Pharmacy Assistant - Green Cross Publishing

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10 pharmacy assistant C hemicals that produce a photoreaction (reaction with exposure to UV light) are called photoreactive agents or, more commonly, photosensitizers. After exposure to UV radiation either from natural sunlight or from an artificial source such as tanning booths, these photosensitizers cause chemical changes that increase a person’s sensitivity to light, causing the person to become photosensitized. Medications, food additives, and other products that contain photoreactive agents are called photosensitizing products. Photoreactive agents can cause both acute and chronic effects. Acute effects, from shortterm exposure, include exaggerated sunburnlike skin conditions, eye burn, mild allergic reactions, urticaria, abnormal reddening of the skin, and eczema-like rashes with itching, UV radiation from natural sunlight can cause chemical changes that increase a person’s sensitivity to light, causing the person to become photosensitized. drug induced phototoxicity SeVerAl CoMMoNly USeD DrUgS CAN CAUSe PhotoSeNSItIVe reACtIoNS. the USe of A hIgh leVel broAD-SPeCtrUM SUN ProteCtIoN hAS beeN ShoWN to PreVeNt PhototoxIC erytheMA CAUSeD by kNoWN PhotoSeNSItISINg DrUgS swelling, blistering, oozing, and scaling of the skin. Chronic effects from long-term exposure include prematurely ageing skin, stronger allergic reactions, cataracts, blood vessel damage, a weakened immune system, and skin cancer. Everyday medications Widely used medications containing photoreactive agents include antihistamines, used in cold and allergy medicines; nonsteroidal anti-inflammatory drugs (NSAIDs), and antibiotics, including the tetracyclines and the sulphonamides, or ‘sulpha’ drugs. In photoallergic reactions, which generally occur due to medications applied to the skin, UV light may structurally change the drug,
causing the skin to produce antibodies. The result is an allergic reaction. Symptoms can appear within 20 seconds after sun exposure, producing eczema-like skin conditions that can spread to nonexposed parts of the body. But sometimes, photoallergic reactions can be delayed. Other regularly used products that can cause photoallergic reactions include ibuprofen, digitoxin, doxepin, amiodarone, trimethoprim, chlorpropamide, piroxicam, doxycycline, promethazine, chlorpromazine. Phototoxic reactions, which do not affect the body’s immune system, are more common than photoallergic reactions. These reactions can occur in response to injected, oral or topically applied medications. In phototoxic reactions, the drug absorbs energy from UV light and releases the energy into the skin, causing skin cell damage or death. The reaction occurs from within a few minutes to up to several hours after UV light exposure. Though sunburn-like symptoms appear only on the parts of the body exposed to UV radiation, resulting skin damage can persist. Long lasting effects For example, Dr Henry Lim, reported in the March 1990 issue of the Archives of Dermatology that several patients previously exposed to photoallergens continued to have phototoxic skin eruptions up to 20 years after discontinuing medication use, even though they avoided further exposure to the photoallergens. Frequently prescribed medications that cause phototoxic reactions include tetracycline antibiotics, NSAIDS, and amiodarone. Because drug-induced photosensitivity disorder symptoms mimic sunburns, rashes and allergic reactions, many cases go unreported. Also, although research has shown that the numbers of photosensitized individuals may be high, most people do not associate the sun’s light with the development of their skin eruptions. In phototoxic reactions, the drug absorbs energy from UV light and releases the energy into the skin, causing skin cell damage or death. Brand Name Generic Name Therapeutic Class Advil Advil Cold & Flu Nurofen Nurofen Plus Nurofen Cold & Flu NSAID, (non steroidal anti-inflammatory) Brufen ibuprofen Solfen antiarthritic Melfen Bufigen Codafen Lanoxin digitoxin antiarrhythmic Sinequan doxepin antidepressant Cordarone amiodarone antiarrhythmic Bactrim Duobact trimethroprim antibiotic Septrin Tri-Minulet Diabinese chlorpropamide antidiabetic (oral) Feldene piroxicam NSAID, antiarthritic Vibramycin doxycycline antibiotic Phenergan promethazine antihistamine Although those with fair skin are more susceptible to photosensitizing, it is not uncommon for dark-skinned individuals to have chronic photodermatitis. People infected with HIV, or immunosuppressed patients, are also more susceptible to photosensitive disorders so they need to exercise special care in UV light exposure. Photo-recall What is termed a ‘photo-recall’ can take place when a nonphotoreactive product prompts the repeat of a previous reaction to a photoreactive agent. Photoreactive products can also aggravate existing skin problems like eczema, herpes, psoriasis and acne, and can inflame scar tissue. They can also precipitate or worsen autoimmune diseases, such as lupus erythematosus and rheumatoid arthritis. In a recent clinical study carried out by Professor Nishigori, the use of Anthelios 50+ was shown to prevent phototoxic erythema caused by photosensitising treatments including doxycycline, dacarbazine, and chlorpropamide. Common photosensitizes The Table below lists just some of the more commonly used drugs that can cause photosensitivity reactions in some people: Clonazine per-medication. emesis, schizophrenia Largactil chlorpromazine schizophrenia La Roche-Posay is the no.1 photo protection recommended by over 25,000 dermatologists worldwide. The efficacy of La Roche-Posay Anthelios has been demonstrated through 20 studies and a new clinical study proves the efficiency of La Roche-Posay Anthelios XL SPF50+ in the prevention of photo-toxic reactions in 95% of patients tested.* * Source: C. Nishigori, Division of Dermatology, Clinical Molecular Department, Kobe, Japan, 2006 pharmacy assistant 11
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