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Life-Threatening Drug-Induced Rashes

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81. Guidelines for the Clinical and Operational Management of Drug-Resistant Tuberculosis

? oxacin Cm capreomycin CPC cetylpyridinium chloride Cs cycloserine DALY disability-adjusted years of life DM diabetes mellitus DOT directly observed treatment DOTS originally an acronym for directly observed treatment, short course, DOTS became the term used to describe the tuberculosis control strategy recommended by the WHO DR-TB drug-resistant tuberculosis DST drug susceptibility testing E ethambutol EBA early bactericidal activity Eth ethionamide FDA ? uorescein diacetate used for vital staining (...) tuberculosis strain resistant to at least isoniazid and rifampicin NEML National Essential Medicines List NTM non-tuberculous mycobacteria NTP national tuberculosis programme Ofx o? oxacin PAS p-aminosalicylate (p-aminosalicylic acid) PIH Partners in Health PLH person/people living with HIV Pto prothionamide QALY quality-adjusted years of life REMA resazurin microplate assay R rifampicin rGLC regional Green Light Committee S streptomycin SLD second-line drug TB tuberculosis TB-IRIS TB-immune reconstitution

2013 International Union Against TB and Lung Disease

82. Deciding when to stop: towards evidence-based deprescribing of drugs in older populations

hypoglycaemic agents, cardiovascular and central nervous system drugs). Clinicians need to look for pre-existing drug toxicity presenting as falls, confusion and lethargy, effects too often inappropriately attributed to ageing. Estimating a patient's life expectancy is important in determining the goals of care and potential long-term value of many preventive medications. Patients with a limited lifespan (12 months or less) due to marked frailty, advanced dementia, metastatic cancer and endstage organ (...) of benefits and harms on older persons’ willingness to take medication for primary cardiovascular prevention . Al-Rashed SA , Wright DJ , Roebuck N , et al . The value of inpatient pharmaceutical counselling to elderly patients prior to discharge . Garfinkel D , Zur-Gil S , Ben-Israel J . The war against polypharmacy: a new cost-effective geriatric-palliative approach for improving drug therapy in disabled elderly people . Garfinkel D , Mangin D . Feasibility study of a systematic approach

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2013 Evidence-Based Medicine (Requires free registration)

83. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection

lamivudine ABC abacavir AIDS acquired immunodeficiency syndrome Ar T antiretroviral therapy Ar V antiretroviral (drug) ATV atazanavir ATV/r atazanavir/ritonavir AZT zidovudine (also known as ZDV) BMI body mass index CD4 T–lymphocyte cell bearing CD4 receptor CDC United States Centers for Disease Control and Prevention CNS central nervous system d4T stavudine DALYs death- and disability-adjusted life-years DBS dried blood spot ddI didanosine DNA deoxyribonucleic acid DrV darunavir DrV/r darunavir (...) Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection 1 Introduction 1. Introduction CONSOLIDATED GUIDELINES ON the use of ANt IRet RoVIRAL DRuGs fo R t ReAt ING AND PReVeNt ING hIV INfe Ct IoN r ECOmm ENDATIONS f Or A p Ub LIC h EALTh A ppr OACh JUNE 2013 GuIDeLINesCONSOLIDATED GUIDELINES ON the use of ANt IRe t Ro VIRAL DRu Gs f o R t Re At ING AND PRe Ve Nt ING h IV INf e Ct Io N r ECOm m ENDATIONS f Or A p Ub LIC h EALTh Ap pr OACh JUNE 2013WHO

2013 World Health Organisation HIV Guidelines

84. Skin test for acyclovir drug allergy

Skin test for acyclovir drug allergy Allergy Notes: Skin test for acyclovir drug allergy Allergy, Asthma and Immunology News Updated Daily by Board-certified Allergist at Cleveland Clinic Florida Pages Skin test for acyclovir drug allergy affect up to 10% of people. When drug reactions resembling allergy happen, they are called drug hypersensitivity reactions (DHRs). Drug hypersensitivity reactions may be allergic or nonallergic. Drug allergies are drug hypersensitivity reactions caused (...) by the immune system. Case scenario: A 50-year-old male reported generalized pruritus and maculopapular rash after the second dose of acyclovir taken around 2014 for suspected shingles (no shingles developed). No LOC or SCARs. He takes amlodipine and metoprolol XL for BP control. SPT/ID test with acyclovir can be done using the following protocol: ----- Acyclovir Skin Test Immediate Reaction ----- Prick Test Substance / Concentration / W/F (mm) Saline Histamine Acyclovir 0.5 mg/ml ----- Intradermal Test

