with... 

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