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{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
! style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Cutaneous Reactions}}
! style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Cutaneous reactions}}
! style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Clnical Features}}
! style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Clnical features}}
! style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Implicated Medications}}
! style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Implicated medications}}
|-
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Exanthems
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Exanthems
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Diffuse fine macules and papules <BR> Evolve over days after drug initiation <BR> Delayed-type hypersensitivity
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Delayed-type hypersensitivity <BR> Evolve over days after drug initiation <BR> Diffuse macules and papules
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Allopurinol, aminopenicillins, cephalosporins, antiepileptic agents, and antibacterial sulfonamides
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | [[Allopurinol]], [[amphotericin]], [[barbiturates]], [[captopril]], [[carbamazepine]], [[cephalosporins]], [[chloramphenicol]], [[erythromycin]], [[furosemide]], [[gentamicin]], [[gold salts]], [[lithium]], [[nalidixic acid]], [[nitrofurantoin]], [[penicillins]], [[phenothiazines]], [[phenylbutazone]], [[phenytoin]], [[sulfonamides]]), [[thiazides]]
|-
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Urticaria, angioedema
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Urticaria/ angioedema
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Onset within minutes of drug initiation <BR> Potential for anaphylaxis <BR> Often IgE mediated
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Often IgE mediated <BR> Onset within minutes of drug initiation
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | IgE mediated: β-lactam antibiotics <BR> Bradykinin mediated: ACE-Is
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | [[ACE inhibitors]], [[aminosalicylic acid]], [[anticonvulsants]], [[aspirin]], [[atropine]], [[cephalosporins]], [[dextran]], [[hydralazine]], [[monoclonal antibodies]], [[NSAIDs]], [[opioids]], [[penicillins]], [[pentamidine]], [[quinine]], [[sulfonamides]], [[tetracyclines]], [[thiouracil]], [[tubocurarine]], [[vancomycin]]
|-
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Fixed drug eruption
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Fixed drug eruption
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Hyperpigmented plaques <BR> Recur at same skin or mucosal site
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Hyperpigmented plaques that recur at same skin or mucosal site
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Tetracyline, NSAIDs, and carbamezapine
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | [[ACE inhibitors]], [[allopurinol]], [[amlodipine]], [[aspirin]], [[barbiturates]], [[benzodiazepines]], [[carbamazepine]], [[cephalosporins]], [[clindamycin]], [[co-trimoxazole]], [[dextromethorphan]], [[diltiazem]], [[fluconazole]], [[lamotrigine]], [[lansoprazole]], [[metronidazole]], [[NSAIDs]], [[paclitaxel]], [[paracetamol]], [[penicillin]], [[phenolphthalein]][[omeprazole]], [[quinine]], [[salicylates]], [[sulfonamides]], [[terbinafine]], [[tetracyclines]], [[trimethoprim]]
|-
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Pustules
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Pustules
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Aceneiform <BR> Acute generalized eczematous pustulosis (AGEP)
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Acute generalized eczematous pustulosis (AGEP) <BR> Acneiform
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Acneiform: corticosteroids, sirolimus <BR> AGEP: antibiotics, calcium-channel blockers
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | AGEP: [[antibiotics]], [[calcium-channel blockers]] <BR> Acneiform: [[corticosteroids]], [[sirolimus]]
|-
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Bullous
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Bullous
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Tense blisters <BR> Flaccid blisters
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Flaccid blisters <BR> Tense blisters  
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Furosemide, vancomycin <BR> Captopril, penicillamine
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Flaccid blisters: [[captopril]], [[penicillamine]] <BR> Tense blisters: [[furosemide]], [[vancomycin]]
|-
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | SJS
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Cutaneous lupus erythematosus
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Fever, erosive stomatitis, ocular involvement, purpuric macules on face and trunk with &lt;10% epidermal detachment
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Erythematous/scaly plaques in photodistribution
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Antibacterial sulfonamides, anticonvulsants, oxicam NSAIDs, and allopurinol
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | [[Hydrochlorothiazide]], [[calcium-channel blockers]], [[ACEIs]]
|-
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | TEN
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Stevens-Johnson syndrome (SJS)
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Similar features as SJS but >30% epidermal detachment <BR> Mortality as high as 50%
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Purpuric macules on face and trunk with &lt;10% epidermal detachment, fever, stomatitis, ocular involvement
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Same as SJS
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | [[antibiotics]], [[barbiturates]], [[Beta-lactam|β-lactam antibiotics]], [[carbamazepine]], [[chlorpropamide]], [[co-trimoxazole]], [[gold]], [[H2 blocker]], [[histamine]], [[lamotrigine]], [[leflunomide]], [[macrolides]], [[mefloquine]], [[NSAIDs]], [[phenothiazines]], [[phenytoin]], [[rifampicin]], [[sulfonamides]], [[tetracyclines]], [[thiazides]]
|-
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Cutaneous lupus
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Toxic epidermal necrolysis (TEN)
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Erythematous/scaly plaques in photodistribution
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Similar to SJS but >30% epidermal detachment
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Hydrochlorothiazide, calcium-channel blockers, ACE-Is
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | [[Allopurinol]], [[barbiturates]], [[carbamazepine]], [[gold]], [[griseofulvin]], [[lamotrigine]], [[leflunomide]], [[nitrofurantoin]], [[NSAIDs]], [[penicillins]], [[phenytoin]], [[salicylates]], [[sulfonamides]], [[tetracyclines]]
|}
|}




