Drug Eruptions Medication

Updated: Feb 15, 2019
  • Author: Jonathan E Blume, MD; Chief Editor: Dirk M Elston, MD  more...
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Medication

Medication Summary

Therapy for most drug eruptions is mainly supportive in nature. Morbilliform eruptions are treated with oral antihistamines and topical steroids. IVIG is currently the most common agent used to treat TEN. Cyclosporine may also have a role in the treatment of TEN. Prednisone may be used in the treatment of hypersensitivity syndrome with heart and lung involvement, severe serum sickness–like reaction, and Sweet syndrome.

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First-generation antihistamines

Class Summary

These agents antagonize H1 receptors and block release of histamine. They provide symptomatic relief of pruritus and help improve eruptions.

Hydroxyzine HCl (Anxanil, Atarax, Atozine, Durrax, Vistaril)

Hydroxyzine antagonizes H1 receptors in the periphery. It may suppress histamine activity in the subcortical CNS. Hydroxyzine is available as 10-, 25-, 50-, or 100-mg tablets.

Diphenhydramine HCl (Benadryl, Benylin, Diphen, AllerMax)

Diphenhydramine is used for symptomatic relief of allergic symptoms caused by the release of histamine in immune reactions.

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Second-generation antihistamines, nonsedating

Class Summary

These agents cause less, if any, drowsiness than first-generation agents.

Loratadine (Claritin)

Loratadine selectively inhibits peripheral histamine H1 receptors.

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Corticosteroids

Class Summary

Topical agents provide symptomatic relief of pruritus. Systemic steroids are used in persons with hypersensitivity syndrome, severe serum sickness–like reactions, and Sweet syndrome.

Desonide

Desonide is for inflammatory dermatoses responsive to steroids; it decreases inflammation by suppressing the migration of PMN leukocytes and reversing capillary permeability.

Prednisone (Deltasone, Orasone, Sterapred)

Prednisone is an immunosuppressant for the treatment of immune disorders; it may decrease inflammation by reversing increased capillary permeability and suppressing PMN activity; it is available in 2.5-, 5-, 10-, 20-, or 50-mg tablets.

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Immunoglobulins

Class Summary

These agents are used to treat TEN.

Intravenous immunoglobulin (Gammagard, Gamimune)

Intravenous immunoglobulin is a blood product prepared from the pooled plasma of healthy donors. The following features are possibly relevant to efficacy: neutralization of circulating myelin antibodies through anti-idiotypic antibodies; down-regulation of proinflammatory cytokines, including IFN-gamma; blockade of Fc receptors on macrophages; suppression of inducer T and B cells and augmentation of T-suppressor cells; blockade of complement cascade; promotion of remyelination; and 10% increase in CSF IgG.

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