Severe cutaneous adverse reactions to drugs: a case series study

Objective: to describe five cases of severe cutaneous adverse reactions to drugs (SCARD) that led to hospitalization and were investigated and diagnosed by the dermatology service of a university hospital. Methods: this is a descriptive observational study of the case series type in which were incl...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Clarisse F. CASTRO, Cesar A. TEIXEIRA, Nurimar C. FERNANDES, Guacira C. MATOS
Formato:	article
Lenguaje:	EN PT
Publicado:	Sociedade Brasileira de Farmácia Hospitalar e Serviços de Saúde 2020
Materias:	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/53d196445b1b4130ac5ab7e5260ca964
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:53d196445b1b4130ac5ab7e5260ca964
record_format	dspace
spelling	oai:doaj.org-article:53d196445b1b4130ac5ab7e5260ca9642021-11-28T02:44:47ZSevere cutaneous adverse reactions to drugs: a case series study10.30968/rbfhss.2020.113.04712179-59242316-7750https://doaj.org/article/53d196445b1b4130ac5ab7e5260ca9642020-09-01T00:00:00Zhttps://www.rbfhss.org.br/sbrafh/article/view/471https://doaj.org/toc/2179-5924https://doaj.org/toc/2316-7750 Objective: to describe five cases of severe cutaneous adverse reactions to drugs (SCARD) that led to hospitalization and were investigated and diagnosed by the dermatology service of a university hospital. Methods: this is a descriptive observational study of the case series type in which were included patients aged 18 years old or older from both sexes, hospitalized between January 2015 and July 2019, in a university hospital in Rio de Janeiro, Brazil and whose reason for hospitalization was SCARD diagnosed by the dermatology service. For SCARD causality assessments, two internationally adopted criteria were used: the Naranjo algorithm and the WHO-UMC causality assessment system. Results: five cases of RCAG have been reported. Amongst these, three cases of erythroderma, one of Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) and one of drug reaction with eosinophilia and systemic symptoms (DRESS). The cases of erythroderma have presented as suspected drugs substances such as hydrochlorothiazide, furosemide, captopril and carbamazepine, which is consistent with the literature reports. In the reported case of SJS/TEN, both the suspected drug, allopurinol, and the presence of an anti-HIV positive laboratory test are also referred to in the literature. The case of DRESS has shown allopurinol as a suspected drug, which is already related to this well-described skin reaction. The causalities were assessed as possible for the first two cases and probable for the following three. The results of the study supported the proposal for a model of pharmacovigilance of SCARD in a hospital environment, consisting of spontaneous reporting, periodic checking of medical records and for requests of opinion from the dermatology service registered in the hospital's computerized system. Conclusion: this study contributes to add knowledge and better understanding about SCARD, in regards to the nature of the type of reaction, identification of patients at risk, early detection of these and the responsible drugs. Furthermore, it proposes a model for monitoring SCARD to be implemented in the hospital, which combines passive and active pharmacovigilance strategies and encourage notification by health professionals. Clarisse F. CASTROCesar A. TEIXEIRANurimar C. FERNANDESGuacira C. MATOSSociedade Brasileira de Farmácia Hospitalar e Serviços de SaúdearticlePublic aspects of medicineRA1-1270Pharmacy and materia medicaRS1-441Therapeutics. PharmacologyRM1-950ENPTRevista Brasileira de Farmácia Hospitalar e Serviços de Saúde, Vol 11, Iss 3 (2020)
institution	DOAJ
collection	DOAJ
language	EN PT
topic	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950
spellingShingle	Public aspects of medicine RA1-1270 Pharmacy and materia medica RS1-441 Therapeutics. Pharmacology RM1-950 Clarisse F. CASTRO Cesar A. TEIXEIRA Nurimar C. FERNANDES Guacira C. MATOS Severe cutaneous adverse reactions to drugs: a case series study
description	Objective: to describe five cases of severe cutaneous adverse reactions to drugs (SCARD) that led to hospitalization and were investigated and diagnosed by the dermatology service of a university hospital. Methods: this is a descriptive observational study of the case series type in which were included patients aged 18 years old or older from both sexes, hospitalized between January 2015 and July 2019, in a university hospital in Rio de Janeiro, Brazil and whose reason for hospitalization was SCARD diagnosed by the dermatology service. For SCARD causality assessments, two internationally adopted criteria were used: the Naranjo algorithm and the WHO-UMC causality assessment system. Results: five cases of RCAG have been reported. Amongst these, three cases of erythroderma, one of Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) and one of drug reaction with eosinophilia and systemic symptoms (DRESS). The cases of erythroderma have presented as suspected drugs substances such as hydrochlorothiazide, furosemide, captopril and carbamazepine, which is consistent with the literature reports. In the reported case of SJS/TEN, both the suspected drug, allopurinol, and the presence of an anti-HIV positive laboratory test are also referred to in the literature. The case of DRESS has shown allopurinol as a suspected drug, which is already related to this well-described skin reaction. The causalities were assessed as possible for the first two cases and probable for the following three. The results of the study supported the proposal for a model of pharmacovigilance of SCARD in a hospital environment, consisting of spontaneous reporting, periodic checking of medical records and for requests of opinion from the dermatology service registered in the hospital's computerized system. Conclusion: this study contributes to add knowledge and better understanding about SCARD, in regards to the nature of the type of reaction, identification of patients at risk, early detection of these and the responsible drugs. Furthermore, it proposes a model for monitoring SCARD to be implemented in the hospital, which combines passive and active pharmacovigilance strategies and encourage notification by health professionals.
format	article
author	Clarisse F. CASTRO Cesar A. TEIXEIRA Nurimar C. FERNANDES Guacira C. MATOS
author_facet	Clarisse F. CASTRO Cesar A. TEIXEIRA Nurimar C. FERNANDES Guacira C. MATOS
author_sort	Clarisse F. CASTRO
title	Severe cutaneous adverse reactions to drugs: a case series study
title_short	Severe cutaneous adverse reactions to drugs: a case series study
title_full	Severe cutaneous adverse reactions to drugs: a case series study
title_fullStr	Severe cutaneous adverse reactions to drugs: a case series study
title_full_unstemmed	Severe cutaneous adverse reactions to drugs: a case series study
title_sort	severe cutaneous adverse reactions to drugs: a case series study
publisher	Sociedade Brasileira de Farmácia Hospitalar e Serviços de Saúde
publishDate	2020
url	https://doaj.org/article/53d196445b1b4130ac5ab7e5260ca964
work_keys_str_mv	AT clarissefcastro severecutaneousadversereactionstodrugsacaseseriesstudy AT cesarateixeira severecutaneousadversereactionstodrugsacaseseriesstudy AT nurimarcfernandes severecutaneousadversereactionstodrugsacaseseriesstudy AT guaciracmatos severecutaneousadversereactionstodrugsacaseseriesstudy
_version_	1718408440112480256

Severe cutaneous adverse reactions to drugs: a case series study

Ejemplares similares