STUDY - Technical - New Dacian's Medicine
Drug-Induced
Skin Reactions (1)
Translation Draft
Skin reactions are among the most common side effects to medications.
Skin reactions are among the most common side effects to medications.
In the early stages of the
drug-induced disease, prompt therapeutic intervention may limit
toxicity. According to the documentation Available to me, I will
only be able to make presentations about adverse reactions to
medicines other than topical agents, and we can only have data
on the incidence, manifestations and pathogenicity of signal
skin reactions given by drugs and therapeutic agents.
Note "of mine": That, at least, for this post (for starters).
Note "of mine": That, at least, for this post (for starters).
I'm forced to go ahead
with posts related to allopathic medicine. obliged!!! And,
here's why. My interaction and the things I have read, mastered
and processed over time (where we can already talk about decades
- 24 years) with the thousands (if not the tens of thousands of
people) with whom I have interacted, in the exchanges of
experience and discussions we have had directly and/ or through
the web space, have shown me that the triad "body-mind-soul" is
quickly found at the level of the cognitive baggage of the
individual.
Thus, the impulse, if not my search, in this field (of the New Medicine), must be "grouped" and presented so that I can achieve "groups" of information based precisely on this triad, so that my effort can be perceived "gradually" by: 1. those who limit their perception to the body (and we are dealing here with the vast majority of individuals, those who do not have time for assimilation and processing of information, those who limit their existence to matter, those for whom the life of the body represents the life perceived by them, or other similar interpretations - those who have to do almost exclusively with allopathic, classical medicine, the all-present one nowadays), 2. those who "raise their perceptions" and at the level of the mind (regardless of the "floor" achieved by this effort of theirs; here would fit all those who seek, analyze, react, etc. to the impossibility of "subjecting" to reactions of patching, service to a stricken car, damaged to varying degrees of the driver's behavior represented by someone other than the body, them limiting themselves to the mind, brain, feedback reactions, and other bla-blas; and we are dealing here with those who turn to alternative elements of medicine, nutritional therapies, "lifestyle", Silva or ThetaHealing, acupuncture, biotherapy, etc. in search of a leap towards simple treatment of signs of manifestation and transition to a more complete treatment , more appropriate; I can't help but recall here the "Hamer paradox", as I called it, being one of the main promoters of the New Medicine, be it egotisticalally called the New German Medicine, an oncologist with a doctorate in cerebral oncology, the one who took an official step in considering medicine as "alopathic" in something else oriented towards an integrated "body-mind" approach and was given the right to practice, possibly to exist, for only a few "rates"/ deaths, without having the good sense to look at other oncologists who, regardless of their performance and good intentions, have only a few successes/ life extensions in their work, against the almost generalised background of the deaths/deaths; so do those who do not comply with the "martial laws of the army of white robes", those who serve, often out of conviction, often out of material interests, their own and/ or the system... oopsss, I don't want to "do" politics here, but the doctor has to be that person dedicated to the patient and not the social security system, the way/desire to make as much money as possible and to have a life as... as do those in this army, which I remembered... otherwise, what does it matter...) and 3. those who discover little by little the connection with the spirit (the real "driver" that we mentioned earlier and that we will discuss much later). Offf, how much there is to say here. But all in their time! However, I will introduce more and more such notes, preparing the leap to dorinm.ro.
