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2089. ¾à¹° ¾Ë·¹¸£±âÀÇ ÁÖ¿ä Áõ»óÀ» ¿°ÅÇÑ´Ù.
2090. ¾à¹° ¾Ë·¹¸£±â¸¦ °¨º° Áø´ÜÇÑ´Ù.
2091. ¾Æ½ºÇǸ° °ú¹Î ¹ÝÀÀÀÇ Áõ»ó°ú ¿¹¹æ¹ýÀ» ±â¼úÇÑ´Ù.
2092. Æä´Ï½Ç¸° ¾Ë·¹¸£±âÀÇ Áø´Ü°ú ¿¹¹æ¹ýÀ» ¼³¸íÇÑ´Ù.
¾à¹° ¾Ë·¹¸£±â¶õ ¸é¿ªÇÐÀû ¾à¹°¹ÝÀÀÀÌ´Ù.
¾à¹°ÀÇ ÀÌ»ó¹ÝÀÀ (Adverse Drug Reactions, ADR)Àº ¿ÜºÎ·ÎºÎÅÍ Åõ¿©µÈ ¾à¹°¿¡ ÀÇÇÑ Ã¼³»ÀÇ ¿øÇÏÁö ¾Ê´Â ¸ðµç ¹ÝÀÀÀ» ¸»ÇÑ´Ù. ÀϹÝÀεéÀº À̸¦ ¡°¾à¹°ÀÇ ºÎÀۿ롱À̶ó´Â ¿ë¾î¸¦ »ç¿ëÇϱ⿡ ¾à¹°ÀÇ ÀÌ»ó¹ÝÀÀÀº ³ÐÀº Àǹ̿¡¼ ¡°¾à¹°ÀÇ ºÎÀۿ롱À̶ó°íµµ ÇÒ ¼ö ÀÖ´Ù. ±×·¯³ª ¡°¾à¹°ÀÇ ºÎÀۿ롱À» side-effect (ÜùÀÛ¿ë)Ãø¸éÀ¸·Î Çмú¿ë¾î·Î Á¦ÇÑÀ» ÇÑ´Ù¸é, ¿ë¾î »ç¿ëÀÇ È¥µ·À» ÁÙÀ̱â À§Çؼ ¡°¾à¹°ÀÇ ºÎÀۿ롱Àº ¾à¹°ÀÇ ÀÌ»ó¹ÝÀÀÀÇ ÇÑ ÇüÅ·ΠÁ¦ÇÑÀ» ÇÏ°í ³ÐÀº Àǹ̷Π¡°¾à¹°ÀÇ ÀÌ»ó¹ÝÀÀ¡±À» ÀÌ°÷¿¡¼´Â »ç¿ëÇÏ¿´´Ù. ¾ÆÁ÷ ±¹³» ÇÐȸÀÇ ¿ë¾î ÅëÀϵÈ
°ßÇØ´Â ¾ø´Ù.
¾à¹°ÀÇ ÀÌ»ó¹ÝÀÀÀº ¸é¿ªÇÐÀû ±âÀü¿¡ ÀÇÇÑ °Í°ú ºñ ¸é¿ªÇÐÀû ±âÀü¿¡ ÀÇÇÑ´Ù. ¾à¹° ¾Ë·¹¸£±â´Â ¸é¿ªÇÐÀû ±âÀü¿¡ ÀÇÇÑ ÀÌ»ó¹ÝÀÀÀÇ ÇϳªÀÌ´Ù. ¾à¹° ÀÌ»ó¹ÝÀÀÀº ¾à¸®ÀÛ¿ëÀ̳ª ¿ë·®°ú °ü·ÃµÇ¾î ¿¹Ãø°¡´É ±âÀü¿¡ ÀÇÇϱ⵵ Çϳª ¾à¹° ¾Ë·¹¸£±â¿Í °°ÀÌ ¿¹ÃøÀÌ ºÒ°¡´ÉÇÑ Æ¯Á¤ÇÑ »ç¶÷µé¿¡°Ô¼ ³ªÅ¸³ª±âµµ ÇÑ´Ù. À̸¦ ºÐ·ùÇÏ¸é ¾Æ·¡¿Í °°´Ù.
