Basic Reactions

Exanthematous reactions

Any

Most common; initial reaction usually <14 days after drug intake; recurs after rechallenge (see Adverse Cutaneous Drug Reactions)

Urticaria/angioedema

See Table 23-4

Second most common; usually within 36 hours after initial exposure; within minutes after rechallenge (see Urticaria and Angioedema) (Figs. 14-1, 14-2, 14-3)

Fixed drug eruptions

See Fixed Drug Eruption

Third most common, see Table 23-6

Anaphylaxis and anaphylactoid reactions

Antibiotics, extracts of allergens, radiocontrast media, monoclonal antibodies (see Table 23-5)

Most serious type of ACDR, within minutes and hours; more common with oral than parenteral drug administration.

Intermittent administration of drug may predispose to anaphylaxis.

Serum sickness

IVIg, antibiotics, bovine serum albumin (used for oocyte retrieval in in vitro fertilization), cefaclor, cefprozil, bupropion, minocycline, rituximab, infliximab

5-21 days after initial exposure

Minor form: fever, urticaria, arthralgia

Major (complete) form: fever, urticaria, angioedema, arthralgia, arthritis, lymphadenopathy, eosinophilia, ± nephritis, ± endocarditis.