Thus, the impulse, if not my search, in this field (of the New Medicine), must be "grouped" and presented so that I can achieve "groups" of information based precisely on this triad, so that my effort can be perceived "gradually" by: 1. those who limit their perception to the body (and we are dealing here with the vast majority of individuals, those who do not have time for assimilation and processing of information, those who limit their existence to matter, those for whom the life of the body represents the life perceived by them, or other similar interpretations - those who have to do almost exclusively with allopathic, classical medicine, the all-present one nowadays), 2. those who "raise their perceptions" and at the level of the mind (regardless of the "floor" achieved by this effort of theirs; here would fit all those who seek, analyze, react, etc. to the impossibility of "subjecting" to reactions of patching, service to a stricken car, damaged to varying degrees of the driver's behavior represented by someone other than the body, them limiting themselves to the mind, brain, feedback reactions, and other bla-blas; and we are dealing here with those who turn to alternative elements of medicine, nutritional therapies, "lifestyle", Silva or ThetaHealing, acupuncture, biotherapy, etc. in search of a leap towards simple treatment of signs of manifestation and transition to a more complete treatment , more appropriate; I can't help but recall here the "Hamer paradox", as I called it, being one of the main promoters of the New Medicine, be it egotisticalally called the New German Medicine, an oncologist with a doctorate in cerebral oncology, the one who took an official step in considering medicine as "alopathic" in something else oriented towards an integrated "body-mind" approach and was given the right to practice, possibly to exist, for only a few "rates"/ deaths, without having the good sense to look at other oncologists who, regardless of their performance and good intentions, have only a few successes/ life extensions in their work, against the almost generalised background of the deaths/deaths; so do those who do not comply with the "martial laws of the army of white robes", those who serve, often out of conviction, often out of material interests, their own and/ or the system... oopsss, I don't want to "do" politics here, but the doctor has to be that person dedicated to the patient and not the social security system, the way/desire to make as much money as possible and to have a life as... as do those in this army, which I remembered... otherwise, what does it matter...) and 3. those who discover little by little the connection with the spirit (the real "driver" that we mentioned earlier and that we will discuss much later). Offf, how much there is to say here. But all in their time! However, I will introduce more and more such notes, preparing the leap to dorinm.ro.
For this reason I will
limit myself to the allotated presentations, without further
comment, at least until that promised "Holy Great" on August 15,
when I will start work on "dorinm.ro/nouamedicina", and I will
officially give up my posts on this blog (and his copy on
facebook) where, possibly, I will only improve the existing
materials as the time available and, of course, the materials
traveled (in fact I think I am bragging, because I do not know
exactly what will follow). But let me get to work and continue
the presentations of where I left off (no more divas)!
Every year we are dealing with billions and billions of prescriptions (not to mention self-medication), for over 60,000 medicinal products that include over 2,000 different active agents (their number is constantly increasing). Only hospitalized patients receive hundreds of millions (if not billions) of therapeutic drug cures each year, and nearly half of adults receive prescription prescription drugs in outpatients on a regular basis. And now comes the "bomb", it is estimated that up to 15% of hospital days are dedicated to the treatment of drug toxicity (and this is due to an estimate made at the U.S. level where the high level of medical services cannot be disputed).
By focusing on our subject, let's address the incidence of skin reactions! Although drug side effects are common, it is difficult to specify their incidence, severity and health effects (and that "says" the medical reference works). The fact that the detailed information on these reactions is inadequate reflects in part the difficulty of establishing a system for postmarketing surveillance (after marketing) that is economically achievable and, at the same time, capable of providing useful clinical data.
The available information comes from the assessment of hospitalized patients, epidemiological surveys, premarketing studies and voluntary reporting. In one study, about 2% of hospitalized patients had skin reactions, consisting of rash, hives or itching during hospitalization, and the overall reaction index on drug treatment regimen was 3 per thousand. Penicillins, sulfonamides and blood derivatives are responsible for two-thirds of skin reactions.
Specific algorithmic estimates of specific quantitative reaction indices for certain drugs of the commonly used in hospitalized medicines have been calculated. Reaction indices for certain commonly used drugs are, for example, for amoxicillin of 51 per thousand, trimetoprim-sulfamethoxazole 34 per thousand, ampicillin 33, blood 21, allopurinol 8, gentamicin 5, barbiturates 4, etc.
The study showed that most skin reactions occur in the first week of drug exposure. Exceptions were semisynthetic penicillins and ampicillin, where about half of the reactions to these drugs occurred more than a week after initial administration. The risk of allergic reactions was not related to age, diagnosis or blood level of urea at admission, skin reactions being most common in women.
For another example, the distribution of morphological patterns of medical rashes cared for in a dermatology ward with special interest for post-medicinal fixed erythema included exantem reactions (32%), hives and or angioedema (20%), fixed drug rashes (34%), polymorphic erythema (2%), Stevens-Johnson syndrome (1%), exfoliative dermatitis (1%) and photosensitivity reactions (3%).
Attesting the risk of the most serious forms of drug rashes associated with certain medicines remains an important concern. Consisting of retrospective specialized studies on a population sample representative of toxic epidermal necrolysis (NET) and Stevens-Johnson syndrome, there are currently prospective studies that serve as the basis for control studies.