¾à¹° ÀÌ»ó¹ÝÀÀ(Drug Adverse Reaction) ºÐ·ù
- ¿¹Ãø °¡´É ±âÀü(Type A)
Á¤»óÀο¡°Ô¼ ³ªÅ¸³´Ù. ¾à¹° ÀÌ»ó¹ÝÀÀÀÇ 80%Á¤µµ¿¡¼ ³ªÅ¸³´Ù. ¾Ë·ÁÁø ¾à¸®ÇÐÀû ±âÀü¿¡ ÀÇÇÏ¸ç ¾à ¿ë·®°ú °ü·ÃÀÌ ÀÖ´Ù. ±×¸® Áõ»óÀÌ ½ÉÇÏÁö ¾Ê°í ÁÖÀǸ¦ Çϸé ÁÙÀÏ ¼ö ÀÖ´Ù.
- µ¶¼º, ¿ë·® ÃÊ°ú ; ÇØ¿Á¦ °ú¿ë·®¿¡ ÀÇÇÑ °£µ¶¼º(´ëºÎºÐ »ç¶÷µéÀÌ ¾à¹° °ú·® Åõ¾à ½Ã¿¡ ³ªÅ¸³¯ ¼ö ÀÖ´Â ¹ÝÀÀÀÌ´Ù.)
- µ¶¼º, ºÎÀÛ¿ë ; ÀÌ´Â ¿ë·®ÀÌ ¸¹Áö ¾ÊÀ½¿¡µµ ºÒ±¸ÇÏ°í ¾à¸®ÀÛ¿ë°ú ÇÔ²² ³ªÅ¸³ª´Â °ÍÀÌ¸ç ¾à¹°ÀÇ µ¶¼ºÀÛ¿ë¿¡ ÀÇÇÑ °ÍÀÌ´Ù. ¸·À» ¼ö ¾ø±â¿¡ ÀÌ·ÎÀÎÇØ ¹®Á¦°¡ ¹ß»ýÇÏ¸é ¾à¹°À» ²÷¾î¾ß ÇÑ´Ù. ÀÌ¿¡´Â Ç×È÷½ºÅ¸¹ÎÁ¦¿¡ ÀÇÇÑ Á¹¸²Çö»ó, Ç×¾ÏÁ¦¿¡ ÀÇÇÑ Å»¸ðÁõ»óÀÌ ÀÌ¿¡ ÇØ´çµÈ´Ù.
- 2Â÷ ¹ÝÀÀ(Á¶°ÇÀû È¿°ú, Facultative effects) ; ¾à¹° Åõ¿©·Î ÀÎÇÑ ÀåÁ¡¸·À̳ª ÇǺΠ±ÕÃÑÀÇ º¯È·Î ÀÌÂ÷ÀûÀÎ º¯È°¡ À¯µµµÇ¾î ³ªÅ¸³ª´Â °ÍµéÀ» ¸»ÇÑ´Ù. ÀÌ¿¡´Â Ç×»ýÁ¦ »ç¿ëÀ¸·Î Àå³» ¼¼±ÕÀÇ º¯È, Clindamycin Ç×»ýÁ¦¿¡ ÀÇÇÑ °¡¼ºÀ帷¿°(Pseumomembranous enterocolitis) °¡ ÀÖ´Ù.
- »óÈ£ÀÛ¿ë ; µÎ°¡Áö ÀÌ»óÀÇ ¾à¹°À» Åõ¾àÇÏ¸é¼ ³ªÅ¸³ª´Â °ÍÀ» ¸»ÇÑ´Ù. Á¦»êÁ¦ÀÇÇÑ Tetracyclin Èí¼öÀúÇÏ. Theophylline Á¦¿Í Erythromycin º´¿ëÅõ¾à½Ã¿¡ ³ªÅ¸³ª´Â °ÍµîÀÌ ÀÖ´Ù.