{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
! style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Extracutaneous Reactions}}
! style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Organ-specific reactions}}
! style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Clnical Features}}
! style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Clnical features}}
! style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Implicated Medications}}
! style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Implicated medications}}
|-
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Hematologic
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Pulmonary
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Hemolytic anemia, thrombocytopenia, granulocytopenia
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Pulmonary fibrosis, hypersensitivity pneumonitis
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Penicillin, quinine, sulfonamides
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | [[Nitrofurantoin]], [[bleomycin]], [[methotrexate]]
|-
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Hepatic
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Hepatic
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Hepatitis, cholestatic jaundice
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Hepatitis, cholestasis
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Para-aminosalacylic acid, sulfonamides, phenothiazines
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | [[Aminosalicylic acid|Para-aminosalicylic acid]], [[sulfonamides]], [[phenothiazines]]
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Pulmonary
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Pneumonitis, fibrosis
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Nitrofurantoin, bleomycin, methotrexate
|-
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Renal
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Renal
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Interstitial nephritis, membranous glomerulonephritis  
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Interstitial nephritis, membranous glomerulonephritis  
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Penicillin, sulfonamides, gold, penicillamine, allopurinol
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | [[Penicillin]], [[sulfonamides]], [[gold]], [[penicillamine]], [[allopurinol]]
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Hematologic
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Hemolytic anemia, thrombocytopenia, granulocytopenia
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | [[Penicillin]], [[quinine]], [[sulfonamides]]
|}
|}




{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
| style="background: #4479BA; padding: 5px 5px; font-weight: bold;" | {{fontcolor|#FFFFFF|Multiorgan Reactions}}
| style="background: #4479BA; padding: 5px 5px; font-weight: bold;" | {{fontcolor|#FFFFFF|Multiorgan reactions}}
! style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Clnical Features}}
! style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Clnical features}}
! style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Implicated Medications}}
! style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Implicated medications}}
|-
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Anaphylaxis
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Anaphylaxis
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Urticaria/angioedema, bronchospasm, gastrointestinal β-lactam antibiotics, mAbs symptoms, hypotension <BR> IgE- and non–IgE-dependent reactions
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Urticaria, angioedema, bronchospasm, gastrointestinal symptoms, hypotension
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | β-lactam antibiotics, mAbs
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | [[Beta-lactam|β-lactam antibiotics]], [[monoclonal antibodies]]
|-
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | DRESS
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Systemic lupus erythematosus
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Cutaneous eruption, fever, eosinophilia, hepatic dysfunction, lymphadenopathy
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Arthralgia, myalgias, fever, malaise
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Anticonvulsants, sulfonamides, minocycline, allopurinol
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | [[Hydralazine]], [[procainamide]], [[isoniazid]]
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Serum Sickness
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Arthralgias, myalgias, fever, malaise
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Hydralazine, procainamide, isoniazid
|-
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Vasculitis
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Vasculitis
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Cutaneous or visceral vasculitis
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Cutaneous or visceral vasculitis
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Hydralazine, penicillamine, propylthiouracil
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | [[Allopurinol]], [[aspirin]], [[Beta-lactam|β-lactam antibiotics]], [[carbamazepine]], [[carbimazole]], [[co-trimoxazole]], [[diltiazem]], [[erythromycin]], [[furosemide]], [[gold]], [[G-CSF]], [[GM-CSF]], [[hydralazine]], [[interferons]], [[methotrexate]], [[minocycline]], [[NSAIDs]], [[penicillamine]], [[propylthiouracil]], [[retinoids]], [[sulfasalazine]], [[sulfonamides]], [[thiazides]], [[thrombolytics]]
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Serum sickness
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Urticaria, arthralgia, fever
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | [[Heterologous]] [[antibodies]], [[infliximab]]
|-
| style="background: #DCDCDC; padding: 5px 5px; font-weight: bold;" valign=top | Drug reaction with eosinophilia and systemic symptoms (DRESS)
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | Cutaneous eruption, fever, eosinophilia, hepatic dysfunction, lymphadenopathy
| style="background: #F5F5F5; padding: 5px 5px;" valign=top | [[Anticonvulsant]]s, [[sulfonamide]]s, [[minocycline]], [[allopurinol]]
|}
|}
<ref>{{Cite journal | doi = 10.1016/j.jaci.2009.10.028 | issn = 1097-6825 | volume = 125 | issue = 2 Suppl 2 | pages = –126-137 | last = Khan | first = David A. | coauthors = Roland Solensky | title = Drug allergy | journal = The Journal of Allergy and Clinical Immunology | date = 2010-02 | pmid = 20176256 }}</ref><ref>{{cite book | last = Lee | first = Anne | title = Adverse drug reactions | publisher = Pharmaceutical Press | location = London Chicago | year = 2006 | isbn = 0853696012 }}</ref>
==References==
{{reflist|2}}