This information, along with data from health promotion organizations and from Medicaid, suggests that the risk of these reactions is 1 and 10 per million person-years (???!!!???). The drugs most commonly associated with these reactions include sulfonamide antibiotics, aminopenicillins, phenytoin and structurally related antiepileptic medications and some non-steroidal anti-inflammatory drugs.
I will complete this post with a few presentations on the pathogenicity of drug reactions. Unfavorable skin responses to drugs may occur as a result of immunological or non-immunological mechanisms. Immunological reactions require activation of the host's immunological paths and are designated as drug allergies. Medicinal reactions occurring by non-immunological mechanisms may be due to activation of effector pathways, overdose, cumulative toxicity, side effects, ecological disorders, interactions between medicinal products, metabolic changes, exacerbation of pre-existing dermatological conditions or hereditary protein or enzyme deficiencies.
Nonimmunological skin reactions to medicines are more common and the occurrence of immunological reactions is unpredictable. Often, it is not possible to specify the responsible drug or pathogenic mechanism, because the skin responds to stimuli varied by a limited number of reaction patterns. The mechanism of many drug reactions is unknown.
With regard to immunological drug reactions, medicines frequently give rise to an immune response, but only a small number of individuals have clinically manifest hypersensitivity reactions. For example, most patients exposed to penicillin form demonstrable antibodies to penicillin, but do not exhibit clinically manifested drug reactions when exposed to penicillin. Multiple factors determine a drug's ability to cause an immune response, including the molecular characteristics of the drug and the effects on the host.
Increases in complexity and molecular size are associated with increased immunogenicity, and macromolecular drugs, such as proteins or peptide hormones, are highly antigenic. Most drugs are small organic molecules with sizes below 1,000 daltons, and the ability of such small molecules to cause an immune response depends on their ability to act as haptenes, i.e. to form stable bonds, usually covalent, with tissue macromolecules.
Fortunately, most drugs have low or no ability to form covalent bonds with tissue components, and clinical sensitivity occurs due to minor contaminants or from the conversion of the drugs themselves into reactive metabolic products.
The route of administration of a simple medicine or chemical may influence the nature of the host's immune response. For example, topical application of antigens tends to induce delayed hypersensitivity, and exposure to oral or nasal antigens stimulates the production of secretory immunoglobulins, IgA and IgE, and occasionally IgM. Some agents, such as pentadecacatechol, quickly cause sensitization if applied to the skin, but only to a small extent if they are orally ingested or applied to the surface of a mucous membrane.
The frequency of sensitization by intravenous administration of drugs is variable, but anaphylaxis is a more likely clinical consequence for this route of exposure. The degree of exposure to the drug and individual variability in the absorption and metabolism of a particular antigen may alter immunogenic power. The variable degree of in vivo acetylsalicylics of hydralazine is a clinical example for this phenomenon.
Hydralazine produces a lupus-like syndrome, associated with the formation of antinuclear antibodies more frequently in slow-acetitory patients. Frequently high-dose therapeutic belts and discontinued therapeutic belts are also important risk factors for the development of drug allergy.
Allergic drug reactions are most commonly dependent on IgE or immune complexes. Cytotoxicity and delayed hypersensitivity have not been shown to cause systemic skin reactions to medicines. IgE-dependent drug reactions are usually manifested by the skin, gastrointestinal, respiratory and cardiovascular. Symptoms and main signs include itching, urticaria, nausea and vomiting, muscle cramps, bronchospasm and laryngeal edema and sometimes anaphylactic shock with hypotension and exitus.
Immediate reactions may occur within minutes of exposure to the medicine, and accelerated reactions occur within hours or days of taking the medicine. Accelerated reactions are usually urticaria and can induce laryngeal edema. IgE-dependent reactions are usually due to penicillins, the manifestations being caused by the release from the mastocytes of sensitised tissues or circulating basophilic leukocytes of chemical mediators such as histamine, adenosine, leukotrienes, prostaglandins, platelet activation factor, enzymes and proteoglycans.
The release is triggered when the polyvalent protein-drug complex is cross-coupled with IgE molecules attached to the sensitised cells. clinical manifestations are determined by the interaction of the chemical mediator released with its target organ, e.g. skin, respiratory, gastrointestinal and/ or cardiovascular apparatus. Some routes of administration favor certain clinical manifestations (e.g. the oral route - gastrointestinal effects, intravenous pathway - circulatory effects).
