PHOTOSENSITIVITY OF DRUGS, CAUSE OF PHOTOSENSITIVITY,

2. Why the Color differentiation in storage of
medicines?

3. Photosensitivity Reaction
Presented By,
L.Janit Asha-Medication Management Nurse,
S.Nizam Pakkir Maideen-Clinical Pharmacist.

4. Photosensitivity
• Photosensitivity is the amount to which an
object reacts to receiving photons, especially
visible light,
• In medicine, the term is principally used for
abnormal reactions of the skin due to light,
• Two types of photosensitivities are
Photoallergy and Phototoxicity.

6. Photoallergy

8. Photoallergy
• Eczematous, itchy type reaction occurs 0-72
hours after exposure to agent and light,
• May spread to areas that have not be
sun-exposed,
• Hyperpigmentation does not occur,
• It was Reversible.

9. Cause of photoallergy
• Many medications and conditions can cause sun sensitivity,
including:
• Sulfa used in some drugs, among them some antibiotics,
diuretics, COX-2 inhibitors, and diabetes drugs.[1]
• Psoralens, coal tars, photo-active dyes (eosin, acridine orange)
• Musk ambrette, methylcoumarin, lemon oil (may be present in
fragrances)
• PABA (found in sunscreens)
• Oxybenzone (UVA and UVB chemical blocker also in sunscreens)
• Salicylanilide (found in industrial cleaners)

10. Cause of Photoallergy
• Hexachlorophene (found in some ℞ antibacterial soaps)
• Tetracycline antibiotics (e.g., tetracycline, doxycycline,
minocycline)
• Benzoyl peroxide
• Retinoids (e.g., isotretinoin)
• Some NSAIDs (e.g., ibuprofen, naproxen sodium)
• Fluoroquinolone antibiotic: Sparfloxacin in 2% of cases
• Amiodarone, used to treat atrial fibrillation
• Pellagra

12. Chemical Structure of Some Drugs
Why These Drugs Undergo Photosensitivity?

13. Methylene Blue
Methylthioninium chloride

14. Effect of Visible Light & UV light in
Diluted Solution of Methylene Blue

15. Photoallergy drugs
• Sunscreens
para-aminobenzoic acid (PABA),
oxybenzone,
cyclohexanol,
benzophenones,
salicylates,
cinnamate.
• Anti-microbials
chlorhexidine
hexachlorophene
dapsone
• Painkillers
celecoxib

16. Phototoxicity

17. Phototoxicity

18. Phototoxicity
• Skin reaction occurs minutes to hours after exposure to agent
and light,
• Appears as an exaggerated sunburn reaction (reddening and
swelling),
• Vesicles, blisters and bullae may occur in severe reactions
(pseudoporphyria),
• May or may not be itchy,
• Less commonly, skin may change colour, e.g. blue-green
pigmentation is associated with amiodarone,
• Reaction is limited to sun-exposed skin,
• Photo-onycholysis (separation of the distal nail plate from the
nail bed) may arise with many oral photosensitising medications
and may be the only sign of phototoxicity in dark-skinned
individuals.

19. PhotoToxic Drugs
• Antibiotics
Ciprofloxacin, Levofloxacin,
• Tetracyclines
Doxycycline,
• Sulfonamides
Sulfamethoxazole,
Trimethoprim,
Cotrimoxazole,
Sulfisoxazole.
• Antihistamines
Diphenhydramine,
• Malaria medications
Quinine,
Chloroquine,
Hydroxychloroquine.

20. PhotoToxic Drugs
• Cancer chemotherapy drugs
5-fluorouracil,
Vinblastine ,
Dacarbazine,
• Cardiac drugs
Amiodarone,
Nifedipine ,
Quinidine,
Diltiazem.
• Diuretics
Frusemide,
Hydrochlorothiazide

21. Amber Colored vial Clear vial
Vial

22. • I.Levitiracetam,
• I.Pantoprazole,
• I.Succinyl Choline,
• I.Cisplatin,
• I.Doxorubicin,
• I.MMR,
• I.Dexamethasone,
• I.Cefotaxime,
• I.Dobutamine,
• I.Cytoplatin,
• I.Cefuroxime,
• I.Benzyl Penicillin,
• I.Trastuzumab,
• I.Isophane Insulin,
Amber Colored Vial Clear Vial

23. Amber Colored Ampule Clear Ampule
Ampule

24. • I.Frusemide,
• I.Chlorpheniramine Maleate,
• I.Dopamine,
• I.Methycobalamin,
• I.Vitamin B-Complex,
• I.Isolin,
• I.Nor-Adrenaline,
• I.Fosphenytoin,
• I.Drotaverine,
• I.Sodium NitroPrusside,
Amber Colored Ampule Clear Ampule
• I.Ondansetron,
• I.Adrenaline,
• I.Torsemide,
• I.Citicoline,
• I.Protamine,
• I.Amidotrizoate meglumine,
• I.Amiodarone,
• I.Atropine sulphate,
• I.Tranexamic Acid,
Amber Colored Ampule Clear Ampule

25. Amber Colored Syrup
Bottle
Clear Syrup Bottle

26. • S.Pedicoryl,
• S.Benadryl,
• S.Mucaine gel,
• S.Alex & P,
• S.Ascoril,
• S.Liv 52,
• S.Sucrafil,
• S.Dexorange.
• S.Augmentin,
• S.Bro zedex,
• S.Zedex,
• S.Creamafin,
• S.Creamafin plus,
Amber Colored syrup
Bottle
Clear syrup Bottle
• S.Pedicoryl,
• S.Benadryl,
• S.Mucaine gel,
• S.Alex & P,
• S.Ascoril,
• S.Liv 52,
• S.Sucrafil,
• S.Dexorange.
• S.Augmentin,
• S.Bro zedex,
• S.Zedex,
• S.Creamafin,
• S.Creamafin plus,
Amber Colored syrup
Bottle
Clear syrup Bottle

27. Amber colored strips Transparent strips

28. • T.MA-DHA,
• C.Alphadol 0.25,
• C.Oxetol 300,
• C.Mega 3,
• C.Absolut,
• T.Hepamerz,
• T.Betaloc 25,
• T.Raricap,
• C.Urimax,
• C.Cranmed,
• T.Aten 25,
• T.Cardivas,
• T.Alprazolam.
Amber Colored strips Clear strips