| 
 Meds: 
| • | vancomycin – “red man syndrome”; releases histamine |  
 | • | dry flushing: vasodilatation (e.g. adriamycin, cisplatin) |  
 | • | wet flushing:  eccrine sweating, more autonomic (e.g. anti-hormone drugs – flutamide, tamoxifen) |  
   
Three syndromes: 
| • | carcinoid syndrome, pheochromocytoma, mastocytosis |  
   
Facial flushing: 
| • | alcohol – may uncover subclinical carcinoid or mastocytosis |  
 | • | disulfiram-like reactions to alcohol – after certain drugs (e.g. griseofulvin, metronidazole, anti-diabetic drugs) |  
 | • | nicotinic acid – may be prostaglandin mediated (blocked by indomethacin and aspirin) |  
   
  
| • | (naloxone blocks alcohol and menopausal flush therefore opioid's may play a role) |  
  
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