2019 Allergy Notes blog

85. Skin Rash Study Before Chemotherapy in Colorectal & Head and Neck Cancer Patients

Go to Primary Outcome Measures : Incidence of Rash [ Time Frame: Change from Baseline, week 3, week 8 ] Evaluate the incidence of cetuximab-induced rash, Compare the severity of cetuximab-induced rash between the extensive treatment group (ETG) and the standard care group (SCG). Secondary Outcome Measures : Quality of Life (QOL) [ Time Frame: Change from Baseline, week 3, week 8 ] Estimate and compare the quality of life (QOL) between the extensive treatment group and standard treatment group (...) associated with Cetuximab (Erbitux®) when compared to receiving standard care for the treatment of skin rash. Condition or disease Intervention/treatment Phase Colorectal Cancer Head and Neck Cancer Drug: Doxycycline Drug: Hydrocortisone 1% cream Other: Sunscreen Other: Moisturizer Drug: Clindamycin Drug: Medrol-dose pack (Steroid) Phase 2 Detailed Description: Of the 100 subjects who will participate in this study, 50 will be in the extensive treatment group and 50 will be in the standard care group

2013 Clinical Trials

86. Tetracycline as a Prophylaxis for Rash in Patients With NSCLC Receiving Treatment With BIBW 2992

-based chemotherapy, with a minimal toxicity compared to chemotherapy. BIBW2992 is associated with adverse effects similar to those for erlotinib and gefitinib, such as rash and diarrhea. These symptoms can reduce the quality of life (QL) in patients and lead to inconsistent EGFR inhibitor dose administration There is not a standard treatment for rash. However, case reports have tried to demonstrate the benefit in the treatment of these cutaneous injuries obtained with alcohol-free emollients (...) Intervention/treatment Phase Skin Rash Lung Cancer Drug: Tetracycline Phase 2 Detailed Description: Case reports have tried to demonstrate the benefit in the treatment of rash obtained with: alcohol-free emollients used 2-3 times daily, sunscreen with titanium dioxide or zinc oxide with a skin protection factor (SPF) greater than 15, topic or oral antibiotic regimens (such as clindamycin, metronidazole, tetracyclines) when there is secondary infection as well as steroidal anti-inflammatory drugs

2013 Clinical Trials

87. From the RFN Archives: Drug-Induced ANCA

(p-ANCA) as opposed to anti-PR3 antibodies. Occasionally, the disease will resolve on its own with removal of the drug--but more often than not, standard immunosuppressive therapy (e.g., Cytoxan and steroids) is required. Rash is a frequent manifestation of the vasculitis. Often, hydralazine-induced ANCA is associated with the production of MANY autoantibodies (e.g., ANA and many others) beyond just ANCA. Also, drug-induced ANCA does not typically occur until the patient has been on the drug (...) From the RFN Archives: Drug-Induced ANCA Renal Fellow Network: From the RFN Archives: Drug-Induced ANCA | | | | | Wednesday, September 7, 2011 From the RFN Archives: Drug-Induced ANCA A subset of patients with ANCA-associated vasculitis have drug-induced ANCA disease. There are a few features of drug-induced ANCA disease which set it apart from "idiopathic" ANCA disease, but overall the clinical symptoms are similar. Drug-induced ANCA almost always involves the production of anti-MPO antibodies

