PMID- 18034968
OWN - NLM
STAT- MEDLINE
DCOM- 20080122
LR  - 20161020
IS  - 1088-5412 (Print)
IS  - 1088-5412 (Linking)
VI  - 28
IP  - 5
DP  - 2007 Sep-Oct
TI  - New concepts in the management of adverse drug reactions.
PG  - 517-24
AB  - Our understanding of drug reactions and their management has changed markedly in 
      recent years with the development of several new concepts. Epidermal cell death 
      seen in Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) may 
      result from Fas-Fas ligand-mediated apoptosis. Intravenous immunoglobulin (IVIG) 
      contains anti-Fas antibodies that can abrogate apoptosis. Most studies on IVIG in 
      SJS and TEN reported improvement in arresting disease progression and reduction 
      in time to healing. Furthermore, several studies have dispelled the myth of 
      sulfonamide cross-reactivity. Immune-mediated reactions against antibacterial 
      sulfonamides are directed against two unique side chains that non-antibacterial 
      sulfonamides do not contain. Certain patients seem to have a genetic 
      predisposition for "multiple drug sensitivities." Hence, they may react to 
      several drugs that are not necessarily cross-reacting. Also, multiple studies 
      have shown that IgE-mediated nonsteroidal anti-inflammatory drugs (NSAIDs) 
      cross-reactivity is uncommon. Rather, it is cyclooxygenase (COX) 1 inhibition 
      that results in pseudoallergic reactions to multiple NSAIDs. Several studies have 
      indicated that selective COX-2 inhibitors can be safely administered in patients 
      with aspirin-exacerbated respiratory disease and NSAID-induced cutaneous 
      reactions, although their use has been curtailed by their cardiovascular side 
      effects. Biological agents, such as infliximab, are being increasingly used for a 
      variety of diseases and have caused adverse reactions in some patients. Studies 
      differ as to whether concomitant immunosuppressive use with infliximab affects 
      the development of drug-specific antibodies and infusion reactions. Successful 
      desensitization protocols have been developed for reactions to some of these 
      agents.
FAU - Bahna, Sami L
AU  - Bahna SL
AD  - Allergy and Immunology Section, Louisiana State University Health Sciences 
      Center, Shreveport, LA 71139-3932, USA. sbahna@lsuhsc.edu
FAU - Khalili, Barzin
AU  - Khalili B
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Allergy Asthma Proc
JT  - Allergy and asthma proceedings
JID - 9603640
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Cyclooxygenase 2 Inhibitors)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Sulfonamides)
RN  - 53608-75-6 (Pancrelipase)
RN  - B72HH48FLU (Infliximab)
SB  - IM
MH  - Anti-Inflammatory Agents, Non-Steroidal/immunology
MH  - Antibodies, Monoclonal/administration & dosage/adverse effects/therapeutic use
MH  - Child
MH  - Cross Reactions
MH  - Cyclooxygenase 2 Inhibitors/administration & dosage/adverse effects/therapeutic 
      use
MH  - Cystic Fibrosis/drug therapy
MH  - Desensitization, Immunologic/*methods
MH  - Drug Hypersensitivity/*etiology/*immunology/*therapy
MH  - Humans
MH  - Immunoglobulins, Intravenous/administration & dosage/adverse effects/therapeutic 
      use
MH  - Infliximab
MH  - Multicenter Studies as Topic
MH  - Pancrelipase/administration & dosage/adverse effects/therapeutic use
MH  - Randomized Controlled Trials as Topic
MH  - Stevens-Johnson Syndrome/*therapy
MH  - Sulfonamides/administration & dosage/adverse effects/immunology
RF  - 55
EDAT- 2007/11/24 09:00
MHDA- 2008/01/23 09:00
CRDT- 2007/11/24 09:00
PHST- 2007/11/24 09:00 [pubmed]
PHST- 2008/01/23 09:00 [medline]
PHST- 2007/11/24 09:00 [entrez]
AID - 10.2500/aap2007.28.3030 [doi]
PST - ppublish
SO  - Allergy Asthma Proc. 2007 Sep-Oct;28(5):517-24. doi: 10.2500/aap2007.28.3030.