![]() There are a lot of misconceptions surrounding beta-lactam and penicillin allergies. (Kernicterus is a unique effect with ceftriaxone, particularly when used in neonates.)īut what if I told you there was more than one correct answer choice here? Which would you think is most likely to also be correct?Īlthough not by the technical NAPLEX study guide, answer choice A is also correct! Which is NOT a cephalosporin class effect? Imagine you are taking a quiz during your Infectious Diseases block and you come across this question: Post-residency, she plans on taking some time to catch up on sleep before embarking on the hunt for a clinical position. (Insert shameless Twitter plug - Outside of pharmacy, she tends to her collection of succulent plants, spends time with family and friends, and enjoys traveling to explore new places. Her professional interests are primarily all things infectious diseases and antimicrobial stewardship, but she’s also interested in a little bit of everything. She is a New Orleans native and graduated from Xavier University of Louisiana College of Pharmacy in New Orleans, LA. Shelby Gross, PharmD is finishing up her PGY-1 residency at University Medical Center New Orleans. The assessment should be done when the patient's underlying condition is in a quiescent state.Here to feed us the blue (or was it red?) pill to show us behind the beta lactam Matrix is Shelby Gross. This evaluation becomes especially important in high-risk groups where steroids are a life-saving treatment. Choosing an alternative CS is not only paramount to the patient's safety but also ameliorates the worry of developing an allergic, and potentially fatal, steroid hypersensitivity reaction. A close and detailed evaluation is required for the clinician to confirm the presence of a true hypersensitivity reaction to the suspected drug and choose the safest alternative. Patients can also develop hypersensitivity reactions to nasal, inhaled, oral, and parenteral CS. Atopic dermatitis and stasis dermatitis of the lower extremities are risk factors for the development of ACD from topical CS. Allergic contact dermatitis (ACD) is the most commonly reported non-immediate hypersensitivity reaction and usually follows topical CS application. The overall prevalence of type I steroid hypersensitivity is estimated to be 0.3-0.5%. Steroid hypersensitivity has been associated with type I IgE-mediated allergy including anaphylaxis. Most reports involve non-systemic application of corticosteroids. There is a paucity of literature on corticosteroid allergy, with most reports being case reports. We discuss the prevalence, mechanism, presentation, evaluation, and therapeutic options in corticosteroid hypersensitivity reactions. We reviewed the literature using the search terms "hypersensitivity to steroids, adverse effects of steroids, steroid allergy, allergic contact dermatitis, corticosteroid side effects, and type I hypersensitivity" to identify studies or clinical reports of steroid hypersensitivity. Hypersensitivity reactions to steroids are broadly divided into two categories: immediate reactions, typically occurring within 1 h of drug administration, and non-immediate reactions, which manifest more than an hour after drug administration. Hypersensitivity reactions to corticosteroids (CS) are rare in the general population, but they are not uncommon in high-risk groups such as patients who receive repeated doses of CS.
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