Anybody please suggest treatment for Steven Johnson syndrome
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Dr. Sushma Mothe
Anybody please suggest treatment for Steven Johnson syndrome. It's an emergency
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Dr. D●●●●i S●●h
Dr. D●●●●i S●●h General Medicine
In emergency primarily identify the cause & try to eliminate it. Treatment is usually symptomatic & supportive in form of IV Fluids, fluid replacement, wound dressing & artificial tears.
Mar 21, 2020Like
Dr. g●●●a s●●●●r
Dr. g●●●a s●●●●r Dentistry
1st line treatment is always urgent evaluation & withdrawal of causative agent. On diagnosis, immediately withdraw the causative agent. The most frequent drugs implicated in SJS and TEN are: anticonvulsants (e.g., carbamazepine, phenobarbital, phenytoin, valproic acid, lamotrigine), antibiotics (e.g., sulfonamides, aminopenicillins, quinolones, cephalosporins), antifungals, antiretrovirals (e.g., nevirapine), antivirals (e.g., telaprevir, acyclovir), anthelmintics, analgesics (e.g., acetaminophen), nonsteroidal anti-inflammatory drugs, selective COX-2 inhibitors, antimalarials, azathioprine, sulfasalazine, allopurinol, tranexamic acid, corticosteroids, psychotropic agents, anticancer drugs (e.g., bendamustine, busulfan, chlorambucil), chlormezanone, and retinoids. Examine the patient on admission to assess airway, breathing, and circulation status ("ABC"). Determine whether the patient is in respiratory distress. Arterial blood gases and oxygen saturation will help determine patient clinical respiratory status. One of the complications of SJS/TEN is mucosal involvement of the upper and lower respiratory tract, with vesicle formation, ulceration, and actual mucosal sloughing that may lead to laryngeal stridor, and possible retractions and edema of the nasopharynx: the patient may need to be intubated to maintain the airway An immediate assessment of total body surface area (TBSA) involvement is required. Approximately one hand (palm and fingers) of the patient is the equivalent of 1\% TBSA, or use the "rule of 9s." The greater the percentage of TBSA involved, the greater the fluid requirement. Look at the burn criteria for calculations. Wallace rule of 9s external link opens in a new window. Contact burn centers that specialize in the critical care needs of these patients for advice or possible transfer. Also evaluate ophthalmologic and urogenital systems for possible involvement. There is a very good full pdf document available on BMJ Best Practice, you can go through that to understand the treatment algorithm further in detail.... Read more
Mar 21, 2020Like