Latest revision as of 20:34, 23 September 2014


Cutaneous reactions Clnical features Implicated medications
Exanthems Delayed-type hypersensitivity
Evolve over days after drug initiation
Diffuse macules and papules
Allopurinol, amphotericin, barbiturates, captopril, carbamazepine, cephalosporins, chloramphenicol, erythromycin, furosemide, gentamicin, gold salts, lithium, nalidixic acid, nitrofurantoin, penicillins, phenothiazines, phenylbutazone, phenytoin, sulfonamides), thiazides
Urticaria/ angioedema Often IgE mediated
Onset within minutes of drug initiation
ACE inhibitors, aminosalicylic acid, anticonvulsants, aspirin, atropine, cephalosporins, dextran, hydralazine, monoclonal antibodies, NSAIDs, opioids, penicillins, pentamidine, quinine, sulfonamides, tetracyclines, thiouracil, tubocurarine, vancomycin
Fixed drug eruption Hyperpigmented plaques that recur at same skin or mucosal site ACE inhibitors, allopurinol, amlodipine, aspirin, barbiturates, benzodiazepines, carbamazepine, cephalosporins, clindamycin, co-trimoxazole, dextromethorphan, diltiazem, fluconazole, lamotrigine, lansoprazole, metronidazole, NSAIDs, paclitaxel, paracetamol, penicillin, phenolphthaleinomeprazole, quinine, salicylates, sulfonamides, terbinafine, tetracyclines, trimethoprim
Pustules Acute generalized eczematous pustulosis (AGEP)
Acneiform
AGEP: antibiotics, calcium-channel blockers
Acneiform: corticosteroids, sirolimus
Bullous Flaccid blisters
Tense blisters
Flaccid blisters: captopril, penicillamine
Tense blisters: furosemide, vancomycin
Cutaneous lupus erythematosus Erythematous/scaly plaques in photodistribution Hydrochlorothiazide, calcium-channel blockers, ACEIs
Stevens-Johnson syndrome (SJS) Purpuric macules on face and trunk with <10% epidermal detachment, fever, stomatitis, ocular involvement antibiotics, barbiturates, β-lactam antibiotics, carbamazepine, chlorpropamide, co-trimoxazole, gold, H2 blocker, histamine, lamotrigine, leflunomide, macrolides, mefloquine, NSAIDs, phenothiazines, phenytoin, rifampicin, sulfonamides, tetracyclines, thiazides
Toxic epidermal necrolysis (TEN) Similar to SJS but >30% epidermal detachment Allopurinol, barbiturates, carbamazepine, gold, griseofulvin, lamotrigine, leflunomide, nitrofurantoin, NSAIDs, penicillins, phenytoin, salicylates, sulfonamides, tetracyclines


Organ-specific reactions Clnical features Implicated medications
Pulmonary Pulmonary fibrosis, hypersensitivity pneumonitis Nitrofurantoin, bleomycin, methotrexate
Hepatic Hepatitis, cholestasis Para-aminosalicylic acid, sulfonamides, phenothiazines
Renal Interstitial nephritis, membranous glomerulonephritis Penicillin, sulfonamides, gold, penicillamine, allopurinol
Hematologic Hemolytic anemia, thrombocytopenia, granulocytopenia Penicillin, quinine, sulfonamides


Multiorgan reactions Clnical features Implicated medications
Anaphylaxis Urticaria, angioedema, bronchospasm, gastrointestinal symptoms, hypotension β-lactam antibiotics, monoclonal antibodies
Systemic lupus erythematosus Arthralgia, myalgias, fever, malaise Hydralazine, procainamide, isoniazid
Vasculitis Cutaneous or visceral vasculitis Allopurinol, aspirin, β-lactam antibiotics, carbamazepine, carbimazole, co-trimoxazole, diltiazem, erythromycin, furosemide, gold, G-CSF, GM-CSF, hydralazine, interferons, methotrexate, minocycline, NSAIDs, penicillamine, propylthiouracil, retinoids, sulfasalazine, sulfonamides, thiazides, thrombolytics
Serum sickness Urticaria, arthralgia, fever Heterologous antibodies, infliximab
Drug reaction with eosinophilia and systemic symptoms (DRESS) Cutaneous eruption, fever, eosinophilia, hepatic dysfunction, lymphadenopathy Anticonvulsants, sulfonamides, minocycline, allopurinol


[1][2]

References

  1. Khan, David A. (2010-02). "Drug allergy". The Journal of Allergy and Clinical Immunology. 125 (2 Suppl 2): –126-137. doi:10.1016/j.jaci.2009.10.028. ISSN 1097-6825. PMID 20176256. Unknown parameter |coauthors= ignored (help); Check date values in: |date= (help)
  2. Lee, Anne (2006). Adverse drug reactions. London Chicago: Pharmaceutical Press. ISBN 0853696012.