- ¾à¹° ÃÖ±âÇü¼º ; ÀӽŠÁß ¾à¹° Åõ¾à¿¡ ÀÇÇÑ ±âÇüÀ¯¹ß °¡´É¼ºÀÌ ³ô±â¿¡ ÀÌ¿¡ÀÇÇÑ °ÍÀ» ¸»ÇÑ´Ù. Å»¸®µµ¸¶À̵忡 ÀÇÇÑ »çÁö ¹ßÀ°ºÎÀüÀÌ ÀÖ´Ù.
- ¸ðü-ÅÂ¾Æ µ¶¼º¾à¹° Àü´Þ ; ÀӽŠ±â°£ Áß¿¡ ±âÇü¹ß»ý°ú °ü·Ã¾øÀÌ Å¾ƿ¡°Ô Àü´ÞµÇ¾î ³ªÅ¸³ª´Â Çö»óÀ» ¸»ÇÑ´Ù. ½Å»ý¾Æ ¸¶Ãë È¿°ú°¡ ¿¹ÀÌ´Ù.
- ¿¹Ãø ºÒ°¡´É ±âÀü
¾à¸® ±âÀü°ú °ü·ÃÀÌ ¾øÀ¸¸ç ¿ë·®°úµµ °ü°è¾øÀÌ ÀûÀº ¿ë·®¿¡¼µµ ½ÉÇÑ Áõ»óÀÌ ³ªÅ¸³ª±âµµ ÇÑ´Ù. ¿¹ÃøÇÏÁö ¸øÇÏ°í ÀûÀº ƯÁ¤ÇÑ ±º¿¡¼ ³ªÅ¸³´Ù.
- ¸é¿ªÇÐÀû ¾à¹° ¹ÝÀÀ(True Drug Allergy) :¾à¸®ÀÛ¿ëÀ̳ª ¿ë·®¿¡ ¹«°üÇÑ ¸é¿ªÇÐ ¹ÝÀÀ
- ºÒ³»¼º : ¾ÆÁÖ ÀûÀº ¿ë·®¿¡ ºñÁ¤»óÀû °ú¹Î¹ÝÀÀ
- ƯÀ̹ÝÀÀ(Idiosyncratic drug reactions)
- À§¾Ë·¹¸£±â(Pseudo Allergy reactions)
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¾à¹° ¾Ë·¹¸£±â¸¦ ¹ß»ý½Ã±âº°, ¸é¿ª¹ÝÀÀ Á¾·ù¿¡ µû¶ó ºÐ·ùÇÒ ¼ö ÀÖ´Ù.