2011 Renal Fellow Network

88. Monitoring of Nonsteroidal Immunosuppressive Drugs in Patients With Lung Disease and Lung Transplant Recipients

. For patients who will undergo CNI therapy, the monitoring of drug concentrations, BP, glu- cose, potassium, magnesium, lipids, CBC count, and renal function is recommended (Grade 1B) . 3.2b. For patients who undergo CNI ther apy, monitoring of drug levels when CYP3A4 inducers or inhibitors are added or stopped and adjusting doses are recommended when using cyclosporin A (Grade 1A) or tacrolimus (Grade 1B) therapy. 3.2c. For lung transplant recipients receiving CNI therapy who develop renal dysfunction (...) who undergo sirolimus ther- apy and develop new or worsening respiratory symptoms or signs, an evaluation for sirolimus- induced pulmonary toxicity is recommended (Grade 1B) . 3.7 Other Immunosuppressive Drugs 3.7a. For patients receiving hydroxychloroquine and chloroquine, an eye examination at least once per year is suggested (Grade 2B) . 3.7b. For patients who undergo imatinib mesy- late therapy, monitoring of CBC and hepatic function is suggested (Grade 2C) . V arious conditions require

2012 American College of Chest Physicians

89. EVITA - A double-blind, vehicle controlled, randomized phase II trial of vitamin K1 cream as prophylaxis for cetuximab-induced skin toxicity. (PubMed)

EVITA - A double-blind, vehicle controlled, randomized phase II trial of vitamin K1 cream as prophylaxis for cetuximab-induced skin toxicity. Acne-like skin rash is a frequently occurring adverse event associated with drugs against the epidermal growth factor receptor. This randomized vehicle-controlled study investigated the addition of vitamin K1 cream to doxycycline in patients with metastatic colorectal cancer treated with cetuximab.Patients receiving first-line cetuximab + FOLFIRI were (...) randomly assigned to prophylactic treatment with doxycylin and vitamin K1 cream or doxycycline and the vehicle. The primary end point of the study was the incidence of grade ≥ 2 skin rash (NCI CTCAE version 4.02) during 8 weeks of skin treatment. Secondary end points comprised skin rash according to a more thorough tripartite skin toxicity score (WoMo), quality of life, efficacy, and compliance. The study had 80% power to show a 20% reduction of the incidence of grade ≥ 2 skin rash.A total of 126

2018 Annals of Oncology

90. PSORS1C1 Hypomethylation Is Associated with Allopurinol-Induced Severe Cutaneous Adverse Reactions during Disease Onset Period: A Multicenter Retrospective Case-Control Clinical Study in Han Chinese (PubMed)

PSORS1C1 Hypomethylation Is Associated with Allopurinol-Induced Severe Cutaneous Adverse Reactions during Disease Onset Period: A Multicenter Retrospective Case-Control Clinical Study in Han Chinese Background: Allopurinol-induced severe cutaneous adverse reactions (SCARs), including drug rash with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS) and toxic epidermal necrosis (TEN), are life-threatening autoimmune reactions. Evidence is growing that epigenetic variation

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2018 Frontiers in pharmacology

91. Severe cutaneous adverse reactions induced by targeted anticancer therapies and immunotherapies (PubMed)

Severe cutaneous adverse reactions induced by targeted anticancer therapies and immunotherapies With the increasing use of targeted anticancer drugs and immunotherapies, there have been a substantial number of reports concerning life-threatening severe cutaneous adverse reactions (SCARs), including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug rash with eosinophilia and systemic symptoms, drug-induced hypersensitivity syndrome, and acute generalized exanthematous (...) discuss the clinical course, latency, concomitant medication, tolerability of rechallenge or alternatives, tumor response, and mortality associated with these devastating conditions. Imatinib, vemurafenib, and rituximab were the top three offending medications that most commonly caused SJS/TEN, while EGFR inhibitors were the group of drugs that most frequently induced SJS/TEN. For drug rash with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome and acute generalized

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2018 Cancer management and research

92. Evaluation of Fenofibrate on Radiation-induced Skin Injury

of fenofibrate is safe and effective for radiation-induced skin injury. Condition or disease Intervention/treatment Phase Radiodermatitis Drug: Fenofibrate Drug: Saline Not Applicable Detailed Description: Radiation-induced skin injury is a significant side effect of ionizing radiation delivered to the skin during cancer treatment as well as a result of other exposure to radiation. The skin is one of radiosensitive organ systems in human body because it is a continuously renewing organ containing rapidly (...) and the quality of patients' life. Despite substantial improvements in radiation technology, radiation-induced skin toxicity is still a concerning problem. The purpose of this study is to determine whether topical application of fenofibrate is safe and effective for radiation-induced skin injury. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 30 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: Single