And finally, in terms of reactions dependent on immune complexes, serum disease is produced by circulating immune complexes, and is characterized by fever, arthritis, nephritis, neuritis, edema and a papular or pruriginous urticaria exanthema. The syndrome requires an antigen that remains in circulation for a long time, so when the antibody is synthesized, the circulating antigen-antibody complexes are formed.
Serum disease was first described after the administration of heterosers, but currently drugs are the common cause. Drugs that produce serum disease include penicillins, sulfonamides, thiouracili, cholecystographic contrast substances, phenytoin, aminosalicylic acid, streptomycin, heparin and antilymphocytic globulin. Symptoms occur 6 days or more after exposure to a drug, the latency period being the time it takes to synthesize the antibody. The antibodies responsible for drug reactions dependent on immune complexes are largely of the IgG or IgM class.
That's enough for today!
Every year we are dealing with billions and billions of prescriptions (not to mention self-medication), for over 60,000 medicinal products that include over 2,000 different active agents (their number is constantly increasing). Only hospitalized patients receive hundreds of millions (if not billions) of therapeutic drug cures each year, and nearly half of adults receive prescription prescription drugs in outpatients on a regular basis. And now comes the "bomb", it is estimated that up to 15% of hospital days are dedicated to the treatment of drug toxicity (and this is due to an estimate made at the U.S. level where the high level of medical services cannot be disputed).
By focusing on our subject, let's address the incidence of skin reactions! Although drug side effects are common, it is difficult to specify their incidence, severity and health effects (and that "says" the medical reference works). The fact that the detailed information on these reactions is inadequate reflects in part the difficulty of establishing a system for postmarketing surveillance (after marketing) that is economically achievable and, at the same time, capable of providing useful clinical data.
The available information comes from the assessment of hospitalized patients, epidemiological surveys, premarketing studies and voluntary reporting. In one study, about 2% of hospitalized patients had skin reactions, consisting of rash, hives or itching during hospitalization, and the overall reaction index on drug treatment regimen was 3 per thousand. Penicillins, sulfonamides and blood derivatives are responsible for two-thirds of skin reactions.
Specific algorithmic estimates of specific quantitative reaction indices for certain drugs of the commonly used in hospitalized medicines have been calculated. Reaction indices for certain commonly used drugs are, for example, for amoxicillin of 51 per thousand, trimetoprim-sulfamethoxazole 34 per thousand, ampicillin 33, blood 21, allopurinol 8, gentamicin 5, barbiturates 4, etc.
The study showed that most skin reactions occur in the first week of drug exposure. Exceptions were semisynthetic penicillins and ampicillin, where about half of the reactions to these drugs occurred more than a week after initial administration. The risk of allergic reactions was not related to age, diagnosis or blood level of urea at admission, skin reactions being most common in women.
For another example, the distribution of morphological patterns of medical rashes cared for in a dermatology ward with special interest for post-medicinal fixed erythema included exantem reactions (32%), hives and or angioedema (20%), fixed drug rashes (34%), polymorphic erythema (2%), Stevens-Johnson syndrome (1%), exfoliative dermatitis (1%) and photosensitivity reactions (3%).
Attesting the risk of the most serious forms of drug rashes associated with certain medicines remains an important concern. Consisting of retrospective specialized studies on a population sample representative of toxic epidermal necrolysis (NET) and Stevens-Johnson syndrome, there are currently prospective studies that serve as the basis for control studies.
This information, along with data from health promotion organizations and from Medicaid, suggests that the risk of these reactions is 1 and 10 per million person-years (???!!!???). The drugs most commonly associated with these reactions include sulfonamide antibiotics, aminopenicillins, phenytoin and structurally related antiepileptic medications and some non-steroidal anti-inflammatory drugs.
I will complete this post with a few presentations on the pathogenicity of drug reactions. Unfavorable skin responses to drugs may occur as a result of immunological or non-immunological mechanisms. Immunological reactions require activation of the host's immunological paths and are designated as drug allergies. Medicinal reactions occurring by non-immunological mechanisms may be due to activation of effector pathways, overdose, cumulative toxicity, side effects, ecological disorders, interactions between medicinal products, metabolic changes, exacerbation of pre-existing dermatological conditions or hereditary protein or enzyme deficiencies.