- °¡¼ÓÇü ; 1 – 72 ½Ã°£ ³»
- ¹ßÁø, ¿, µÎµå·¯±â, ºñµÎµå·¯±â¼º È«Áø, Ç÷°üºÎÁ¾ µî
- Áö¿¬Çü ; 72 ½Ã°£ ÀÌÈÄ
- ¹ßÁø, Ç÷ûº´ À¯»ç¹ÝÀÀ, ´Ù¾çÇÑ ±â°ü Áõ»ó
- ¸é¿ªÇÐÀû ±âÀü¿¡ ÀÇÇØ ºÐ·ù
- Type 1 ;
- Æä´Ï½Ç¸°¿¡ ÀÇÇÑ ¾Æ³ªÇʶô½Ã½º, µÎµå·¯±â, Àν¶¸°¿¡ ÀÇÇÑ ¾Æ³ªÇʶô½Ã½º
- Á¶¿µÁ¦, ¸¶ÃëÁ¦¿Í °°Àº ¾à¹°¿¡ ÀÇÇÑ ¾Æ³ªÇʶô½Ã½º¾ç ¹ÝÀÀ
- Ç×»ýÁ¦, ¹é½Å, Àν¶¸°, µî¿¡ ÀÇÇÑ ¹ÝÀÀ
- Type II ;
- Æä´Ï½Ç¸°, alpha- Methyldopa ¶Ç´Â Quinidine¿¡ ÀÇÇÑ º¸Ã¼ È°¼ºÈ¿Í ¿ëÇ÷¼º ºóÇ÷, Ç÷¼ÒÆÇ °¨¼ÒÁõ
- Type III ;
- Æä´Ï½Ç¸°¿¡ ÀÇÇÑ Ç÷°ü¿°, Ç÷ûº´¾ç Áõ»ó, ¹ß¿
- ¾à¹° À¯µµ¼º ·çÇÁ½º ; Hydralazine, Procainamide, Isoniazid, Phenytoin µî
- Type IV ;
- ±¹¼Ò¸¶ÃëÁ¦, Paraben º¸Á¸Á¦, ³×¿À¸¶À̽ſ¡ ÀÇÇÑ Á¢Ã˼º ÇǺο°,
- ¸é¿ªÇÐÀû ¹ÝÀÀÀ¸·Î ÃßÁ¤ÇÏÁö¸¸ Gell & Coombs ·Î ºÎÇÕµÇÁö ¾Ê´Â ¾à¹°¹ÝÀÀ
- ¾à¹°°ü·Ã ÇǺιßÁø
- ¹ß¿¼º Á¡¸· ÇǺΠÁõÈıº
- Stevens-Johnson syndrome
- Lyell syndrome
- ¾à¹°¿
- °£Áú¼º ½Å¿°
- ¹«±Õ¼º ³ú¸·¿°
- °£¼¼Æ÷¼º, ´ãÁóÁ¤Ã¼¼º ¹× À°¾ÆÁ¾¼º °£Àå ¹ÝÀÀ
- Àü½Å¼º ¸²ÇÁ¼± ºñ´ëÁõ
ÇǺιßÁøÀº ¾à¹° ¾Ë·¹¸£±â ¹ÝÀÀÀÇ Áß¿äÇÑ Áõ»óÀÌ´Ù.
¾à¹°ÀÇ ÀÌ»ó¹ÝÀÀÀº º´¿ø¿¡¼ ÀÔ¿øÇÏ¿© ¾à¹°º¹¿ëÇÑ »ç¶÷ÀÇ 5.5%¿¡¼ ³ªÅ¸³ª¸ç ÀÌÁß 2.2%´Â ÇǺιÝÀÀÀ¸·Î ³ªÅ¸³´Ù. ¼Ò¾Æ¿¡¼´Â ´ëºÎºÐ ÇǺηΠ³ªÅ¸³´Ù. ¿Ü·¡¿¡¼´Â ¾à¹° Åõ¾àÇÑ ¼Ò¾ÆÀÇ 2.2%¿¡¼ ¾à¹° ÀÌ»ó¹ÝÀÀÀÌ ³ªÅ¸³ª¸ç Ç×»ýÁ¦ º¹¿ëÇÑ ¼Ò¾ÆÀÇ 12%¿¡¼ ÇǺÎÀÌ»ó¹ÝÀÀÀÌ ³ªÅ¸³´Ù. ±×·¯³ª ¼Ò¾Æ¿¡¼´Â ¹ÙÀÌ·¯½º ¹ßÁøÀÌ ¸Å¿ì ÈçÇϹǷΠÀ̸¦ °¨º°Çϴµ¥´Â ¸Å¿ì ¾î·Æ´Ù.
ÈçÈ÷ ÇǺιßÁø¿¡ »ç¿ëµÇ´Â ¿ë¾îÁ¤ÀÇ
- ¹ÝÁ¡ (Macules) : ÇǺΠÀ¶±â¾øÀÌ »ö±ò º¯È·Î ´Ù¸¥ ÇǺÎÁ¶Á÷°ú ±¸º°µÇ´Â ¹ßÁø. º¸Åë 5 mm ÀÌÇϸ¦ ¸»ÇÑ´Ù.