2018 Clinical Trials

93. Vancomycin-Induced Stevens-Johnson Syndrome in a Boy Under 2 Years Old: An Early Diagnosis by Granulysin Rapid Test (PubMed)

Vancomycin-Induced Stevens-Johnson Syndrome in a Boy Under 2 Years Old: An Early Diagnosis by Granulysin Rapid Test Stevens-Johnson syndrome (SJS) is a life-threatening disease, which is mainly ascribed to drugs, such as sulfonamides and psychoepileptics. In this article, we present a pediatric case of vancomycin-induced SJS and an alternative diagnostic algorithm. The patient presented with multiple target-like rashes and vesicles throughout the whole body after receiving vancomycin. Despite (...) the fact that skin biopsy remains the gold standard for diagnosing SJS, the granulysin rapid test by immunochromatographic assay is a non-invasive option for children. In this article, we describe our use of the Algorithm of Drug causality for Epidermal Necrolysis and a modified T-cell activation assay for granzyme B and interferon gamma to screen for the culprit drug. Moreover, we applied the granulysin rapid test as an early diagnosis method for children with drug-induced SJS.

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2018 Frontiers in pediatrics

94. Grover’s-like drug eruption in a patient with metastatic melanoma under ipilimumab therapy (PubMed)

Grover’s-like drug eruption in a patient with metastatic melanoma under ipilimumab therapy Dermatologic toxicity is an important adverse effect of immune checkpoint inhibitors targeting cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and programmed cell death 1 receptor (PD-1) or PD ligand 1 (PD-L1). Skin toxicity most commonly includes a maculopapular erythematous rash and pruritus. Rarely life threatening complications such as Steven's Johnson syndrome or toxic epidermal necrolysis may (...) occur.Here we report the uncommon event of a drug-induced transient acantholytic dermatosis (Grover's disease) in a 73-year-old Caucasian male treated with ipilimumab for metastatic melanoma. Five weeks after initiation of therapy, the patient developed a widespread polymorphic papulovesicular dermatosis on the trunk and proximal extremities with intense pruritus. Skin biopsy showed acantholytic dyskeratosis with interface dermatitis consistent with a Grover's-like drug eruption.These findings should

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2016 Journal for immunotherapy of cancer

95. Pharmacodynamic modeling of adverse effects of anti-cancer drug treatment (PubMed)

Pharmacodynamic modeling of adverse effects of anti-cancer drug treatment Adverse effects related to anti-cancer drug treatment influence patient's quality of life, have an impact on the realized dosing regimen, and can hamper response to treatment. Quantitative models that relate drug exposure to the dynamics of adverse effects have been developed and proven to be very instrumental to optimize dosing schedules. The aims of this review were (i) to provide a perspective of how adverse effects (...) of anti-cancer drugs are modeled and (ii) to report several model structures of adverse effect models that describe relationships between drug concentrations and toxicities.Various quantitative pharmacodynamic models that model adverse effects of anti-cancer drug treatment were reviewed.Quantitative models describing relationships between drug exposure and myelosuppression, cardiotoxicity, and graded adverse effects like fatigue, hand-foot syndrome (HFS), rash, and diarrhea have been presented

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2016 European journal of clinical pharmacology

96. Adverse Drug Reaction

the actions of one or both drugs. The drugs might not work, or you could get side effects. Side effects are unwanted effects caused by the drugs. Most are mild, such as a stomach aches or drowsiness, and go away after you stop taking the drug. Others can be more serious. Drug allergies are another type of reaction. They can be mild or life-threatening. Skin reactions, such as hives and rashes, are the most common type. When you start a new prescription or over-the-counter medication, make sure you (...) Reaction Aka: Adverse Drug Reaction , Medication Hypersensitivity , Drug Reaction From Related Chapters II. Types: Medication-induced Hypersensitivity Reaction See III. Differential Diagnosis: Non-immune mediated Drug Reaction (examples) Medication intolerance Significant gastrointestinal upset with Sensitization See Idiosyncratic reaction (examples) Pseudoallergic reaction (direct mast cell activation) anaphylactoid reaction s See Example: (examples) Medication toxicity (examples) s s Medication

