2024-09-01 00:42:59
Nervous reactions typically account for up to 8% of all drug-related adverse events, although the incidence may be higher.
With the arrival of summer and increased sun exposure, we must be aware of possible allergic reactions that may occur with certain medications. In many cases, they are manifested by causing erythema, edema, vesicles, and itchy blisters on the skin.
Amiodarone, chlorpromazine, hydrochlorothiazide, some antibiotics and antifungals, non-steroidal anti-inflammatory drugs (NSAIDs) and systemic retinoids are the most commonly associated with the development of these reactions.
Victoria Villagrasa, PhD in Pharmacy and professor of Pharmacology at CEU Cardenal Herrera University in Madrid, points out that there are around 400 drugs that can cause photo-sensitivity. Among the medical groups that have the greatest potential to cause this adverse reaction are those belonging to the medical group of non-steroidal anti-inflammatory drugs (NSAIDs), diuretics, antiarrhythmics, antineoplastics, antibiotics, systemic retinoids , antifungals, antipsychotics and antifibrotics, with their highest associated drugs (as seen in the attached table).
The main medical groups and their drugs that cause reactions with sleep. Photo: VICTORIA VILLAGRASA.
“Photosensitization can manifest as phototoxic and/or photoallergic reactions, depending on the pathophysiological mechanism. 95% are phototoxic reactions and only 5% photoallergic. Phototoxicity reactions, which are the most common, are characterized mainly by causing erythema of the skin, sometimes with edema and hyperpigmentation. In the case of photoallergic reactions, which are type IV hypersensitivity reactions, the most common skin lesion is an eczematous rash, a type of contact dermatitis.”
Most of the time, and fortunately, these reactions are mild or moderate. However, some may be more serious, depending on the doses administered. “Phototoxicity reactions are dose dependent. Therefore, if the dose of the drug administered is high and the exposure time to UV radiation from the sun is long, increased sun exposure may occur with the formation of vesicles and blisters with itching.
Other manifestations of focal reactions may include lichenoid eruptions, pseudoporphyria, onycholysis, erythema multiforme, and telangiectasias. “Photogenic reactions are not a cause of illness in affected people, but, in some cases, they are a future risk of damage, especially melanoma and keratinocyte carcinoma.”
Photosensitive reactions typically account for up to 8% of all drug-related adverse events. “Although in general, it is believed that this event is under record, due to the difficulty of identifying the hospital and the lack of documentation in public databases,” said Villagrasa.
In addition, the drug, its dosage and the time of exposure to sunlight, the type of individual skin affect the possibility of suffering focal reactions. According to the pharmacist, reactions have been described in different skin photos, with people with phototypes I and II (light skin) being at higher risk.
The most vulnerable groups
“We know that men are more prone to suffer from this type of reaction, and it can occur at any age.” Special attention, in this sense, to pediatric people, since “the wounds made on their skin can be more important, since in children it is always lighter than in adults.”
There are also some people who, because of the type of treatment they receive, are especially susceptible to suffering these reactions. These groups will be, according to the specialist, “patients with chronic pain, especially those treated with non-steroidal anti-inflammatory drugs (NSAIDs), oncological patients who recently received chemotherapy, psychiatric patients receiving chronic treatment with phenothiazines and patients with chronic infections. , especially those treated with tetracyclines, quinolones or sulfonamides. Likewise, hypertensive patients or patients with heart disease are treated with thiazide diuretics, and the elderly and immunosuppressives.” Raquel Serrano
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