- ±¸Áø (Papules): ÇǺΰ¡ À¶±âµÇ¾î ÁÖÀ§ ÇǺÎÁ¶Á÷°ú ±¸º°µÇ´Â ¹ßÁøÀ» ¸»ÇÑ´Ù. ³óÀÌ ¾ø±â¿¡ pustule°ú ´Ù¸£´Ù. º¸Åë 5 mm ÀÌÇϸ¦ ¸»ÇÑ´Ù.
- ÆÇ (Plaque) : ¹ÝÁ¡°ú ºñ½ÁÇϳª 5 mm ÀÌ»óÀ¸·Î Á¶±Ý Å« ¹ÝÁ¡.
- ÆØÁø (Wheal) : ÇǺΰ¡ ºÎÀº °Í ó·³ ¿Ã¶ó¿Â °ÍÀ» ¸»ÇÑ´Ù. Å©±â°¡ ±¸Áøº¸´Ù Å©¸ç ÆÇÇüÅ·ΠÀ¶±âµÇ¾î ÀÖ´Â »óŸ¦ ¸»ÇÑ´Ù.
- µÎµå·¯±â (Urticaria) : °¡·Á¿òÁõÀ» µ¿¹ÝÇÑ ÆØÁøÀ» ¸»ÇÑ´Ù.
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1. Exanthematous Drug Eruptions
°¡Àå ÈçÇÏ´Ù. ¾à¹° Åõ¾à ÈÄ 5 ~ 14ÀÏ ÈÄ °©Àڱ⠹߻ýÇÑ´Ù. Ampicillin Ç×»ýÁ¦¸¦ Åõ¾àÇÑ 5 ~ 10% ȯÀÚ¿¡¼ ¹ß»ýÇÒ ¼ö ÀÖ´Ù. ¹ÙÀÌ·¯½º °¨¿°°ú °°ÀÌ µ¿¹ÝµÇ¸é ¹ßÇöºñÀ²ÀÌ Áõ°¡ÇÑ´Ù. EB ¹ÙÀÌ·¯½º °¨¿°ÀÌ µÈ ȯÀÚ¿¡°Ô¼ AmpicillinÀ» Åõ¾àÇϸé 95%¿¡¼ ¹ß»ýÇÑ´Ù.
Ç×È÷½ºÅ¸¹ÎÁ¦¿Í º¸Á¶ÀûÀÎ Ä¡·á°¡ ÇÊ¿äÇÏ´Ù. ¹ßÁøÀÌ °¡¶ó¾ÉÀº ÈÄ DesquamationÀÌ ³ªÅ¸³¯ ¼ö ÀÖ´Ù. °£Áö·¯¿òÀÌ ½ÉÇϸé Àú°µµ ½ºÅ×·ÎÀ̵带 »ç¿ëÇÒ ¼ö ÀÖ´Ù. ÀÌÈÄ Hyperpigmentation, HypopigmentationÀÌ ³ªÅ¸³ª±âµµ ÇÏ¸ç ¸î ´Þ¿¡¼ ¸î ³â »çÀÌ¿¡ »ç¶óÁø´Ù. ÇÞºû³ëÃâÀ» ÇÇÇØ¾ß ÇÑ´Ù.
2. µÎµå·¯±â
±Þ¼º µÎµå·¯±â´Â ¸ðµç »ç¶÷ÀÇ 15 ~ 25% ´Â Àü»ý¾Ö¿¡ ÇѹøÁ¤µµ´Â °æÇèÇÑ´Ù. ´ëºÎºÐ Áõ»óÀÌ °æÇÏ°í self limiting ÁúȯÀÌ´Ù. ±Þ¼º µÎµå·¯±â´Â ¸¸¼º µÎµå·¯±â¿Í ´Þ¸® ºñ¸¸¼¼Æ÷¿¡¼ IgE ¸Å°³¹ÝÀÀÀ̰ųª IgE ¹ÝÀÀ ¾øÀÌ Á÷Á¢ÀÚ±ØÇüÅ·Πºñ¸¸¼¼Æ÷¿¡¼ ÈÇй°Áú ºÐºñÇÏ¿© ³ªÅ¸³ª´Â ÁúȯÀÌ´Ù.
