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[Drug allergy]

B E del Río-Navarro1, E G Sol-Monterrey, J J Sienra-Monge

  • 1Departamento de Neumología, Hospital Infantil de México Federico Gómez, D.F.

Boletin Medico Del Hospital Infantil De Mexico
|July 1, 1993
PubMed
Summary

Adverse drug reactions, affecting 1-5% of the population, are classified as immunological or non-immunological. Allergic reactions, though dangerous, are rare, while pseudoallergic reactions mimic anaphylaxis without an immune mechanism.

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Area of Science:

  • Pharmacology
  • Immunology
  • Toxicology

Context:

  • Adverse drug reactions (ADRs) are common, affecting 1-5% of the general population.
  • ADRs are broadly categorized into immunological and non-immunological types.
  • Allergic reactions, while severe, constitute only 5-10% of all ADRs.

Purpose:

  • To classify adverse drug reactions.
  • To discuss the immunological mechanisms of drug allergies.
  • To outline management strategies for adverse drug events.

Summary:

  • Immunological ADRs can be triggered by drugs or their metabolites, influenced by dose, timing, and administration route.
  • The Gell and Coombs classification system is applied to drug-induced hypersensitivity, with a focus on penicillin.
  • Cutaneous reactions, febrile mucocutaneous syndrome, phototoxic, and photoallergic reactions are discussed.
  • Pseudoallergic reactions mimic anaphylaxis but lack an immunological basis, seen with anesthetics and radiopaque contrast media.
  • Immediate cessation of the offending drug is crucial; treatment involves adrenaline, fluids, steroids, and antihistamines.

Impact:

  • Provides a comprehensive overview of drug hypersensitivity.
  • Clarifies the distinction between allergic and pseudoallergic reactions.
  • Offers guidance on immediate management of severe adverse drug events.

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