2018 FP Notebook

97. Antecedent Drug Exposure Aetiology and Management Protocols in Steven-Johnson Syndrome and Toxic Epidermal Necrolysis, A Hospital Based Prospective Study (PubMed)

%) and in no male. Drugs implicated in causing these life threatening reactions were identified as anticonvulsant agents like carbamazepine (CBZ), phenytoin (PHT) and Lamotrigine (LTG), oxicam NSAID, Sulfasalazine and levofloxacin. Despite higher reported mortality rates in SJS and TEN all patients survived with 2 patients surviving TEN suffered from long term opthalmological sequelae of the disease.Present study suggest that drug induced cutaneous eruptions are common ranging from common nuisance rashes (...) to rare life threatening diseases like SJS and TEN, SJS/TEN typically occur 1-3 weeks after initiation of therapy. Aromatic AED's, LTG, oxicam NSAID's, sulfasalazine and levofloxacin have a tremendous potential to trigger SCARS's. To ensure safe use of pharmaceutical agents and better treatment outcomes post marketing voluntary reporting of severe rare and unusual reactions remains inevitable.

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2016 Journal of clinical and diagnostic research : JCDR

98. 1% Topical Pimecrolimus Cream for the Treatment of the Rash Associated With ERBITUX

and their quality of life. Participants will be in this study for about four weeks if their rash does not get worse. They will need to apply the study cream and placebo two times daily and answer quality of life questionnaires during this study. Participants will also be seen by a dermatologist and have pictures taken of their rash. Condition or disease Intervention/treatment Phase Rash Drug: Pimecrolimus Drug: Placebo Phase 2 Study Design Go to Layout table for study information Study Type : Interventional (...) Update Posted : March 15, 2017 Sponsor: West Virginia University Information provided by (Responsible Party): West Virginia University Study Details Study Description Go to Brief Summary: When cancer patients are treated with the drug cetuximab they very often develop a rash. Usually it appears on their face and back and other parts of the body. The rash looks like acne and is treated with skin creams or antibiotics most of the time. The rash can become very painful and cause patients to stop using

2012 Clinical Trials

99. Prophylactic EVOZAC® Calming Skin Spray for EGFR-TKIs Associated Rash Eruption in NSCLC

Prophylactic EVOZAC® Calming Skin Spray for EGFR-TKIs Associated Rash Eruption in NSCLC Prophylactic EVOZAC® Calming Skin Spray for EGFR-TKIs Associated Rash Eruption in NSCLC - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies (...) before adding more. Prophylactic EVOZAC® Calming Skin Spray for EGFR-TKIs Associated Rash Eruption in NSCLC The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT01528488 Recruitment Status : Completed First Posted : February 8, 2012 Last Update Posted : November 5, 2013 Sponsor: Sun Yat-sen University

2012 Clinical Trials

100. Febuxostat-induced agranulocytosis in an end-stage renal disease patient: A case report. (PubMed)

Febuxostat-induced agranulocytosis in an end-stage renal disease patient: A case report. Febuxostat, a nonpurine xanthine oxidase inhibitor, is approved as the first-line urate-lowering therapy in gout patients with normal renal function or mild to moderate renal impairment. The most common adverse effects of febuxostat are liver function test abnormalities, diarrhea, and skin rash. However, there is insufficient data in patients with severe renal impairment and end-stage renal disease (ESRD (...) showed myeloid hypoplasia without evidence of hematologic neoplasms.As febuxostat use may become more common in the population of advanced renal failure, clinicians should be aware of this rare but potentially life-threatening adverse effect. Based on our experience, close monitoring hemogram and immediate discontinuation of this medication may prevent serious consequences.

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2017 Medicine

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