Nonimmunological skin reactions to medicines are more common and the occurrence of immunological reactions is unpredictable. Often, it is not possible to specify the responsible drug or pathogenic mechanism, because the skin responds to stimuli varied by a limited number of reaction patterns. The mechanism of many drug reactions is unknown.
With regard to immunological drug reactions, medicines frequently give rise to an immune response, but only a small number of individuals have clinically manifest hypersensitivity reactions. For example, most patients exposed to penicillin form demonstrable antibodies to penicillin, but do not exhibit clinically manifested drug reactions when exposed to penicillin. Multiple factors determine a drug's ability to cause an immune response, including the molecular characteristics of the drug and the effects on the host.
Increases in complexity and molecular size are associated with increased immunogenicity, and macromolecular drugs, such as proteins or peptide hormones, are highly antigenic. Most drugs are small organic molecules with sizes below 1,000 daltons, and the ability of such small molecules to cause an immune response depends on their ability to act as haptenes, i.e. to form stable bonds, usually covalent, with tissue macromolecules.
Fortunately, most drugs have low or no ability to form covalent bonds with tissue components, and clinical sensitivity occurs due to minor contaminants or from the conversion of the drugs themselves into reactive metabolic products.
The route of administration of a simple medicine or chemical may influence the nature of the host's immune response. For example, topical application of antigens tends to induce delayed hypersensitivity, and exposure to oral or nasal antigens stimulates the production of secretory immunoglobulins, IgA and IgE, and occasionally IgM. Some agents, such as pentadecacatechol, quickly cause sensitization if applied to the skin, but only to a small extent if they are orally ingested or applied to the surface of a mucous membrane.
The frequency of sensitization by intravenous administration of drugs is variable, but anaphylaxis is a more likely clinical consequence for this route of exposure. The degree of exposure to the drug and individual variability in the absorption and metabolism of a particular antigen may alter immunogenic power. The variable degree of in vivo acetylsalicylics of hydralazine is a clinical example for this phenomenon.
Hydralazine produces a lupus-like syndrome, associated with the formation of antinuclear antibodies more frequently in slow-acetitory patients. Frequently high-dose therapeutic belts and discontinued therapeutic belts are also important risk factors for the development of drug allergy.
Allergic drug reactions are most commonly dependent on IgE or immune complexes. Cytotoxicity and delayed hypersensitivity have not been shown to cause systemic skin reactions to medicines. IgE-dependent drug reactions are usually manifested by the skin, gastrointestinal, respiratory and cardiovascular. Symptoms and main signs include itching, urticaria, nausea and vomiting, muscle cramps, bronchospasm and laryngeal edema and sometimes anaphylactic shock with hypotension and exitus.
Immediate reactions may occur within minutes of exposure to the medicine, and accelerated reactions occur within hours or days of taking the medicine. Accelerated reactions are usually urticaria and can induce laryngeal edema. IgE-dependent reactions are usually due to penicillins, the manifestations being caused by the release from the mastocytes of sensitised tissues or circulating basophilic leukocytes of chemical mediators such as histamine, adenosine, leukotrienes, prostaglandins, platelet activation factor, enzymes and proteoglycans.
The release is triggered when the polyvalent protein-drug complex is cross-coupled with IgE molecules attached to the sensitised cells. clinical manifestations are determined by the interaction of the chemical mediator released with its target organ, e.g. skin, respiratory, gastrointestinal and/ or cardiovascular apparatus. Some routes of administration favor certain clinical manifestations (e.g. the oral route - gastrointestinal effects, intravenous pathway - circulatory effects).
And finally, in terms of reactions dependent on immune complexes, serum disease is produced by circulating immune complexes, and is characterized by fever, arthritis, nephritis, neuritis, edema and a papular or pruriginous urticaria exanthema. The syndrome requires an antigen that remains in circulation for a long time, so when the antibody is synthesized, the circulating antigen-antibody complexes are formed.
Serum disease was first described after the administration of heterosers, but currently drugs are the common cause. Drugs that produce serum disease include penicillins, sulfonamides, thiouracili, cholecystographic contrast substances, phenytoin, aminosalicylic acid, streptomycin, heparin and antilymphocytic globulin. Symptoms occur 6 days or more after exposure to a drug, the latency period being the time it takes to synthesize the antibody. The antibodies responsible for drug reactions dependent on immune complexes are largely of the IgG or IgM class.
That's enough for today!
Have a good day!
Dorin, Merticaru