µÎµå·¯±âÀÇ °¡Àå ÈçÇÑ ¿øÀÎÀº ¹ÙÀÌ·¯½º °¨¿°ÀÌ´Ù. ÇÑ ¿¬±¸ÀÚ´Â ±Þ¼º µÎµå·¯±âÀÇ 59%°¡ ¹ÙÀÌ·¯½º °¨¿°À̶ó°í ÇÏ¿´´Ù(25% Escherichia coli, 13% Chlamydia pneumoniae, 8% Streptococcus, 4% Mycoplasma pneumoniae or Helicobacter pylori). ³ª¸ÓÁö´Â 5% ¾à¹°, 3% ½ÄÇ°À̶ó°í ÇÏ¿´´Ù. ´Ù¸¥ ¿¬±¸µµ ÀÌ¿Í ºñ½ÁÇϹǷΠ¾à¹°º¸´Ù´Â °¨¿°À» ¸ÕÀú °í·ÁÇØ º¸¾Æ¾ß ÇÒ °ÍÀÌ´Ù.
3. °íÁ¤¾àÁø (Fixed drug eruptions, FDE)
¾à¹°À» Åõ¾à ÈÄ 30ºÐ³» ¶Ç´Â 2°³¿ù À̳»¿¡ °°Àº Àå¼Ò¿¡ Well-demarcated, solitary or multiple edematous papules or plaque ·Î ³ªÅ¸³´Ù. »ö±òÀÌ Â£Àº Àû»ö¿¡¼ º¸¶ó»öÀ» ¶í´Ù. ¸Å¿ì °¡·Æ´Ù. ¿°ÁõÀÌ °¡¶ó¾ÉÀ¸¸é Á¡Â÷ »ö°¥ÀÌ grayish brown »ö±òÀ» ¶ì¸ç »ö¼ÒħÂøµÈ ºÎÀ§´Â ¸î ³âÀ» Áö¼ÓÇÒ ¼ö ÀÖ´Ù.
4. ±¤°ú¹Î¼º ¹ÝÀÀ (Photosensitivity reactions)
¾à¹°¿¡ÀÇÇÑ ÇǺΠ¹ÝÀÀÀÇ 8%¸¦ Â÷ÁöÇÑ´Ù. ÀÌ¿¡´Â Phototoxic, PhotoallergicÀÌ ÀÖ´Ù. ±¤µ¶¼º¹ÝÀÀÀº ±¤(Photoradiation)°ú ÇǺÎÀÇ ÈÇй°Áú°ú ¹ÝÀÀÇÏ¿© free radicalÀ» ¸¸µé¾î³»¾î¼ ¹ÝÀÀÇÏ´Â °ÍÀÌ´Ù. žçºû¿¡ ³ëÃâµÇ´Â ºÎÀ§ÀÎ ¾ó±¼, ¸ñºÎÀ§¿Í ¼Õµî¿¡ »ý±ä´Ù. ÀÌ´Â ºñ ¸é¿ªÇÐÀû ¹ÝÀÀÀÌ¸ç ³ëÃâ¾ç°ú ºñ·ÊÇÑ´Ù. ±¤¾Ë·¹¸£±â ¹ÝÀÀÀº SensitizationÀÌ ÀÖÀº ÈÄ ´Ù½Ã ³ëÃ⠽ÿ¡ ³ªÅ¸³ª´Â ¹ÝÀÀÀÌ´Ù. Papulovesicular eruption, °£Áö·¯¿ò°ú ½ÀÁø¼º ÇǺο°ÀÌ ÇÞºû¿¡ ³ëÃâ ÈÄ 1 ~ 2ÁÖ³»¿¡ ³ªÅ¸³´Ù.
