Allergy Unit, Department of Dermatology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
Med Clin North Am. 2010 Jul;94(4):681-9, xv-x. doi: 10.1016/j.mcna.2010.04.007.
ADRs are frequently considered iatrogenic complications and, therefore, pose a specific challenge for the physician-patient relationship. Early recognition of a potential ADR is possible, especially on the skin, in addition to characteristic clinical danger signs. Cutaneous manifestations are variable, depending on the causative pathomechanism. It is impossible to conclude the causative agent from the morphology of the cutaneous lesions. The intake of several drugs in the time before the elicitation of the drug reaction usually poses a diagnostic challenge. It is crucial for the precision of any further allergological work-up to document the type of rash precisely as well as the time course of drug intake and appearance of the first symptoms. involvement of internal organs or circulating blood cells. Timely recognition of such cutaneous lesions and the correct differential diagnosis with prompt withdrawal of the putative culprit drug are essential to reducing morbidity and preventing mortality. This article discusses risk factors, early symptoms, and danger signs indicating a possibly severe course of an ADR and advises on early actions.
药物不良反应通常被认为是医源性并发症,因此对医患关系构成了特殊挑战。除了特征性的临床危险信号外,早期识别潜在的药物不良反应是可能的,尤其是在皮肤上。皮肤表现因致病机制而异。从皮肤损伤的形态不可能得出致病因素的结论。在引发药物反应之前的一段时间内服用多种药物通常会带来诊断挑战。准确记录皮疹的类型、药物摄入的时间过程以及首次症状出现的时间,对于任何进一步的过敏工作的准确性至关重要。涉及内部器官或循环血细胞。及时识别这些皮肤损伤,并与可能的罪魁祸首药物迅速停药进行正确的鉴别诊断,对于降低发病率和预防死亡率至关重要。本文讨论了药物不良反应的风险因素、早期症状和危险信号,这些信号表明药物不良反应可能会严重发展,并就早期行动提供了建议。