药物过敏诊断与管理.pptxVIP

药物过敏的诊断与管理;Allergy2014;69:420–437;Allergy2017;72:1006–1021.;

Drugadversereactions

Adversedrugreactions

Adversereactiontodrug

DrugAllergy

Drughypersensitivityreactions

(DHRs)

;

De?nitionandclassi?cationsofDHRs

Pathogenesisandpathophysiology

Clinicalpresentations

Diagnosis

Biologicaltests

Principlesofdrugallergymanagement

DHRs=Drughypersensitivityreactions

;De?nitionandclassi?cationsof

Drughypersensitivityreactions（DHRs）;DHRs的定义;DHRs的分型;PathogenesisandpathophysiologyofDHR;Pathogenesisandpathophysiology;ClinicalpresentationsofDHRs;ImmediateDHRs：

;NonimmediateDHRs

（skinwithvariablecutaneoussymptoms）;Internalorganscanbeaffectedeitheraloneorwithcutaneoussymptoms(HSS/DRESS/DiHS,vasculitis,SJS/TEN)

;青霉素、解热镇痛类、巴比妥类及磺胺类药物，尤其是半合成青霉素(氨苄青霉素和羟氨苄青霉素)多引起该型药疹。

麻疹样药疹为散在或密集、红色针头至米粒大的斑疹或斑丘疹，对称分

布，可泛发全身，以躯干为多，类似麻疹，严重者可伴发小出血点。;2、猩红热样药疹;3、固定性药疹

;4、荨麻疹型药疹

;5、湿疹型药疹;湿疹型药疹;6、紫癜型药疹;7、多形红斑型药疹;多形性红斑,渗出性多形红斑,SJS;多形性红斑,渗出性多形红斑,斯-约二氏综合征;8、大疱性表皮松解型药疹;中毒性表皮坏死松解症(TEN);多形性红斑,渗出性多形红斑,斯-约二氏综合征/中毒性表皮坏死松解症(SJS/TEN)

;9、剥脱性皮炎型药疹;剥脱性皮炎型药疹;Danger/severitysignsofDHRs

DHRs的危险/严重信号（征兆）;Multipledrughypersensitivitysyndrome

多种药物超敏反应综合症（MDHS）;ThediagnosisofDHRs;ThediagnosisofDHRs;….;BiomarkerstestofDHRs;;;Principlesofdrugallergymanagement;Principlesofdrugallergymanagement;

应该在高度专业化的中心、专家团队、抢救药物、设备完善及时发现、及时救治Anaphylaxis

Anadrenalineautoinjectorandanexposureactionplandescribingfeaturesofbothmildandworseningreactions,andhowtoinjectadrenaline.

Antihistamines

Drugdesensitization

;西替利嗪(cetirizine)仙特敏、适迪、赛特赞