5. Ç÷ûº´¾ç ¹ÝÀÀ (Serum Sickness-Like Reactions, SSLR)
Ç÷ûº´Àº Á¦3Çü ¸é¿ª¹ÝÀÀÀÌ´Ù. Ç׿ø-Ç×ü º¹ÇÕü°¡ ÇǺÎ, °üÀýÀÇ ¹Ì¼¼Ç÷°ü¿¡ ħÂøÇÏ°í º¸Ã¼¸¦ È°¼ºÈ½ÃÄÑ ¿°Áõ¹ÝÀÀÀ» À¯µµÇÏ°í Á¶Á÷¿¡ ¼Õ»óÀ» ÁÖ´Â ¹ÝÀÀÀÌ´Ù. ÀÌ·¯ÇÑ Ç÷ûº´°ú ´Þ¸® SSLRÀº Ç׿ø-Ç×ü ¸é¿ªº¹ÇÕü¸¦ È®ÀÎÇÒ ¼ö ¾ø°í, º¸Ã¼°¡ ¶³¾îÁ®ÀÖÁö ¾ÊÀ¸¸ç, Ç÷°ü¿°µµ ¾ø°í ÄáÆÏ ¼Õ»óµµ ¾ø´Â °ÍÀ» ¸»ÇÑ´Ù. ´ÜÁö ¹ß¿, °¡·Á¿òÁõ, µÎµå·¯±â¿Í °üÀýÅëÀÌ ¾à¹° Åõ¿© ÈÄ 1 ~ 3ÁÖÈÄ ³ªÅ¸³ª°í ¾à¹° Åõ¿©¸¦ ²÷Àº ÈÄ »ç¶óÁö´Â °ÍÀ» ¸»ÇÑ´Ù. °¡Àå ¸¹ÀÌ º¸°íµÈ ¾à¹°Àº Cefaclor ÀÌ´Ù. ÃÖ±Ù¿¡ CefaclorÀÇ ³»¼º¹®Á¦·Î ¼Ò¾Æ°ú¿¡¼´Â »ç¿ëÀÌ ¸¹ÀÌ ÁÙ¾î¼ º¸°íµµ
ÁÙ°í ÀÖ´Ù.
ÇǺο¡ ³ªÅ¸³ª´Â ½ÉÇÑ ¾à¹° ÀÌ»ó¹ÝÀÀ
1. ¾Æ³ªÇʶô½Ã½º (Anaphylaxis)
2. Drug hypersensitivity syndrome (DHS)
3. Stevens-Johnson syndrome (SJS)
ÇǺÎÁõ»óÀÌ¿Ü¿¡ µÎ ±ºµ¥ ÀÌ»óÀÇ Á¡¸·¿¡¼ ¿°Áõ¹ÝÀÀÀÌ ÀϾ ¶§ ÀǽÉÇÑ´Ù. ¾à¹°°ú °ü·Ã¼ºÀº 50% ³»¿ÜÀ̸ç, Ç×°æ·ÃÁ¦, Æä´Ï½Ç¸°°ú Sulfonamide°¡ ÀÌÁß 90%¸¦ Â÷ÁöÇÑ´Ù.
4. Toxic-epidermal necrosis (TEN)
* ´ÙÇü¼º È«¹Ý (Erythema multiform) ; ´ÙÇü¼º È«¹ÝÀº ¾à¹°¿¡ ÀÇÇÑ ¿øÀÎÀº ¸Å¿ì Àû´Ù. ´ëºÎºÐ ¹ÙÀÌ·¯½º °¨¿°¿¡ ÀÇÇÑ´Ù. ±×·¯¹Ç·Î ÀÌ°÷¿¡¼´Â ¼³¸íÇÏÁö ¾Ê°Ú´Ù.
¾à¹°Àº ºÐÀÚ·®ÀÌ Àû±â¿¡ IgE ¹ÝÀÀÀÌ ÀϾ±â À§Çؼ´Â Carrier Protein ÀÌ ÇÊ¿äÇÏ´Ù.
IgE ¹ÝÀÀÀÌ ÀϾ±â À§Çؼ´Â ¾Ë·¹¸£°ÕÀÌ Cross-linking ÀÌ ÀϾ¾ß ÇÑ´Ù. À̸¦ À§Çؼ´Â ¾Ë·¹¸£°ÕÀº ÀÏÁ¤ÇÑ Å©±â¸¦ °¡Áö°í ÀÖ¾î¾ß Çϴµ¥ ¾à¹°Àº ºÐÀÚ·®ÀÌ ³Ê¹« ÀÛ´Ù. ¿¹¸¦µé¾î Penicillin G BenzathineÀÇ ºÐÀÚ½ÄÀº 2(C16H18N2O4S).C16H20N24H2O ÀÌ°í ºÐÀÚ·®Àº 981.2 ÀÌ´Ù (¾Ë·¹¸£°ÕÀº ¾Ë·¹¸£±â ¸é¿ª¹ÝÀÀÀ» ÀÏÀ¸Å°´Â ¹°ÁúÀÌ´Ù).
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- ¾à¹° Åõ¿© °æ·Î¿¡ µû¶ó À§Çèµµ Â÷ÀÌ. IV, IM >>> PO
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Penicillins, monobactams, carbapenems, imipenems, °ú cephalosporins Àº Beta-lactam ringÀ» °¡Áö°í ÀÖ´Ù.
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Benxyl penicillin G, Penicilloates, Benzylpenicilloylamin µî
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º¸Åë Æä´Ï½Ç¸°ÀÇ Áï½ÃÇü ¹ÝÀÀÀ» À¯¹ß
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Å»°¨ÀÛ¿ä¹ý(Desensitization)Àº ºñ¸¸¼¼Æ÷¿¡ Áö¼ÓÀûÀ¸·Î ÀÚ±ØÀ» ÁÖ¾î¼ ´õ ÀÌ»ó ÈÇй°ÁúÀ» ºÐºñÇÏÁö ¸øÇϵµ·Ï ÇÏ´Â ¹æ¹ýÀÌ´Ù. ¿¹Àü¿¡´Â IgE ¹ÝÀÀ ¾à¹°¿¡ »ç¿ëµÇ¾úÀ¸³ª ¿äÁîÀ½¿¡´Â ´Ù¸¥ ±âÀüÀÇ ¾à¹°¿¡¼µµ »ç¿ëÇÑ´Ù. ¹æ¹ýÀº ÀûÀº ¿ë·®À¸·Î ½ÃÀÛÇÏ¿© Ä¡·á¿ë·®À¸·Î µµ´ÞÇϵµ·Ï ÇÏ°í ÀÌÈÄ Áö¼ÓÀûÀ¸·Î À¯Áö½ÃÅ°´Â °ÍÀÌ´Ù. À¯ÁöÅõ¿©°¡ ÁßÁöµÇ¾úÀ» ¶§ ´Ù½Ã ¾Ë·¹¸£±â ¹ÝÀÀÀÌ ³ªÅ¸³¯ ¼ö ÀÖ´Ù.
Å»°¨ÀÛ ¿ä¹ýÀÌ È®¸³µÈ ¾à¹° ; Insulin, Penicillin, Heterologous anti-sera, Tetanoid toxoid, Sulfa, Furosemide, MMR vaccine
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- Pediatrics. 2007 Oct;120(4):e1082-96. Cutaneous reactions to drugs in children.Segal AR, Doherty KM, Leggott J, Zlotoff B. Massachusetts College of Pharmacy & Health Sciences, Department of Pharmacy Practice, 179 Longwood Ave, Boston, MA 02115-5896, USA. alissa.segal@mcphs.edu
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